Transcript Anxiety Disorders

Anxiety Disorders
A Closer Look at Psychological
Disorders
First, a warning…
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Don’t overreact if you begin to discover in yourself
some of the symptoms we will discuss. That’s
typical.
We all have some of these symptoms some of the
time.
Just remember, they do not suggest a disorder
unless they meet all four of the criteria we
talked about before – the symptoms must be
maladaptive, unjustifiable, disturbing, and
atypical.
Anxiety Disorders
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Anxiety is a general state of
dread or uneasiness that a
person feels in response to a
real or imagined danger.
People suffering from anxiety
disorders feel anxiety but not just
normal anxiety. They suffer
anxiety that is out of proportion
to the situation provoking it.
Anxiety disorders are the most
common type of mental illness in
the United States, affecting 40
million Americans annually.
Portion of population meeting criteria for disorder (%)
0
5
10
15
20
25
30
35
40
45
50
Category
Any Disorder
Substance Use
Disorders (Including
Alcoholism)
Anxiety Disorders
Mood Disorders
Schizophrenic
Disorders
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Anxiety Disorders (cont.)
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There are several different kinds of anxiety disorders:
Anxiety
Disorders
Generalized
anxiety
disorder
Panic
disorder
Phobia
Obsessivecompulsive
disorder
Posttraumatic
stress
disorder
Generalized Anxiety Disorder
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An anxiety disorder in which a person is continuously
tense, apprehensive and in a state of autonomic
nervous system arousal (“free-floating” anxiety).
While we all may experience the symptoms of G.A.D
For true sufferers, the symptoms are more lasting and
are often not attached to any specific event.
Individuals with generalized anxiety disorder must
experience at least 3 of the following symptoms:
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Restlessness
Feeling on edge
Difficulty concentrating or mind going blank
Irritability
Muscle tension
Sleep disturbance
Panic Disorder
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Panic is a feeling of sudden, helpless terror, such as the
overwhelming fright one might experience when cornered by a
predator.
Sufferers of a panic disorder have anxiety accompanied by panic
attacks – episodes of unexplained terror and fear that something
bad is going to happen.
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Symptoms: may include a sense of smothering, choking, or
difficulty breathing; faintness or dizziness; nausea; and chest
pains.
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Panic attacks can last for a few minutes or for an hour or more.
Panic disorder may be inherited.
The panic victim usually experiences the first attack shortly after
a stressful event, but future attacks usually appear out of
nowhere.
Can cause secondary disorders, such as agoraphobia.
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After a number of panic attacks, victims may become so concerned
about exhibiting panic in public that they may be afraid to leave home,
developing agoraphobia, or a fear of going out in public
Examples of People Suffering from
Jonathan
Panic Disorder and
Jordan
http://www.y
outube.com/
watch?v=27
7Q8dsArhI
Panic Disorder
http://www.youtube.com/watch?v=
2gNGUartUEI
NKOTB - Jon and Jordan Knight talk Panic
disorder
http://www.youtube.com/watch?v=gR4AOEOjp4s&f
eature=related
Phobic Disorder
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The word “phobia” is the Greek word for “morbid fear.”
It refers to Phobos, the Greek god of terror. The names
of most phobias begin with the Greek word for the feared
object or situation.
A phobia is a fear that is both irrational and disruptive
(impairs the ability to lead a normal life).
People can have
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Specific phobias – fear of a particular object, thing, or
situation (heights, dogs, spiders, enclosed spaces, etc.)
Social phobias – fear you will embarrass yourself in a social
setting (fear of speaking in public, eating in public, meeting
strangers, etc.)
Agoraphobia – fear of being away from a safe place (like
home); of being away from a familiar person (like a spouse);
or of being in crowds or in other situations that are difficult to
leave.
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Going out by
oneself
Being alone
Crowds
Social Phobias
Tunnels or bridges
Public transport
Eating in public
Speaking to new
acquaintances
Simple Phobias
Speaking in public
Animals
Closed places
Storms
Water
Heights
Bugs, mice,
snakes, bats
Portion of population
reporting each phobia (%)
Type of Phobias
Agoraphobias
25
20
15
10
5
0
Eating
Disorders
Phobias beginning with “o”:
Obesophobia- Fear of gaining weight.
Ochlophobia- Fear of crowds or mobs.
Ochophobia- Fear of vehicles.
Octophobia - Fear of the figure 8.
Odontophobia- Fear of teeth or dental
surgery.
Odynophobia or Odynephobia- Fear of
pain.
Oenophobia- Fear of wines.
Oikophobia- Fear of home surroundings,
house.
Olfactophobia- Fear of smells.
Ombrophobia- Fear of rain or of being
rained on.
