1. Anxiety Disorders Chapter 6
In this chapter, we are going to be talking about anxiety more generally and then some anxiety disorders in particular.

2. Outline of Chapter 6 Fear, Anxiety, and Panic Attacks
Panic Disorder with & without Agoraphobia
Generalized Anxiety Disorder
Specific Phobia
Social Phobia
Obsessive-Compulsive Disorder
This is a list of topics we’re going to cover in this chapter. For each disorder, we will discuss symptoms, etiology and treatment.

3. What do anxiety disorders have in common?
People with anxiety disorders share a preoccupation with or persistent avoidance of thoughts and situations that provoke fear or anxiety.
anxiety disorders often severly impair a peron’s life. They may, for example, interfere with work. If a person suffers from agoraphobia, he/she may be unable to leave home to go and perform at work. If a person suffers from social phobia, he/she may be unable to have a satisfying social life.

4. Epidemiology of Anxiety
Prevalence: Anxiety disorders are more common than any other form of mental disorders.
Comorbidity: High comorbidity among different anxiety disorders. High level of comorbidity between anxiety and depression.
Comorbidity means that that the symptoms of anxiety and depression or different anxiety disorders overlap considerably. In clinical practice, they often appear together.

5. Why the comorbidity? Anxiety and depression:
both defined in terms of negative emotional experience
both triggered by stressful experiences
Anxiety and depression have many similar features that may cause them to appear together. (read from slide)

6. Clark and Watson model
2 dimensions of experience: positive affect and negative affect
Both anxiety and depression have high negative affect
Anxiety has high positive affect
Depression has low positive affect
Tell them that this is the model talked about in their book that tries to address the issue of comorbidity.
two dimensions of mood: positive and negative affect
negative affect: high = upset; low = relaxed
descriptive adjectives such as angry, guilty, afraid, sad, disgusted, or worried
positive affect: high = energetic; low = tired
descriptive adjectives such as delighted, interested, enthusiastic, proud
So if you’re anxious, you are upset, but you are also wound-up and may feel energetic.

7. Depression Anxiety High negative affect Low arousal/positive affect
High arousal/positive affect
The term “affect” can be a little confusing.
Here is that model in graph form-
general distress: depressed people and anxious people both experience high levels of negative affect
they are distinguished on the basis of arousal of level of positive affect.
depressed people are low on positive affect (e.g., loss of interest; fatigue; anhedonia)
anxious people also experience high levels of physiological arousal
(positive affect does not imply happiness in this context).
Low negative affect

8. Anxiety versus fear FEAR
-anxious apprehension and worry that is a more general reaction that is out of proportion to threats in environment
-future oriented
-can be adaptive if not excessive
FEAR
-Experienced when a person is faced with real and immediate danger.
-Present-oriented
-Can be adaptive
Another important issue to note when thinking about comorbidity is,
Although they are both emotions, anxiety is not the same concept as fear.
Fear is also adaptive– fight or flight helps us get out of dangerous situations. But if fearful at inappropriate times, it is a problem.
Difference between fear and anxiety: lion coming into the room vs. worrying about a lion coming in.
Anixety can be adaptive as well. For example, worrying about your trip can lead you to do a better job planning for the trip.

9. A new model of anxiety ANXIETY ANXIOUS APPREHENSION ANXIOUS AROUSAL
To further the clark and watson model that we discussed earlier, researchers have distinguished between anxious apprehension or worry, and anxious arousal, or somatic anxiety.
ANXIOUS APPREHENSION
ANXIOUS AROUSAL

10. Anxiety: a new model Anxious apprehension
characterized by concern for the future and verbal rumination about negative expectancies or fears
often accompanied by muscle tension, restlessness and fatigue
Important variable in GAD
Anxious arousal
-characterized by a set of somatic symptoms including shortness of breath, pounding heart, dizziness, sweating and feelings of choking
-important variable in panic attacks
This model was developed in greg and wendy’s lab!!!
Anxious apprehension is characterized by concern for the future and verbal rumination about negative expectancies or fears. It is often accompanied by muscle tension, restlessness and fatigue. This type of anxiety would be most characteristic of OCD and GAD. For example, worry has been shown to be an important variable in differentiating people with GAD from other anxiety disorder groups.
Anxious arousal or somatic is characterized by a set of somatic symptoms including shortness of breath, pounding heart, dizziness, sweating and feelings of choking. This type of somatic anxiety would be related to the development of panic attacks and specific phobia.
Similar model to clark and watson’s but adding anxious apprehension and anxious arousal to the mix. They also hypothesize that these two facets of anxiety are related to different areas of brain activity.
DO PANIC ATTACK ACTIVITY.

