1. Anxiety Disorders Distressing, persistent anxiety or maladaptive behaviors that reduce anxiety

2. Manifestations of Anxiety CognitiveCognitive –Thought process range from generalized worry to overwhelming fear (focus on impending doom) BehavioralBehavioral –The avoidance of anxiety- provoking situation SomaticSomatic –Physiological complaints due to activation of sympathetic nervous system (stomach aches, headaches, shakiness, etc.)

3. Specific Phobias Specific phobias = irrational, persistent fear of specific objects or situationsSpecific phobias = irrational, persistent fear of specific objects or situations Simple phobias:Simple phobias: –Claustrophobia = enclosed spaces –Agoraphobia = open spaces –Arachnophobia = spiders –Acrophobia = heights Social phobia = fear of social situations & embarrassmentSocial phobia = fear of social situations & embarrassment

4. Phobias - irrational fears http://phobialist.com/ http://phobialist.com/ Hematophobia: BloodHematophobia: Blood Gephyrophobia: Crossing a bridgeGephyrophobia: Crossing a bridge Kenophobia: Empty roomsKenophobia: Empty rooms Cynophobia: DogsCynophobia: Dogs Coulrophobia: clownsCoulrophobia: clowns Aerophobia: Flying Entomophobia: Insects Gamophobia: Marriage Ophdophobia: Snakes Xenophobia: Strangers Melissophobia: Bees

5. Anxiety Disorders Common and uncommon fearsCommon and uncommon fears Afraid of itBothers slightlyNot at all afraid of it Being closed in, in a small place Being alone In a house at night Percentage of people surveyed 100 90 80 70 60 50 40 30 20 10 0 SnakesBeing in high, exposed places MiceFlying on an airplane Spiders and insects Thunder and lightning DogsDriving a car Being In a crowd of people Cats

6. Generalized Anxiety Disorder (GAD) Persistent high levels of anxiety and excessive worry with symptoms for at least 6 monthsPersistent high levels of anxiety and excessive worry with symptoms for at least 6 months Restlessness, difficulty sleeping, lack of concentration, muscle tension, irritabilityRestlessness, difficulty sleeping, lack of concentration, muscle tension, irritability

7. Panic Disorder Recurrent, unexpected panic attacksRecurrent, unexpected panic attacks –Feelings of terror –Pounding heart, difficulty breathing –Fearful of future attacks Often accompanied by secondary conditions, such as agoraphobiaOften accompanied by secondary conditions, such as agoraphobia

8. Posttraumatic Stress Disorder Flashbacks or nightmares following extremely troubling eventFlashbacks or nightmares following extremely troubling event http://www.youtube.com/watc h?v=6VsVA5p7heQ&feature=r elatedhttp://www.youtube.com/watc h?v=6VsVA5p7heQ&feature=r elatedhttp://www.youtube.com/watc h?v=6VsVA5p7heQ&feature=r elatedhttp://www.youtube.com/watc h?v=6VsVA5p7heQ&feature=r elated Posttraumatic Stress Disorder in a Community Sample..., Brian Engdahl et al, American Journal of Psychiatry, 1997, pp. 1576-81.

9. Obsessive-Compulsive Disorder (OCD) Persistent, unwanted thoughts (obsessions) cause someone to feel the need (compulsion) to engage in an action Persistent, unwanted thoughts (obsessions) cause someone to feel the need (compulsion) to engage in an action (did I already do this slide?… I better do it again (did I already do this slide?… I better do it again (did I already do this slide?… I better do it again) (did I already do this slide?… I better do it again) http://www.youtube.com/watch?v=44DCWslbsNM&feature=relatedhttp://www.youtube.com/watch?v=44DCWslbsNM&feature=relatedhttp://www.youtube.com/watch?v=44DCWslbsNM&feature=related http://www.youtube.com/watch?v=tPFQMRx2l3Y http://www.youtube.com/watch?v=tPFQMRx2l3Y http://www.youtube.com/watch?v=tPFQMRx2l3Y

10. Common Examples of OCD Common Obsessions: Common Compulsions: Contamination fears of germs, dirt, etc. Washing Imagining having harmed self or others Repeating Imagining losing control of aggressive urges Checking Intrusive sexual thoughts or urges Touching Excessive religious or moral doubt Counting Forbidden thoughts Ordering/arranging A need to have things "just so" Hoarding or saving A need to tell, ask, confess Praying

