Transcript Anxiety Disorders

Anxiety Disorders
Symptoms Checklist
Presence of symptoms determines
the assigning of a diagnosis
Panic Attack
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Palpitation, pounding heart, or accelerated heart rate
Sweating
Trembling or shaking
Sensations of shortness of breath or smothering
Feelings of choking
Chest pain or discomfort
Nausea or abdominal distress
Feeling dizzy, unsteady, lightheaded, or faint
Derealization (feelings of unreality) or depersonalization (being detached
from one’s self)
Fear of losing control or going crazy
Fear of dying
Paresthesias (numbness or tingling sensation)
Chills or hot flashes
Agoraphobia
• Not a codable disorder
• Anxiety about being in places or situations from
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which escape might be difficult (or
embarrassing) or in which help may both be
available in the event of having an unexpected
or situationally predisposed panic attack
The situations are avoided or else are endured
with marked distress or with anxiety about
having a panic attack
Panic Disorder without Agoraphobia
• Recurrent unexpected panic attacks
– Persistent concern about having another panic
attack
• Absence of agoraphobia
Panic Disorder with Agoraphobia
• Recurrent unexpected panic attacks
– Persistent concern about having another panic
attack
• Presence of agoraphobia
Specific Phobia
(formerly simple phobia)
• Marked and persistent fear that is excessive or unreasonable, cued
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by the presence or anticipation of a specific object or situation (e.g.,
flying, heights, animals, receiving an injection, seeing blood)
Exposure to the phobic stimulus almost invariably provokes an
immediate anxiety response, which may take the form of a
situationally bound or situationally predisposed panic attack
The person recognizes that the fear is excessive or unreasonable
The phobic situation is avoided or else is endured with intense
anxiety or distress
The avoidance, anxious anticipation, or distress in the feared
situations interferes significantly with the person’s normal routine,
work, school, social activities, or relationships
Social Phobia
• A marked or persistent fear of one or more social or performance
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situations in which the person is exposed to unfamiliar people or to
possible scrutiny by others. The individual fears that he/she will act
in a way (or show anxiety symptoms) that will be humiliating or
embarrassing.
Exposure to the feared social situation almost invariably provokes
anxiety, which may take the form of a situationally bound or
situationally predisposed panic attack.
The person recognizes that the fear is excessive or unreasonable.
The feared social or performance situations are avoided or else are
endured with intense anxiety or distress.
Again, there is significant impairment in social, occupational,
academic, or relationship functioning
Obsessive-Compulsive Disorder
• Obsession
– Recurrent and persistent thoughts, impulses, or images that are
experienced, at some time during the disturbance, as intrusive
and inappropriate and that cause marked anxiety or distress.
– The thoughts, impulses, or images are not simply excessive
worries about real-life problems.
– The person attempts to ignore or suppress such thoughts,
impulses, or images, or to neutralize them with some or thought
or action.
– The person recognizes that the obsessional thoughts, impulses
or images are a product of his/her own mind (not imposed from
without as in thought insertion)
Obsessive-Compulsive Disorder
• Compulsion
– Repetitive behaviors (e.g., hand washing, ordering,
checking) or mental acts (e.g., praying, counting,
repeating words silently) that the person feels driven
to perform in response to an obsession, or according
to rules that must be applied rigidly
– The behaviors or mental acts are aimed at preventing
or reducing distress or preventing some dreaded
event or situation, however, these behaviors or
mental acts either are not connected in a realistic way
with what they are designed to neutralize or prevent
or are clearly excessive.
Obsessive-Compulsive Disorder
• At some point during the course of the
disorder, the person has recognized that
the obsessions or compulsions are
excessive or unreasonable.
• Again, there is significant impairment in
social, occupational, academic, or
relationship functioning
Posttraumatic Stress Disorder
• The person has been exposed to a traumatic
event in which both of the following were
present
– The person experienced, witnessed, or was
confronted with an event or events that involved
actual or threatened death or serious injury, or a
threat to the physical integrity of self or others
– The person’s response involved intense fear,
helplessness, or horror.