11. Panic Attack
Panic attack: abrupt experience of intense fear or acute discomfort , accompanied by physical symptoms (e.g., heart palpitations, chest pain, shortness of breath, dizziness).
Symptoms develop suddenly and reach a peak within 10 minutes
Now we move onto talking about a specific anxiety disorder, panic attacks.
Preoccupation: worrying about being in enclosed places, sweating, increased heart rate when in enclosed spaces.
Avoidance: staying away from enclosed places, going out of way to not be in them (always taking stairs instead of elevator)

12. Criteria for panic attack
Palpitations, pounding heart, or accelerated heart rate
Sweating
Trembling and shaking
Sensations of shortness of breath or smothering
Feeling of choking
Chest pain or discomfort
These are the DSM criteria for a panic attack.
Explain again that a panic attack is a discrete period of intense fear or discomfort in which 4 or more of the following symptoms developed abruptly and reached a peak within 10 minutes.

13. Criteria for panic attack (contd.)
7) Nausea or abdominal distress
8) Feeling dizzy, unsteady or faint
9) Derealization (feelings of unreality) or depersonalization (being detached from oneself)
10) Fear of losing control or going crazy
11) Fear of dying
12) Paresthesias (numbness or tingling sensations)
13) Chills or hot flushes
Family studies support the idea that GAD, generalized social phobia and panic disorder run in families.
-OCD also appears more frequently in certain families.

14. Panic Attacks Three types of Panic Attacks
Situationally bound (cued): panic only when see a spider
Unexpected (uncued): unexpected, out of the blue
Situationally predisposed: you are more likely to have a panic attack where you have had one before (crowded restaurant), but it isn’t inevitable-- you don’t know if it will happen today
Situationally bound are more common in specific and social phobias

15. Agoraphobia
The essential feature of agoraphobia is anxious apprehension about being in places or situations from which:
escape might be difficult or embarrassing
help may not be available if one has a panic attack.
Some people who have experienced panic attacks or even just some symptoms of a panic attack develop a fear that they will have a panic attack in situations where it would be embarrassing if that happened or where they might not be able to get help if they had a panic attack. Because of this fear they often avoid such situations or they may only be able to endure them with a trusted companion.
Some people with panic disorder have agoraphobia, but not all.
This anxious apprehension typically leads to a persistent avoidance of such situations. These situations may include being home alone, being in a crowd of people, travelling in a car, bus or plane, being on a bridge or in an elevator. This anxiety may impair individuals ability to travel to work, go grocery shopping or do tasks for their children like take them to their doctor.

16. Panic Disorder
Panic disorder is the presence of:
recurrent, unexpected panic attacks followed by at least 1 month of persistent concern about having another attack
worry about the possible implications of the panic attacks
significant behavioral change related to the attacks.
Panic disorder can be present with or without agoraphobia.
Panic disorder can be present with or without agoraphobia.
Unexpected and situationally predisposed panic attacks are important in panic disorder .
WATCH PANIC DISORDER VIDEO.

17. Panic attacks: etiological factors
What is Catastrophic misinterpretation?
Step 1: A person misinterprets bodily sensations such as rapid heart rate associated with anxiety as serious
Step 2:this leads to increased awareness of biological reactions
Step 3: misinterprets these sensations as catastrophic events (I’m going crazy, I’m going to die)
Some research indicates that people who have panic attacks have a cognitive pattern called catastrophic misinterpretation.
Sensations that accompany anxious mood such as rapid heart rate, respiration, dizziness).
A person misinterprets the biological reactions of anxiety as a catastrophic event. This cycle leads to a panic attack.

18. Panic attacks: etiological factors
Neurochemistry:
- Another biological vulnerability to anxiety disorders may involve neurochemicals.
-One theory suggests that several neurotransmitter systems may be “hyperactive” in people with panic disorder.
Another biological vulnerability to anxiety disorders may involve neurochemicals.
All they need to know. Not much more info out there about this.