Ommetaphobia or Ommatophobia- Fear
of eyes.
Oneirophobia- Fear of dreams.
Onomatophobia- Fear of hearing a
certain word or of names.
Ophidiophobia- Fear of snakes.
(Snakephobia)
Ophthalmophobia- Fear of being stared
at.
Opiophobia- Fear medical doctors
experience of prescribing needed
pain medications for patients.
Optophobia- Fear of opening one's
eyes.
Ornithophobia- Fear of birds.
Orthophobia- Fear of property.
Osmophobia or Osphresiophobia- Fear
of smells or odors.
Ostraconophobia- Fear of shellfish.
Ouranophobia or Uranophobia- Fear of
heaven.
The Phobia List Link
Obsessive-Compulsive Disorder
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Two major components:
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Obsessions – repetitive __________
Compulsions – repetitive ____________
Obsessions and compulsions are not always
bad things…
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You might become obsessed with the lyrics to your favorite
song, which get stuck in your head all day
A good athlete might be obsessed with winning and
compulsive about training. A good student might be
obsessed with grades and compulsive about studying.
These are not bad things.
Obsessive-Compulsive Disorder (cont.)
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When are obsessions and
compulsions harmful?
When they begin to take
control with some people,
what could have been helpful
tendencies become obsessivecompulsive disorder.
If sufferers are prevented
from engaging in their ritual
behavior, ___________ and
__________ rapidly build.
What Causes Obsessive-Compulsive
Disorder?
Possible causes:
 Obsessions: may serve as
diversions from a
person’s real fears and
their origins and thus may
reduce anxiety.
 Compulsions: provide a
disturbed person with the
evidence that he is at least
doing something well.
Some possible symptoms of OCD
Symptoms may include some, all, or perhaps
none of the following:
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Repeated hand washing or repeated clearing of the throat, although
nothing may need to be cleared.
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Specific counting systems — e.g., counting in groups of four,
arranging objects in groups of three, grouping objects in odd/even
numbered groups, "counting" steps — e.g., feeling the necessity to
take 12 steps to the car in the morning.
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Perfectly aligning objects at complete, absolute right angles, or
aligning objects perfectly parallel etc.
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Having to "cancel out" bad thoughts with good thoughts, like
imagining harming a child and having to imagine a child playing
happily to cancel it out.
Some possible symptoms of OCD
Symptoms may include some, all, or perhaps none of the following:
 A fear of contamination; some sufferers may fear the presence of
human body secretions such as saliva, blood, sweat, tears, vomit, or
mucus, or excretions such as urine or feces. Some OCD sufferers
even fear that the soap they're using is contaminated.
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A need for both sides of the body to feel even. If one hand gets wet,
the sufferer may feel very uncomfortable if the other is not. If the
sufferer is walking and bumps into something, he/she may hit the
object or person back to feel a sense of evenness. These symptoms
are also experienced in a reversed manner. Some sufferers would
rather things to be uneven, favoring the preferred side of the body.
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An obsession with numbers (be it in math class, watching TV, or in a
room). Some people are obsessed with even numbers and loathe
odd numbers (odd numbers cause them a great deal of anxiety and
often make the person uncomfortable or even angry) or vice versa.
Examples of People with OCD
http://www.videobash.com/video_s
how/chad-s-ocd-from-obsessedon-a-amp-e-655399
Howie Mandel
talks about living
with OCD
http://www.youtub
e.com/watch?v=d
SZNnz9SM4g
Examples of People with OCD
As a young man (shown in the photo), Howard Hughes was a handsome, dashing
daredevil pilot and movie producer who appeared to be reasonably well adjusted.
However, as the years went by, his behavior gradually became more and more
maladaptive, as obsessions and compulsions came to dominate his life. In his later
years (shown in the drawing), he spent most of his time in darkened rooms, naked,
unkempt, and dirty, following bizarre rituals to alleviate his anxieties. (The drawing was
done by an NBC artist and was based on descriptions from men who had seen Hughes.)
Post-traumatic Stress
Disorder
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A condition in which a person who has
experienced a traumatic event feels severe and longlasting after-effects.
Intense stress is the trigger, and symptoms include
nightmares, persistent fear, difficulty relating normally
to others, and troubling memories or flashbacks of the
traumatic event.
PTSD can be extremely long-lasting, lasting decades
after the event.
People who are exposed repeatedly or over a long
period of time to distressing conditions are more likely
to develop the disorder
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Example: military combat veterans, rape and assault victims,
abused children, survivors of natural disasters, etc.
Resilience to PTSD
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Only about 10% of women and 20% of men
react to traumatic situations and develop
PTSD.
