1. Anxiety Disorders

2. How much do you know? Anxiety Quiz Anxiety Quiz

3. What is Anxiety? Refers to a general state of dread or uneasiness that occurs in response to a vague or imagined danger. Refers to a general state of dread or uneasiness that occurs in response to a vague or imagined danger. It differs from fear, which is a response to a real danger or threat. It differs from fear, which is a response to a real danger or threat.

4. What does anxiety look like? Physical signs and symptoms: Physical signs and symptoms: –Feelings of panic, dread, horror, and terror –Rapid heartbeat, shortness of breath, trembling –Uncontrollable taking over of avoidant thoughts

5. DSM-IV Classifies Anxiety Disorders to include: Obsessive-Compulsive Disorder Obsessive-Compulsive Disorder Phobic Disorders Phobic Disorders Panic Disorders Panic Disorders Panic Disorders Panic Disorders Generalized Anxiety Disorder Generalized Anxiety Disorder Stress Disorders Stress Disorders

6. Obsessive Compulsive Disorder We’ll cover this in depth later!

7. Medication Therapy (Antidepressants)

8. Phobias 12 percent of American’s are afflicted 12 percent of American’s are afflicted Most common psychiatric illness in women and the second most common in men over ages 25 Most common psychiatric illness in women and the second most common in men over ages 25 Categorized into three groups Categorized into three groups

9. 3 Main Groups of Phobias Include: Specific (simple) Phobia Specific (simple) Phobia Social Phobia Social Phobia Agoraphobia Agoraphobia

10. Specific (simple) Phobia (view cartoons/view phobia wkshts) Most common phobias Most common phobias Produce intense fear of a particular object or situation, that is in fact relatively safe. Produce intense fear of a particular object or situation, that is in fact relatively safe. –Claustrophobia –Arachnophobia –Zoophobia

11. The Origin of Phobias Psychoanalytic Psychoanalytic –Phobias are defenses against the anxiety produced by repressed impulses of the ID –The anxiety is displaced onto some situation or object that is symbolically related to the ID.

12. The Origin of Phobias Sociobiologists Sociobiologists –Suggest the roots of phobias are carried in our genes.

13. The Origin of Phobias Behaviorists Behaviorists – Phobias are learned via: –classical conditioning (little Albert), –operant conditioning (reinforcing staying home for a child from school), –vicarious learning (observation), –or Mowrer’s two-factor model

14. Two Factor Model

15. Social Phobia (view cartoons) Characterized by a persistent fear of social situations in which one might be exposed to the close scrutiny of others and may be humiliated or embarrassed Characterized by a persistent fear of social situations in which one might be exposed to the close scrutiny of others and may be humiliated or embarrassed

16. What do social phobias look like? Feel all eyes are on them Feel all eyes are on them Fear eating out or using public restrooms Fear eating out or using public restrooms Fear talking on the phone or writing in front of others Fear talking on the phone or writing in front of others Fear speaking in public and dating Fear speaking in public and dating Find blushing painfully embarrassing Find blushing painfully embarrassing

17. The Origin of Social Phobia Related to feelings of inferiority and low self- esteem Related to feelings of inferiority and low self- esteem

18. Agoraphobia Fear of being alone in public places from which there is no easy escape. Fear of being alone in public places from which there is no easy escape. Shopping Mall Shopping Mall Movie Theatre Movie Theatre Elevator Elevator Buses, Trains, Airplanes Buses, Trains, Airplanes Agoraphobics commonly experience panic attacks & avoidant behaviors. Agoraphobics commonly experience panic attacks & avoidant behaviors.

19. The Origins of Agoraphobia No apparent cause No apparent cause

20. When can a phobia be diagnosed? When the irrational fear leads to avoidance behaviors (not leaving home) that interferes with the affected person’s normal life. When the irrational fear leads to avoidance behaviors (not leaving home) that interferes with the affected person’s normal life.

21. How can a phobia be treated? Exposure Treatment (Foa & Kozak 1986) Exposure Treatment (Foa & Kozak 1986) –Patient is exposed to the phobic stimulus –Flooding (an extreme version of exposure) is where a person is immersed in the fear until the fear itself fades away.

22. How can a phobia be treated? Counter-Conditioning (Watson 1924) Counter-Conditioning (Watson 1924) –Client is trained to substitute a relaxation response for the fear response HOW???