19. A systems model for panic attacks
Klein’s False Suffocation Alarms Model incorporates biological and psychological factors to explain panic attacks and agoraphobia.
-the brain may have a suffocation monitoring system but people prone to panic attacks are hypersensitive and may have false alarms
-the threshold for a person’s suffocation alarm can be influenced by biological, social and psychological factors such as stressful life events.

20. Obsessive-Compulsive Disorder
Obsessions -- intrusive & nonsensical thoughts, images, urges that one tries to resist or eliminate
Compulsions -- thoughts or actions designed to suppress the thoughts & provide relief from anxiety from obsessions
Obsessions
ex: cleanliness, forgetting to lock door.
Compulsions
ex: hand washing, long showers, checking door repeatedly.
Ask class: intrusive thoughts, behaviors in As Good As It Gets

21. Obsessive-Compulsive Disorder
Typical obsessions include contamination, aggressive impulses, sexual content, somatic concerns, symmetry
Obsessions are often about normal concerns, but differ in intensity level compared to people without OCD
Onset: early adolescence to young adulthood
Course: typically chronic
60% of people have multiple obsessions

22. Obsessive-Compulsive Disorder
The vast majority of people with OCD exhibit both obsessions and compulsions
However, according to the DSM, compulsions cannot exist without obsessions but obsessions can exist without compulsions
Some individuals with OCD do recognize that their obsessions and compulsions are unreasonable
WATCH OCD VIDEO.

23. OCD: etiology Cognition:
-Thought suppression. People who worry excessively try to control their thoughts.
However, trying to control thoughts may make the thought more intrusive and increase the emotions associated with the thoughts
People with OCD may have early life experience w/unacceptable thoughts. About sexual content, for example.

24. OCD: Treatment Exposure and response prevention
Step 1: Information gathering about rituals to enable the client to monitor them effectively
Step 2: repeated, prolonged exposure to situations that provoke anxiety and instructions to refrain from ritual behaviors
In general, this treatment exposes the client to her feared stimulus, and she is then prevented from performing the compulsion that would normally reduce her anxiety.

25. OCD: Treatment
Step 3:patients must keep an accurate record of ritualistic behavior during treatment
Step 4: homework assignments to expose oneself to anxiety-provoking stimuli

26. OCD: Treatment
Step 5: support person must be encouraging and remind the patient of rationale of response prevention
Mental rituals must be prevented as much as overt rituals, even though they are much harder to address
Variations between therapists about how much prevention is insisted on (complete abstinence or degrees of change) as time goes by

27. Specific Phobia
Excessive or unreasonable fear related to a specific object/situation
Most common are snakes & heights
Some anxiety is maladaptive, high levels are maladaptive
often have associated panic attacks
Ask class to describe experiences they have had or that they have heard of/witnessed–Write down 2 fears you have and how it affects your life. Use for class discussion of fear vs. phobia.
Specific Phobia: an irrational fear of a particular object or situation that interferes with functioning.
ex: fear of flying (John Madden)

28. Specific Phobia FRED HATES SNAKES
How do we know if this is a phobia or not?
Fred would be very upset/fearful if
he were thrown into a pit of cobras
someone put a large snake around his neck
he had to walk by a snake in a cage
he had to watch Raiders of the Lost Ark
Go through this, at what level does it become a phobia as opposed to a regular fear?
Which situation is phobia?

29. Specific Phobia: Treatment
Exposure therapy (in vivo) components:
1) phobic learning history – create new learning history
2) Stimulus exposure > anxiety >relaxation > decreased anxiety
3) Fear & Avoidance Hierarchy (FAH)
4) Subjective Units of Distress Scale (SUDS)
SPIDER!!!!!!!!!!!!!!!!
These are the four components of exposure therapy for phobias. The theory behind this treatment is that a person has a phobic learning history. In other words, she was not born being phobic of something, she just has to unlearn her fear and create a new learning history.
FAH
- person rates different events on a scale . The principle behind this exposure treatment is that you cannot be relaxed and anxious at the same time. The way it works is that you imagine or are confronted with one item on your FAH list and then are forced to relax (using deep breathing for example).
SUDS
- make ratings of fear in diff’t situations (0 to 100). Can be used to track progress in therapy.
Gradually exposure to feared stimuli (e.g., fear of flying)
Participant modeling
- watch others respond without anxiety to the stimulus. Should be someone the person trusts (e.g., watch friend or relative hold snake)
SPIDER DEMO

30. Generalized Anxiety Disorder
anxiety focuses on everyday events (worry + physical symptoms)
DSM criteria for GAD include:
--Excessive worry occurring more days than not
--person finds it difficult to control the worry
--restlessness, easy fatigue, muscle tension, sleep disturbance
Generalized Anxiety Disorder (GAD): worry is the most significant component
Barlow hypothesizes (as we discussed earlier) that anxious apprehension, or a future-oriented mood state where a person becomes ready to cope with negative future events is important in GAD.