Posttraumatic Stress Disorder
• The traumatic event is persistently re-experienced in on
or more of the following ways:
– Recurrent and intrusive distressing recollections of the event
including images, thoughts, or perceptions.
– Recurrent distressing dreams of the event.
– Acting or feeling as if the traumatic event were recurring
(includes a sense of reliving the experience, illusions,
hallucinations, and dissociative flashback episodes, including
those that occur on awakening or when intoxicated.
– Intense psychological distress at exposure to internal or external
cues that symbolize or resemble an aspect of the traumatic
event.
– Physiological reactivity on exposure to internal or external cues
that symbolize or resemble an aspect of the traumatic event.
Posttraumatic Stress Disorder
• Persistent avoidance of stimuli associated with the trauma and
numbing of general responsiveness (not present before the trauma),
as indicated by three or more of the following:
– Efforts to avoid thoughts, feelings, or converstaions associated with the
trauma
– Efforts to avoid activities, places, or people that arouse recollections of
the trauma
– Inability to recall an important aspect of the trauma
– Markedly diminished interest or participation in significant activities
– Feeling of detachment or estrangement from others
– Restricted range of affect (e.g., unable to have loving feelings)
– Sense of a foreshortened future (e.g., does not expect to have a career,
marriage, children, or a normal life span)
Posttraumatic Stress Disorder
• Persistent symptoms of increased arousal (not
present before the trauma), as indicated by two
(or more) of the following:
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Difficulty falling or staying asleep
Irritability or outbursts of anger
Difficulty concentrating
Hypervigilance
Exaggerated startle response
Posttraumatic Stress Disorder
• Duration of the disturbance is more than
one month
• The disturbance causes clinically
significant distress or impairment in social
occupational or other important areas of
functioning.
Acute Stress Disorder
• The person has been exposed to a traumatic
event in which both of the following are present
– The person experienced, witnessed, or was
confronted with an event or events that involved
actual or threatened death or serious injury, or threat
to the physical integrity of self or others.
– The person’s response involved intense fear,
helplessness, or horror.
Acute Stress Disorder
• Either while experiencing or after experiencing
the distressing event, the individual has three or
more of the following dissociative symptoms
– A subjective sense of numbing, detachment, or
absence of emotional responsiveness
– A reduction in awareness of his/her surroundings
(e.g., being in a daze)
– Derealization
– Depersonalization
– Dissociate amnesia
Acute Stress Disorder
• The traumatic event is persistently re-
experienced in at least one of the following ways
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Recurrent images
Thoughts
Dreams
Illusions
Flashback episodes
Sense of reliving the experiencing
Distress on exposure to reminders of the traumatic
event
Acute Stress Disorder
• Marked avoidance of stimuli that arouse recollections of the trauma
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(e.g., thoughts, feelings, conversations, activities, places, & people)
Marked symptoms of anxiety or increased arousal (e.g., difficulty
sleeping, irritability, poor concentration, hypervigilance, exaggerated
startle response, motor restlessness)
The disturbance causes clinically significant distress or impairment
in social occupational, or other important areas of functioning.
The disturbance lasts for a minimum of 2 days and a maximum of 4
weeks and occurs within 4 weeks of the traumatic event.
The disturbance is not due to the direct physiological effects of a
substance or a direct medical condition.
Generalized Anxiety Disorder
• Excessive anxiety and worry
(apprehensive expectation), occurring
more days than not for at least 6 months,
about a number of events or activities or
activities (such as work or school
performance)
• The person finds it difficult to control the
worry
Generalized Anxiety Disorder
• The anxiety and worry are associated with three
(or more) of the following symptoms (for the
past 6 months)
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Restlessness or feelings keyed up or on edge
Being easily fatigued
Difficulty concentrating or mind going blank
Irritability
Muscle tension
Sleep disturbance (difficulty falling or staying asleep,
restless unsatisfying sleep)
Generalized Anxiety Disorder
• The anxiety, worry, or physical symptoms
cause clinically significant distress or
impairment in social, occupational, or
other areas of functioning.
Other Anxiety Disorders
• Anxiety Disorders due to a General
Medical Condition
• Substance-induced Anxiety Disorder
• Anxiety Disorder Not Otherwise Specified