1. Anxiety Disorders Thomas G. Bowers, Ph.D. Penn State Harrisburg To insert your company logo on this slide From the Insert Menu Select “Picture” Locate your logo file Click OK To resize the logo Click anywhere inside the logo. The boxes that appear outside the logo are known as “resize handles.” Use these to resize the object. If you hold down the shift key before using the resize handles, you will maintain the proportions of the object you wish to resize.

2. Anxiety Disorders Anxiety Subjective distress, fear, apprehension Elevated heart rate, rapid breathing, Highly similar to fearfulness, but thought to be irrational or unrealistic

3. Types of Anxiety Disorders Phobias Fear mediated avoidance, thought to be unrealistic Some examples –claustrophobia Fear of closed spaces –agoraphobia Fear of public places –acrophobia Fear of heights

4. Types of Anxiety Disorders Phobias Some other examples –Specific phobias Specific unwanted fears –Social phobia Relatively common

5. Types of Anxiety Disorders Panic Disorder Sudden and often unexpected attack of anxiety symptoms Heart palpitations, nausea, choking, dizziness, trembling, apprehension, even terror Often associated with stress

6. Types of Anxiety Disorders Generalized Anxiety Disorders Persistent anxiety, chronic, uncontrollable worry “Free floating”

7. Types of Anxiety Disorders Obsessive-Compulsive Disorder Persistent and uncontrollable thoughts and feelings of a compulsion to repeat certain acts Depression also often noted

8. Types of Anxiety Disorders Posttraumatic Stress Disorder (PTSD) Introduced in 1980 (DSM-III) Earlier conceptions: 1. “Shell shock” (WWI and WWII) 2. “Combat neurosis” (Korea) 3. Noted in Civil War

9. Types of Anxiety Disorders Posttraumatic Stress Disorder (PTSD) Extreme response to severe stressor Increased anxiety, avoidance of stimuli associated with trauma, numbing of emotional responses

10. Types of Anxiety Disorders Acute Stress Disorder (ASD) New to DSM IV Recovery in about one month

11. Types of Anxiety Disorders PTSD symptoms 1. Re-experiencing the traumatic event 2. Avoidance of the stimuli associated with the event or a numbing of responsiveness 3. Increased arousal

12. Etiology of Anxiety Disorders Varied theoretical views Psychoanalytical theories –Anxiety in general represents repressed id impulses –The repressed impulses are displaced to object with some symbolic connection –Represents neurotic level of adjustment

13. Etiology of Anxiety Disorders Behavioral theories –Anxiety is learned –Avoidance conditioning - classical conditioning to a previously neutral stimulus condition –Little Albert Case - conditioned by Watson and Rayner to develop a fear of a white rat

14. Etiology of Anxiety Disorders Behavioral theories –Avoidance conditioning can not account for all of anxiety, however –Modeling theories - vicarious or observational learning

15. Etiology of Anxiety Disorders Cognitive Behavioral Theories –Some patterns of thoughts (as worry) may be maintained by avoiding even less pleasant emotions –Uncontrollable environmental conditions also could contribute to misperception

16. Etiology of Anxiety Disorders Biological Views –There may be genetic components to neuroticism –benzodiazepines (also known as minor tranquilizers) are effective in treating anxiety –Linked with inhibitory neurotransmitter GABA (gamma-aminobutyric acid)

17. Etiology of Anxiety Disorders Biological Views –Linked with inhibitory neurotransmitter GABA (gamma- aminobutyric acid) –Increase in GABA levels yields decreased anxiety

18. Treatment of Anxiety Disorders Analytical –Long relationship, ‘reparent,’ resolve fundamental issues Behavioral –Desensitization for phobic concerns –Flooding

19. Treatment of Anxiety Disorders Cognitive behavioral –Interpretation, reformulation of thought process –Gradual approximation of behaviors –Modeling –Social support

20. Treatment of Anxiety Disorders Biological –benzodiazepines –Use of minor tranquilizers as Valium, Librium, more recently BuSpar –Some dependence liability

21. Treatment of Anxiety Disorders Biological –Antidepressants as selective serotonin reuptake inhibitors (SSRI) –Also effective treating depression