31. Generalized Anxiety Disorder
Characterized by anxious apprehension, a state of
high negative affect and chronic overarousal
sense of uncontrollability
focus on threat-related stimuli that may indicate future negative events
Prevalence: twice as likely for women, as w/ other anxiety disorders
Approximately 4% of population meet criteria for GAD
Female to male ratio 2: 1
Onset usually in early adulthood, often in response to life stressor
Comorbidity: high overlap with other disorders
WATCH GAD VIDEO

32. Generalized Anxiety Disorder
Etiology -- variety of contributing factors
Anxiety as trait does seem to run in families but GAD results less conclusive
The course of GAD has also been related to the presence or absence of life stressors.
There is a high level of comorbidity with other anxiety and mood disorders.
For example, these are the rates from Twin studies: MZ = DZ = .17
Give some examples of life stressors-having children, switching schools, ending a relationship.
The comorbidity issue in controversial in the literature. Some researchers suggest that GAD is often a pre-existing condition for people who later develop other anxiety disorders. Others question the temporal sequence of the development of GAD and other anxiety disorders.

33. Treatment of GAD Targets of treatment:
Cognitive symptoms (e.g. ,excessive worry) have been addressed by cognitive therapy
Somatic symptoms (e.g., muscle tension) have been addressed by relaxation treatments

34. Treatment of GAD Example of cognitive therapy:
Step 1: provide client with overview of how his/her cognitions work, including:
their automatic anxious thoughts
situation-specific nature of anxious predictions about the future
how cognitions responsible for anxiety are not challenged by client
1-they need to keep track of the regularity with which their negative thoughts about the future are almost automatic
2-They also need to be made aware of which situations seem to trigger high rates of anxious thoughts about the future. For example, a person who suffers from panic attacks may be particularly anxious on bridges.
3-finally, they need to acknowledge that they (and the people in their environment) may not do much to challenge their cognitive distortions. For example, someone with GAD who worries constantly about her children getting sick at school needs to learn to challenge herself and the realistic-ness of her worries.
This is an overview step of awareness.

35. Treatment of GAD
Step 2: make client understand the nature of inappropriate anxiety and the role of his/her interpretation of situations that create negative affect.

36. Treatment of GAD: cognitive
Step 3
Identify the specific interpretations/ negative predictions that your client is making and challenge them. Two types are particularly important:
Probability overestimation
Catastrophic thinking
Probablistic overestimation involves getting the client to realise the actual probablity of the worst case scenario occuring.
For example, to challenge catastrophic thinking, you could ask your client to imagine the worst possible feared outcome actually happening and then critically evaluate the impact of the event. This entails giving an estimation of the client’s perceived ability to cope with the event if it were to happen.

37. Treatment of GAD: cognitive
The three main facets of such an approach are:
Considering thoughts as hypotheses rather than facts that can be supported (or not) by evidence
Utilizing past and present evidence to examine the validity of the belief
Exploring and generating all possible predictions or interpretations of an event.

38. Treatment of GAD: Relaxation
Step 1:
Using the 16 muscle groups, clients are taught to discriminate and detect early signs of muscle tension
Step 2:
Relaxation deepening techniques are employed including diaphragmatic breathing

39. Treatment of GAD: Relaxation
Step 3
Clients rationalize that relaxation is aimed at alleviating the physiological components of anxiety by interrupting the learned association between overarousal and worry
Step 4
Clients model relaxation in the session and then practice it at home with tapes of the session

40. Social Phobia: criteria
Marked and persistent fear of one or more social or performance situations in which a person is exposed to unfamiliar people or possible scrutiny by others
Exposed to the feared social situation invariably provokes anxiety
The person realizes that the fear is excessive or unreasonable
The feared situation is avoided or endured with great distress
Social Phobia: fear of being around others, especially in “performance” situations (specific vs. generalized)
- very similar to specific phobia
Affects about 8% of population