23. Through a process of: Systematic Desensitization (Wolpe 1958) Step 1: train the patient to relax (biofeedback) Step 1: train the patient to relax (biofeedback) Step 2: create a scale of anxiety to the stimulus Step 2: create a scale of anxiety to the stimulus Step 3: begin to expose the client to small level of stimulus with relaxation and progress to larger levels of stimulus (cope with modeling) Step 3: begin to expose the client to small level of stimulus with relaxation and progress to larger levels of stimulus (cope with modeling)

25. Post Traumatic Stress Disorder An extreme or traumatic event that one see, experience, or learn about which causes intense fear, helplessness, and horror. An extreme or traumatic event that one see, experience, or learn about which causes intense fear, helplessness, and horror. Event involves actual or threatened death or serious injury, or threats of harm to oneself and others. Event involves actual or threatened death or serious injury, or threats of harm to oneself and others.

26. PTSD Examples: Physically attacked- domestic violence or rape Physically attacked- domestic violence or rape Injured in a serious car, plane, or train accident Injured in a serious car, plane, or train accident Hurt or traumatized by a natural disaster Hurt or traumatized by a natural disaster Told about the sudden, unexpected death of a loved one Told about the sudden, unexpected death of a loved one A soldier views a horrific war scene A soldier views a horrific war scene

27. How does PTSD work? Acute stress of a traumatic event causes chemical reactions in the brain that produce anxiety provoking emotions and physical symptoms. Acute stress of a traumatic event causes chemical reactions in the brain that produce anxiety provoking emotions and physical symptoms.

28. How common is PTSD? In the past is was believed only soldiers who suffered from “battle fatigue” or “shell shock” had PTSD In the past is was believed only soldiers who suffered from “battle fatigue” or “shell shock” had PTSD Currently, we are recognizing more scenarios. Currently, we are recognizing more scenarios. 1 of every 13 Americans will get PTSD at some point in their life. More of the victims are women. 1 of every 13 Americans will get PTSD at some point in their life. More of the victims are women.

29. Why more women sufferers? Studies conclude that women are more likely to experience a lot more different traumatic events: Studies conclude that women are more likely to experience a lot more different traumatic events: –Rape –Sexual Molestation –Neglect by parents –Physical abuse in childhood and adulthood

30. Signs & Symptoms of PTSD The symptoms of this condition are not all in your head or imaginary The symptoms of this condition are not all in your head or imaginary The symptoms must last for more than one month, must cause personal distress in daily life, and you must have a certain number of them in order to be diagnosed with PTSD. The symptoms must last for more than one month, must cause personal distress in daily life, and you must have a certain number of them in order to be diagnosed with PTSD.

31. Signs & Symptoms of PTSD –1. Re-experiencing (1 or more) Frequent upsetting memories/images about the event Frequent upsetting memories/images about the event Distressing dreams repeatedly Distressing dreams repeatedly Acting as if the event were happening again Acting as if the event were happening again Emotional pain when seeing things associated with the event Emotional pain when seeing things associated with the event Physical reactions of shakiness, chills, increased heart rate Physical reactions of shakiness, chills, increased heart rate

32. –2. Avoidance and numbing (3 or more) Avoid conversation about event Avoid conversation about event Avoid activities or people in the event Avoid activities or people in the event Not being able to remember important details about the event Not being able to remember important details about the event No longer enjoying activities you once enjoyed No longer enjoying activities you once enjoyed Feelings of detachment Feelings of detachment Belief that important life goals will not be fulfilled Belief that important life goals will not be fulfilled

33. –3. Hyper arousal (2 or more) Problems falling and staying as asleep Problems falling and staying as asleep Angry outbursts and irritableness Angry outbursts and irritableness Problems concentrating Problems concentrating Feeling “overly alert” Feeling “overly alert” Being “overly startled” Being “overly startled”

34. When do these symptoms occur? Usually start to appear within several weeks of the traumatic event Usually start to appear within several weeks of the traumatic event However, some people may not have them for months or ears after the traumatic event However, some people may not have them for months or ears after the traumatic event

35. PTSD & the possibility of other conditions Anxiety Anxiety Depression Depression Self-medication: alcohol & drugs Self-medication: alcohol & drugs

36. Treatment of PTSD Suggested therapy is a type of psychotherapy called Cognitive Behavioral Therapy (CBT) Suggested therapy is a type of psychotherapy called Cognitive Behavioral Therapy (CBT)

37. Treatment of PTSD CBT- is used to treat PTSD (and other disorders) by focusing on helping the client learn to understand the condition better and to deal with it, while medicating (Zoloft) the patient. CBT- is used to treat PTSD (and other disorders) by focusing on helping the client learn to understand the condition better and to deal with it, while medicating (Zoloft) the patient.