Transcript Phobic Anxiety Disorders

Phobic Anxiety
Disorders
What is a phobia ?
Persistent irrational fear of an
object, activity or situation and a
wish to avoid it.
Phobic anxiety disorder
Core symptoms of Anxiety
(Generalized Anxiety Disorder)
Tremor
Palpitation
Sweating
Blurring of vision etc…..
Occurs only in particular
circumstances
Situations
eg. Crowded places
Objects
eg. Spiders
Natural Phenomena
eg. Thunder
Avoidance of circumstances that
provoke anxiety
Anticipatory Anxiety
Types of phobic anxiety disorders
Specific ( Simple ) Phobias
Agoraphobia
Social Phobia
Specific ( Simple ) Phobias
Inappropriately anxious in the presence
of one or more particular objects or
situations.
Symptoms of anxiety
Avoidance of circumstances that provoke
anxiety
Anticipatory Anxiety
Eg. Phobia of heights
Spider phobia
Phobia of illnesses
Phobia of dental treatment
phobia of flying
Prevalence
Life time prevalence
Men 4 %
Women 13 %
Aetiology
Continuation of childhood phobias
Genetic
Following a stressful experience
Psychoanalytic explanation
Management
Assess severity and level of
incapacitation
Behaviour Therapy
graded exposure with relaxation
training
Agoraphobia
Anxiety when - away from home
- in crowds
- situations they can’t leave easily
- open spaces
- social situations
eg. Buses
Super markets
Cinemas
Anxiety symptoms
Anxious cognitions about fainting
and loss of control
Panic attacks
Panic Attacks
Shortness of breath
Choking
Palpitations
Sweating
Dizziness, unsteady feelings, faintness
Nausea, abdominal distress
Numbness, tingling sensation
Flushes or chills
Trembling or shaking
Fear of dying
Fear of going crazy or losing control
As the illness progresses the patient
tends to avoid more and more
situations
Severe cases
“ Housebound Housewife syndrome”
Less anxious when accompanied by a
trusted companion
- Child
- Dog
- Object
Anticipatory Anxiety
Avoidance
Other anxiety symptoms like
depersonalization
Depressive symptoms
Onset - early and middle twenties
mid thirties
Women > Men
Agoraphobia without panic disorder
1.7 % in men
3.8 % in women
Life time prevalence 6 - 10 %
Aetiology
Cognitive theories - people who are
unreasonably fearful
Biological theories - Normal inhibitory
mechanisms are defective
Psychoanalytic theories
Personality -
Dependent
Avoidance rather than
confronting problems
Overprotective family
can maintain symptoms
Management
Assess
Find out the severity of the problem
Psychological Management
Behaviour Therapy – exposure and
relaxation training
Cognitive Behaviour Therapy
Chemotherapy
Anxiolytic drugs - not regularly
Antidepressant drugs
Tricyclics eg . Imipramine
SSRIs
MAOIs
Social phobia
Excessive, inappropriate anxiety in places
where patient feels he is observed or
could be criticized .
They avoid such situations
eg . Parties
Canteens
Seminars
Avoidance and escape make situation
worse.
Prevalence
One year prevalence
Women – 9 %
Men – 7 %
Onset usually between 17 and 30 years.
The symptoms can last for several years.
Aetiology
Genetic Factor
Cognitive Factor
self critical
perfectionist
low self esteem
Treatment
Psychological Treatment
Cognitive Behaviour Therapy
Social skills training
Relaxation training
Exposure
Drug Treatment