41. Social phobia
Characterized by fear of humiliation by either performing badly or by displaying visible symptoms of anxiety.
More than shyness
If the fears include most social situations, it is considered generalized social phobia

42. Social Phobia: etiology
Cognitive biases that impact social phobia
Attentional bias: what people attend to
Memory bias: what people remember
Judgment bias: how people judge things (e.g., how likely certain outcomes are) and their judgments of what the costs and benefits would be of various outcomes
Although these cognitive biases are common to people with many different anxiety disorders, they are particularly useful in thinking about social phobia.
Cognition (selective attention): people with social phobia tend to focus on negative things in their environment or only remember negative things (e.g., think that you’re a failure because one person fell asleep during speech, got feedback about improving speech).

43. Social Phobia: judgment bias
2 kinds of judgment biases in individuals with anxiety disorders
Exaggerated estimates of the occurrence of negative events
Exaggerated estimates of the cost (valence) of negative events
Social phobia is more distinguished by exaggerated cost.
This slide is just explaining in more detail what judgment biases people may have with social phobia.

44. Social phobia: etiology
There is also evidence that social phobia runs in families
Modeling of socially anxious parents has an effect on children
In particular, overprotective and rejecting behavior increase the odds of developing social phobia

45. Treatment: Cognitive and exposure
Step 1: simulated exposure to feared situations in the session
Step 2: cognitive rethinking about the social cost of behavior
Step 3: homework assignments for in vivo exposure that is developed in the session and is relevant to the person’s life
1: you practice social skills with your therapist first.
2: e.g., how realistic is it to think that if you stammer a little as you talk, you’ll be fired? (refer to the cognitive biases I listed earlier)
3: for example, giving a talk if one is required to do that a lot for your job.

46. Cross-cultural differences in social phobia
Special topic
Cross-cultural differences in social phobia
In this section, we will discuss social phobia in more detail. We will also discuss cross-cultural differences and how to interpret these differences in a comprehensive way.

47. Culture and social phobia
Researchers have consistently found that Asian Americans score higher on measures of social anxiety than White Americans
This has been found in both college (e.g., Okazaki, 1997) and community samples (e.g., Ying, 1988)
In fact, Asian Americans have been found to have the highest rates of social anxiety of any racial group
Ethnic minority mental health researchers have consistently found differences between Asian Americans and White Americans on self-report measures of distress. Studies that have used measures of depression and social anxiety have found a pattern of higher distress reported by Asian Americans (Okazaki, 1997, 2000). This pattern has been replicated in both college (e.g. Okazaki, 1997) and community samples (e.g. Ying, 1988).

48. Sue et al, 1990 study
The students were asked to role-play a series of 13 situations requiring assertion with either an Asian experimenter or a White experimenter.
The Chinese-American students were as assertive as the White Americans on all behavioral measures.
However, one self-report measure revealed a significant difference between the two groups, suggesting that Chinese Americans were more apprehensive than White Americans in social situations.

49. Why these differences?
Hypothesis 1: a higher level of generalized distress among Asian Americans
This could be due to political experiences that Asian Americans face (e.g., racism) (Kuo, 1984)
Acculturative stress of being recent immigrants, including financial difficulties associated with moving to a new country and finding new employment, and learning a new language for personal and professional communication
Various explanations have been posited to explain these ethnic differences. Some researchers have suggested that these differences indicate a higher level of generalized distress among Asian Americans, which could be attributed to cultural, economic and political factors (e.g., Kuo, 1984).

50. Why these differences? Hypothesis 2 :
Cultural values and norms for functioning and distress.
Identify differences in cultural norms and how they predict emotional distress for Asian Americans and White Americans.
A third hypothesis is that the norms of your community may impact how you define both high level functioning and distress. Researchers have attempted to study how differences in cultural norms predict emotional distress for Asian Americans and White Americans.