11. Anxiety Disorders Fear of embarrassing oneself in public to the extent that one is isolated completely.Fear of embarrassing oneself in public to the extent that one is isolated completely. Social phobia Recurrent thoughts that lead to ritual behaviors.Recurrent thoughts that lead to ritual behaviors.OCD Constant anxiety and worry for no particular cause.Constant anxiety and worry for no particular cause. Generalized Anxiety Disorder Fear of being in wide, open, public spaces like a stadium or shopping mall.Fear of being in wide, open, public spaces like a stadium or shopping mall.Agoraphobia Re-occurring flashbacks or nightmares of a prior traumatic event.Re-occurring flashbacks or nightmares of a prior traumatic event.PTSD

12. Anxiety Disorders PET Scan of brain of person with Obsessive/ Compulsive disorderPET Scan of brain of person with Obsessive/ Compulsive disorder High metabolic activity (red) in frontal lobe areas involved with directing attentionHigh metabolic activity (red) in frontal lobe areas involved with directing attention

13. Prevalence of Anxiety Disorders in the U.S. Specific Phobia 19.2 Million Social Phobia 15 Million GAD 6.8 Million Panic Disorder 6 Million OCD 2.2 Million

14. Explaining Anxiety Disorders BiologicalBiological –Fears may have an evolutionary basis (contribute to survival) –Genetic predisposition to fears and anxiety (tend to run in families) –Lack of GABA neurotransmitter CognitiveCognitive –Irrational beliefs regarding feared stimulus (exaggeration)

15. Explaining Anxiety Disorders Behavioral (learning)Behavioral (learning) –Classical conditioning of fear –Avoidance relieves fear (negative reinforcement) Biopsychosocial modelBiopsychosocial model –Anxiety has a biological involvement and learning component, both of which are influenced by culture

16. Somatoform Disorders Complaints of physical symptoms with no physiological explanation (they are psychologically based)

17. Somatization disorder = multiple physical complaints with no physical explanation, onset before age 30Somatization disorder = multiple physical complaints with no physical explanation, onset before age 30 Conversion disorder = specific severe physical complaint (paralysis, blindness) with no physical causeConversion disorder = specific severe physical complaint (paralysis, blindness) with no physical cause –La belle indifference

18. Glove Anesthesia A conversion disorder in which a person can’t feel their hand (B). Neurologically this is impossible because the sensory nerves of the hand and arm are organized as shown in (A) rather than (B).

19. Body Dysmorphic Disorder Excessive preoccupation w/minor or imagined flaw in physical appearanceExcessive preoccupation w/minor or imagined flaw in physical appearance

20. Hypochondriasis Persistent preoccupation with one’s health despite the fact that genuine symptoms of the disorder are lackingPersistent preoccupation with one’s health despite the fact that genuine symptoms of the disorder are lacking

21. Hypochondriasis Occurs equally in men and women. Typical age of onset is 20- 30. Prevalence rate 1%–5%. $20 billion a year spent on unnecessary medical procedures.

22. Explaining Somatoform Disorders Psychoanalytic – unresolved childhood conflicts, experiences Behavioral – –Reinforcement (anxiety is reduced) – –Interpersonal gains in terms of sympathy & support Sociocultural factors

23. Dissociative Disorders Disruption or disturbances in memory, consciousness, or identity due to psychological factors

24. Psychogenic (dissociative) Amnesia Person loses memory due to stress or psychological trauma (no physical cause)

25. Psychogenic (Dissociative) Fugue Confusion over personal identity & assumes new identity (usually travel away from home & start new life)

26. Case Study: Dissociative Fugue Jennifer Wilbanks developed a fear of her upcoming wedding. Over several weeks she bought bus tickets, cut her hair and took the bus to Las Vegas and finally ended up in New Mexico. She confabulated an abduction story but finally admitted to her bus ride. (Neither Wilbanks nor Mason will answer mail or emails for an interview). She was a worker in a doctor's office.

27. Depersonalization Disorder Most common dissociative disorder Feelings of unreality about self “This is not my body…I am trapped in someone else’s body”

28. Dissociative Identity Disorder Person has several personalities rather than one integrated personality (a.k.a. Multiple Personality) http://www.youtube.com/watch?v=NDUw- yCRBUM&feature=relatedhttp://www.youtube.com/watch?v=NDUw- yCRBUM&feature=related http://www.youtube.com/watch?v=xRY7Oj-dl3o

30. Theoretical Causes of Dissociative Disorders Psychodynamic  extremely traumatic event is repressed so that a split in consciousness results Behaviorists  people who have experienced a trauma simply find not thinking about it to be rewarding (negative reinforcement)