1. Anxiety Disorders
Chapter 3

2. Outline The Complexity of Anxiety Disorders
Generalized anxiety disorder
Panic disorder with and without Agoraphobia
Specific Phobia
Social Phobia
Posttraumatic Stress Disorder
Obsessive-Compulsive Disorder

3. The complexity of Anxiety Disorders
Negative mood state characterized by bodily symptoms of physical tension, and apprehension about the future
Fear
Immediate alarm reaction to present danger activating a massive response from the autonomic nervous system (flight or fight)
Panic attack
Abrupt experience of intense fear or discomfort in the absence of danger accompanied by physical symptoms (dizziness, heart palpitations, chest, pain, shortness of breath)

4. Anxiety and its causes Causes of Anxiety Biological contributions
Inherited tendency to be tense, behavioral inhibition system (anxiety), flight or fright system (panic)
Psychological contributions
Early childhood (overprotective and overintrusive parents, psychological vulnerability
Social contributions
Social pressures (family, job, school)
Comorbidity of anxiety disorders
Co-occurrence of two or more disorders in a single individual (high (50%) in anxiety disorders)

5. Generalized anxiety disorder
Intense, uncontrollable, unfocused, chronic, and continuous worry and mental agitation that is distressing and unproductive accompanied by physical symptoms of tenseness, irritability and restlessness (generalized to everyday life)
4% of population (two thirds are women), onset in early adulthood
Psychological treatments (CBT, meditation) have approx. the same benefit as drugs (benzodiazepines) but are better in the long term
Cognitive-Behavioral Therapy (CBT)
systematic exposure to anxiety-provoking situations or thoughts
learning to substitute positive behaviors and thoughts for negative ones
learning new coping skills; relaxation, meditation, breathing exercises

6. Generalized anxiety disorder

7. Panic disorder with and without agoraphobia
Individuals experience severe unexpected panic attacks, they may think they’re dying Y
Agoraphobia is fear and avoidance of situations in which they would feel unsafe in the event of a panic attack (e.g. public places, “fear of market place”)
3.5% of population (two thirds are women), onset in early adulthood
Treatment usually involves medication (antidepressants) but it has high levels of relapse (20-50%), psychological treatments involve gradual exposure combined with coping exercises (panic control treatment)

8. Specific phobia
Irrational fear of a specific object or situation that markedly interferes with an individual’s ability to function Y-Snake Phobia
There are four major subtypes of specific phobia
Animal type
Natural environment type (heights, storms, water)
Blood-injection-injury phobia (runs in families)
Situational phobia (planes, elevators, claustrophobia)
Other (e.g. choking, contracting an illness)
11% of population with different onsets
Treatment consists of exposure-based therapy

9. Social phobia
Extreme, enduring, irrational fear and avoidance of social or performance situations Y-Virtual Reality
Social phobia generalized type vs. performance anxiety
13.3.% of population at some point in their lives (favors females only somewhat); onset 15 years of age
The most effective treatment is cognitive behavioral group therapy; medication in severe cases (antidepressants)

10. Social phobia

11. Posttraumatic stress disorder
Enduring, distressing emotional disorder that follows exposure to a severe helplessness or fear-inducing threat Y - PTSD
It is characterized by reexperiencing the trauma, avoiding stimuli associated with it, increased vigilance and arousal, sometimes suicidal thoughts and attempts, and sometimes memory impairments
Acute PTSD (1-3 months after event) or chronic PTSD (more than 3 months)
Combat and sexual assault are the most common traumas
Treatments – catharsis, gradual imaginal exposure, possibly antidepressants

12. Obsessive-compulsive disorder
Anxiety disorder involving unwanted, persistent, intrusive thoughts and impulses as well as repetitive actions intended to suppress them
Most frequent obsessions (contamination, sexual content, aggressive impulses, need for symmetry) and compulsions (checking, ordering, arranging, washing, cleaning)
2.6% of population (majority female)
Exposure and ritual prevention and CBT treatments
Y-OCD patient