Transcript Anxiety Disorders - People Server at UNCW

Anxiety Disorders
WEB
Anxiety as a Normal
and an Abnormal Response
• Some amount of anxiety is “normal” and is
associated with optimal levels of
functioning.
• Only when anxiety begins to interfere with
social or occupational functioning is it
considered “abnormal.”
The Fear and Anxiety Response
Patterns
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Fear
Panic
Anxiety
Anxiety Disorder
The Bell Curve
An Important Law- The Yerkes Dodson Law
Another Bell CurveCourtesy of Our Good Buddies Yerkes-Dodsen
Phobic Disorders
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Phobias
Specific phobias
Social phobia
Agoraphobia
Specific Phobias
Specific Phobias
• Psychosocial causal factors
• Genetic and temperamental causal factors
• Preparedness and the nonrandom
distribution of fears and phobias
• Treating specific phobias
Social Phobia
• General characteristics
Fear of being in social situations in
which one will be embarrassed or
humiliated
Social Phobia
• Interaction of psychosocial and biological
causal factors
– Social phobias as learned behavior
– Social fears and phobias in an evolutionary
context
– Preparedness and social phobia
Social Phobia
• Interaction of psychosocial and biological
causal factors
– Genetic and temperamental factors
– Perceptions of uncontrollability
– Cognitive variables
Panic Disorder With and
Without Agoraphobia
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Panic disorder
Panic versus anxiety
Agoraphobia
Agoraphobia without panic
Panic Disorder
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Prevalence and age of onset
Comorbidity with other disorders
Biological causal factors
The role of Norepinephrine and
Serotonin
Panic and the Brain
Panic Disorder
• Genetic factors
• Cognitive and behavioral causal factors
• Interoceptive fears
Panic Disorder: The Cognitive
Theory of Panic
Panic Disorder: The Cognitive
Theory of Panic
• Perceived control and safety
• Anxiety sensitivity as a vulnerability factor
for panic
• Safety behaviors and the persistence of
panic
• Cognitive biases and the maintenance of
panic
Treating Panic Disorder and
Agoraphobia
• Medications
• Behavioral and
cognitive-behavioral
treatments
Generalized Anxiety Disorder
• General characteristics
• Prevalence and age of onset
• Comorbidity with other disorders
Generalized Anxiety Disorder:
Psychosocial Causal Factors
• The psychoanalytic viewpoint
• Classical conditioning to many stimuli
• The role of unpredictable and uncontrollable
events
• A sense of mastery: immunizing against
anxiety
Generalized Anxiety Disorder:
Biological Causal Factors
• Genetic factors
• A functional deficiency of GABA
• Neurobiological differences between
anxiety and panic
Obsessive-Compulsive Disorder
• Obsessions- repetitive unwanted ideas that
the person recognizes are irrational
• Compulsions- repetitive, often ritualized
behavior whose behavior serves to
diminish anxiety caused by obsessions
Obsessive-Compulsive Disorder
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Prevalence and age of onset
Characteristics of OCD
Types of compulsions
Comorbidity with other disorders
Obsessive-Compulsive Disorder:
Psychosocial Causal Factors
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Psychoanalytic viewpoint
Behavioral viewpoint
The role of memory
Attempting to suppress obsessive thoughts
Obsessive-Compulsive Disorder:
Biological Causal Factors
• Genetic influences
• Abnormalities in brain
function
• The role of serotonin
Post-Traumatic Stress Disorder
• Critical Component
– Symptoms occurs AFTER a traumatic stressor
Symptoms Categories
• Intrusive
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distressing recollections
dreams
flashbacks
psychological trigger reactions
physiological trigger reactions
Symptoms Categories
• Avoidance
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avoid thoughts, feelings or discussions
avoid activities, places
memory blocks
anhedonia (without pleasure)
numb
alexithymia (emotions unknown)
feeling of doom
Symptom Categories
• Hyperarousal Symptoms
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sleep disturbance
anger problems
concentration
startle response
“on guard” hypervigilence
Diagnoses
• Acute Stress Disorder
– new to DSM-IV (1994)
– symptoms 2 days to 4 weeks following
traumatic event
• PTSD
– new to DSM-III (1980)
– symptoms beyond 4 weeks
– delayed onset
Who Is Vulnerable?
• All ages
• Both genders
• Across Cultures and ethnic groups
Some Stats
Andrews, Wahlberg,
Montgomery (1993)
70
60
50
40
30
Frequency
20
10
0
Black
Hispanic
Native
American
White
Employment
60
50
40
30
Frequency
20
10
0
Employed
Umemployed
Depression
35
30
25
20
Enter
Exit
15
10
5
0
Total Group
Severe PTSD
Moderate PTSD
Types of Traumas
• Natural
– earthquakes
– floods
– fires
• Human induces
– war
– crimes of violence
Co-Morbid Diagnoses
• Alcoholism
– 75% for Vietnam Veterans with PTSD
• Depression
– 77% of firefighters with PTSD also have
depression
• Generalized Anxiety
• Panic Attacks