51. Cultural norms about the self
The role of self-construal:
People socialized by values from Asian societies are more likely to have an interdependent self-construal.
definition includes attending to others, fitting in and harmonious interdependence with others (Markus & Kitayama, 1991)
This study focuses on further examination of the cultural hypothesis to explain ethnic differences in distress. One theoretical framework that researchers have used to understand the complex differences in psychological functioning is self-construal. According to Markus and Kitayama’s work (1991) on independent and interdependent self-construal, people socialized by cultural ideologies in Asian societies are more likely to have an interdependent self-construal, the definition of which includes “attending to others, fitting in and harmonious interdependence with others” (Markus & Kitayama, 1991, p.224). This is in direct contrast to the independent self-construal that is valued by mainstream American society, which include viewing oneself as an independent person and making one’s own decisions for personal benefit (Markus & Kitayama, 1991). There is research that indicates that Asian values and perhaps self-construal does not change significantly over generations of Asian Americans and is fairly unaffected by acculturation to mainstream American life, although behaviors may change (Sodowsky, Kwan & Pannu, 1995). Therefore, researchers can expect many Asian American college students to have some sense of an interdependent self-construal.

52. Cultural norms about the self
Independent self-construal is valued by mainstream American society
Includes viewing oneself as an independent person and making one’s own decisions for personal benefit

53. Okazaki study (1997)
subjects who held less independent self-construal were found to be more socially anxious
also found that Asian Americans’ high reports of distress persisted on a measure of social anxiety but not on depression, after taking into account the comorbidity between social anxiety and depression.

54. Results
Social anxiety appeared to be a particularly salient form of distress for Asian Americans.
This would make sense given the value placed on interpersonal sensitivity in Asian cultures.

55. Cultural norms about functioning
Depending on cultural norms about social anxiety, a person may feel less or more distressed by his/her experience of it
Existing research that has focused on cultural differences in norms has been predominantly in the field of subjective well-being (SWB) (for a review, see Diener et al., 1999). These researchers agree that well-being or happiness is largely subjective because each individual may decide whether she sees her life as worthwhile within her cultural context (Diener, 2000). Diener also suggests that people’s evaluations of their lives are impacted by their expectations of them, which are in turn strongly influenced by the political context, and also by cultural standards about normative functioning. His review also proposes that individualism and collectivism impact the cultural patterns of SWB. For example, Diener (2000) asserts that, “people in collectivist cultures tend to more often consult norms for whether they should be more satisfied and to consider the social appraisals of family and friends in evaluating their lives” (p. 39). Recently, Suh and colleagues have directly tested the contribution of cultural norms to variations in the self-reports of well-being. Suh, Diener, Oishi, and Triandis (1998) compared the relative weight of emotions and cultural norms (i.e., normative desirability of life satisfaction in that culture) in life satisfaction judgments using a large international sample. In making a rating of how satisfied they are with their lives, people in individualistic nations were found to rely primarily on their emotional experiences (e.g., feeling pleasant emotions more frequently), whereas people in collectivistic nations considered cultural norms for whether they should be satisfied, as well as their own affect, to make such ratings. Suh and Diener (1999) further showed that Asian Americans downplayed the importance of emotions but emphasized social appraisal in their life satisfaction judgments.

56. Cultural norms about functioning
Okazaki (2002) examined cultural norms in functioning would contribute to reports of psychological distress
Asian Americans found reports of social anxiety less distressing
Cultural norms significantly predicted how socially anxious they were, compared to White Americans.

57. Conclusions
raises questions about the cultural validity of commonly used assessment tools with different groups
Understanding cultural norms and standards in behavior may further our understanding of distress in different groups.
This study raises questions about the cultural validity of commonly used assessment tools with Asian Americans. Since many of these measures were developed with mainstream populations, it appears that they correlate behaviors associated with Asian Americans (such as a low independent self-construal) with distress, whereas they may not been seen as such by Asian Americans themselves (particularly with regard to social anxiety). This has implications for both assessment and treatment. It is important to consider the role of self-construal and how the relationship between independence and distress implied by distress measures may affect how clinicians evaluate Asian Americans. In responding to questions about depression or social anxiety, Asian American individuals may be relying not just on how distressed and impaired they feel but also what they perceive to be the cultural norm. It is important for clinicians to fully assess and understand the cultural meanings attached to psychological symptoms.
Hopefully this example has illustrated the complex ways we can interpret cross-cultural findings.

58. Prevalence rates for anxiety disorders (lifetime)
Disorder Males Females
Panic
GAD
Social phobia
OCD
All
In other words, OCD is the only anxiety disorder without a significant gender difference.

59. Prevalence rates for anxiety disorders (12 month)
Disorder Males Females
Panic
GAD
Social phobia 7 9
OCD
All