Transcript Anxiety Disorders

Anxiety Disorders
Assessment & Diagnosis
SW 593
Introduction
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Anxiety disorders are serious medical
illnesses that affect approximately 19
million American adults.
Anxiety disorders are chronic, relentless,
and can grow progressively worse if not
treated.
Each anxiety disorder has its own
distinctive features, but they are all
bound together by the common theme of
excessive, irrational fear and dread.
Building Blocks
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Two non-codable disorders:
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Agoraphobia – anxiety focused on situations or
places from which the client may not be able to
escape and/or receive help if the anxiety were
to become too acute.
Panic attack – an episode of anxiety usually
lasting less than a half hour during which the
client experiences a number of physical
complaints and/or cognitive fears about the
outcome of the “attack”.
Phobias
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Specific Phobias:
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the client fears some specific object or
situation.
The phobia is directly related to a
discernible event and is understood by
the client to be an “overreaction”.
Social Phobia:
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The specific fear involves at least one
type of social or performance situation
that involves being “judged” by others.
Generalized Anxiety
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Concern is usually focused on
everyday events and tends to shift
over a number of events or
activities.
The client may not view the worries
as excessive.
They do experience distress
associated with an inability to
control the concerns.
The condition is more chronic; must
have persisted for at least 6
months.
Obsessive-Compulsive Disorder
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Characterized by the presence of
recurrent obsessions and/or
compulsions.
Obsessions are intrusive and
persistent thoughts, ideas,
impulses, or images that are
associated with marked anxiety or
distress.
The specific content of obsessions
does not usually involve any reallife problems.
Obsessive-Compulsive Disorder
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Compulsions are repetitive behaviors that
are performed to prevent or reduce
anxiety.
These behaviors are clearly either
excessive or not realistically associated
with preventing or reducing the feared
situation.
Clients suffering from this disorder have
at one time realized that their symptoms
are excessive or unreasonable, such
insight may be tenuous.
Trauma Related Disorders
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Associated with direct exposure to
extreme traumatic events involving
threats of serious injury or death to
the client or another person.
Acute Stress Disorder:
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Symptoms begin during or immediately
after the trauma
Last for at least 2 days
Resolve within 4 weeks.
Trauma Related Disorders
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The symptoms tend to be largely
dissociative in nature
Include some form of reexperiencing the trauma
Lead to patterns of avoiding
reminders of the event
If the symptoms are not resolved in
the time period, another diagnosis
is in order.
Trauma Related Disorders
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Posttraumatic Stress Disorder (PTSD):
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Symptoms have persisted for at least a month
although the exposure to trauma may have
occurred at any time prior to symptom onset.
Characterized by persistent re-experiencing of
the traumatic event
Avoidance of stimuli associated with the
trauma
Client evidences both numbing of general
responses and persistent symptoms of arousal
that were not present before the traumatic
event.
Etiological Factors
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Anxiety disorder due to a General
Medical condition is used when the
anxiety is directly related to a
diagnosable organic problem.
Substance-Induced Anxiety Disorder
is used when to anxiety is directly
related to the use of recreational
drugs, prescribed medications, or a
toxin.
Worth Noting
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People suffering from anxiety do not
necessarily seek treatment.
Anxiety tends to be variable and
many clients attain symptom relief
through avoidance strategies.
Symptoms are relieved when stress
is reduced.
Self - medication
Assessment
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Attention will be focused on the
person’s fears and worries.
It is difficult for clients to present
detailed and accurate information.
Tendency to minimize symptoms
because of internalized stigma.
When panic attacks are involved,
collateral medical referrals are
warranted.
Cultural Considerations
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Culture undoubtedly influences what is
viewed as anxiety-provoking.
Culture can influence what level of
anxiety is considered problematic.
The standards for displays of emotion
vary by gender.
Little differences are noticed between the
sexes for social phobia, acute stress
disorder, PTSD, GAD, and OCD.
Cultural Considerations
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These all share either a link to an
intense psychosocial stressor or a
relatively private set of symptoms.
The female to male ratio for specific
phobias and panic disorders is 2:1.
Some evidence indicates that males
suffering from panic attacks are
more likely to “self-medicate”.