Holocaust survivors show remarkable
resilience against traumatic situations.
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Can you think of examples of
people/characters from literature, TV, or
movies who suffered from the following
disorders?
Phobic disorder
 Panic disorder
 Obsessive-compulsive disorder
 Post-traumatic stress disorder
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Etiology of Anxiety
Disorders
What causes an anxiety
disorder?
What Causes Anxiety Disorders?
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Predictions:
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What Causes Anxiety Disorders?
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As always seems to be the case, one has
to consider both nature and nurture for
possible explanations as to the cause of
anxiety disorders.
What Causes Anxiety Disorders? (cont.)
 Nature
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(biological):
Heredity – a likelihood for developing anxiety
disorders. The specific fear may not be inherited,
but the predisposition to be fearful is.
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Twin studies suggest a moderate genetic predisposition
to anxiety disorders. They may be more likely in people
who are especially sensitive to the physiological
symptoms of anxiety.
Figure 14.6: Twin studies of anxiety
disorders.
The concordance rate for anxiety
disorders in identical twins is higher
than that for fraternal twins, who share
less genetic overlap. These results
suggest that there is a genetic
predisposition to anxiety disorders.
(Data based on Noyes et al., 1987;
Slater & Shields, 1969; Torgersen,
1979, 1983)
What Causes Anxiety Disorders? (cont.)
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Nature (biological):
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Brain function – Brain scans show that people with anxiety
disorders have brains that literally function differently
from those who don’t (like in the amygdala, the emotion
center). This is why such disorders often respond to
medication.
Abnormalities in neurotransmitter activity at GABA synapses
have been implicated in some types of anxiety disorders, and
abnormalities in serotonin synapses have been implicated in
panic and obsessive-compulsive disorders.
Generalized
anxiety, panic
attacks, and even
OCD are linked
with brain circuits
like the anterior
cingulate cortex.
Anterior Cingulate Cortex
of an OCD patient.
A PET scan of the brain
of a person with
Obsessive-Compulsive
Disorder (OCD). High
metabolic activity (red)
in the frontal lobe areas
are involved with
directing attention.
Brain image of an
OCD patient
What Causes Anxiety Disorders? (cont.)
 Nature
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(biological):
Evolution – We are likely to fear situations that
posed danger to the earliest humans. People who
didn’t have a healthy dose of fear were less likely
to survive. Those who did survive passed on their
tendency to fear these dangers to us.
 Note: We don’t have a similar inherited tendency to
fear threats that have developed more recently.
Cars, for example, kill more people in the modern
world than snake bites do, yet more people fear
snakes than fear cars.
What Causes Anxiety Disorders? (cont.)
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Nurture (learning):
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Conditioning – We associate fear with certain places or
things (like Little Albert). Many anxiety responses, especially
phobias, may be caused by classical conditioning and
maintained by operant conditioning (we are rewarded when
our anxiety is reduced because we avoid the object, for
example).
Observational learning – We can also learn fears from our
parents our older siblings. If we see them experience fear
during a thunderstorm, we may learn to fear thunderstorms
as well (remember the caged monkeys who became afraid of
snakes).
Reinforcement – We also learn to associate emotions with
actions, depending on the results that follow those actions. If
it will reduce our anxiety or fear, we will continue the
behavior. (If we are afraid of heights, we learn to avoid
heights. Someone with OCD might learn that his compulsive
hand-washing reduces his anxiety, so he repeats the
behavior.
Figure 14.7: Conditioning as an explanation for phobias.
(a) Many phobias appear to be acquired through classical conditioning when a neutral
stimulus is paired with an anxiety-arousing stimulus. (b) Once acquired, a phobia may
be maintained through operant conditioning. Avoidance of the phobic stimulus reduces
anxiety, resulting in negative reinforcement.
What Causes Anxiety Disorders? (cont.)
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Other Explanations for Anxiety Disorders:
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Our Unconscious – Freud suggested that we repress our
painful and intolerable ideas, feelings, and thoughts, resulting in
anxiety.
Cognitive Theories – Cognitive theories hold that certain styles
of thinking, over-interpreting harmless situations as threatening,
for example, make some people more vulnerable to anxiety
disorders.
Personality – The personality trait of neuroticism has been
linked to anxiety disorders, and stress appears to precipitate the
onset of anxiety disorders.
Figure 14.8: Cognitive factors in anxiety disorders.
Eysenck and his colleagues (1991) compared how
subjects with anxiety problems and nonanxious
subjects tended to interpret sentences that could be
viewed as threatening or nonthreatening. Consistent
with cognitive models of anxiety disorders, anxious
subjects were more likely to interpret the sentences in
a threatening light.