defining anxiety and anxiety disorders
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Defining Anxiety And Anxiety Disorders
• Anxiety
An unpleasant emotion characterized by a general sense of danger, dread, and physiological arousal
Common Components of Anxiety
Anxiety Disorders• Trait Anxiety
An individual’s tendency to respond to a variety of situations with more or less anxiety
• State AnxietyAn individual’s level of anxiety at a specific time
Classifying Anxiety Disorders(DSM-IV-TR)
Anxiety Disorders• Generalized Anxiety Disorder
Chronic, pervasive, and debilitating nervousness Chronic (>6 months), pervasive anxiety
Difficulty controlling the anxiety
The anxiety includes three or more of the following: Restlessness
Fatigue
Difficulty concentrating
Irritability
Muscle Tension
Sleep disturbance
Anxiety Disorders• Panic Disorder
Panic attacks that cause ongoing distress or impairment
• Panic attackDiscrete episode of acute terror in the absence of real danger
• Criteria for Panic DisorderEpisodes of intense panic (panic attacks)
Persistent concern about having additional attacks, worry about the consequences of an attack, or changes in behavior because of the attack
Anxiety Disorders
• A Panic Attack Cycle
Anxiety Disorders
• Criteria for Panic Disorder
Anxiety Disorders
• Phobias
An intense, persistent, and irrational fear and avoidance of a specific object or situation
Anxiety Disorders
• Types of Phobias
Social phobia
Agoraphobia
Specific phobia
Anxiety Disorders
• Social Phobia
A phobia in which fears are focused on social situations or other activities where there is a possibility of being observed and judged
Example:
Stage Fright
Anxiety Disorders
• AgoraphobiaA fear of wide open spaces or crowded places
Anxiety Disorders
• Specific phobiasAny phobia that is not a social phobia or agoraphobia
Four common types:
animals
natural environment
blood/injection/injury
situational
Anxiety Disorders• Obsessive-Compulsive Disorder
An anxiety disorder in which distressing and unwanted thoughts lead to compulsive rituals that significantly interfere with daily functioning
• Obsessions
Unwanted and upsetting thoughts or impulses
• Compulsions
Irrational rituals that are repeated in an effort to control or neutralize the anxiety brought on by obsessional thoughts
Anxiety Disorders
• Criteria for Phobias
Anxiety Disorders
• Obsessive-Compulsive Disorder
Anxiety Disorders
Anxiety Disorders• Postraumatic and Acute Stress Disorders
• Trauma An emotionally overwhelming experience in which there is a real or perceived possibility of death or serious injury to oneself or a loved one
Anxiety Disorders
• Acute stress disorder
Significant posttraumatic anxiety symptoms that occur within one month of a traumatic experience.
• Posttraumatic stress disorder
Significant posttraumatic anxiety symptoms occurring more than one month after a traumatic experience
Anxiety Disorders
Anxiety DisordersDiagnostic Criteria for Posttraumatic Stress
Disorder (continued)
Anxiety Disorders
Anxiety Disorders
• Advantages and Limitations of the DSM-IV-TR Anxiety Disorder Diagnoses
Comorbidity
The presence of two or more disorders in one person, or a general association between two or more different disorders.
Anxiety Disorders
Anxiety Disorders• Classification in Demographic Context
Age
Separation Anxiety Disorder (SAD)
Gender
Disproportionate rates of anxiety disorders in women have noted that traditional female gender roles have not typically emphasized assertion and self-sufficiency — skills that are important for overcoming anxiety.
Class
People living in poor urban environments are at increased risk for developing PTSD.
Explaining and Treating
Anxiety Disorders• Biological Components
The Autonomic Nervous System
sympathetic nervous system
parasympathetic nervous system
flight-or-fight response
Genetic factors= predisposition
Explaining and Treating
Anxiety Disorders
• Limbic System
amygdala
hippocampus
hypothalamus
Explaining and Treating
Anxiety Disorders
• Biological Interventions
Barbiturates
Benzodiazepines
Anxiety Disorders
• Biological Interventions
Panic Disorder and Agoraphobia
SSRIs
prozac, zoloft, paxil
Tricyclics
tofranil, elavil, and sinequan
Anxiety Disorders
• Biological Interventions
Obsessive-Compulsive Disorder
SSRIs
benzodiazepines and neuroleptics to augment
neuroleptic
Anxiety Disorders
• Biological Interventions
Post Traumatic Stress Disorder
SSRIs
Wellbutrin (bupropion)
Anxiety Disorders
• Biological Interventions
Social Phobias
SSRIs
Beta-blockers
Anxiety Disorders
• Biological Interventions
Generalized Anxiety Disorder
Paxil
Effexor
BuSpar
Anxiety Disorders
• Behavioral Components
Classical conditioning
Little Albert (Watson & Raynor)
Anxiety Disorders
• Behavioral Components
Operant conditioning
Modeling
Anxiety Disorders• Behavioral Interventions
Phobias
systematic desensitization
in vivo desensitization
relaxation training
flooding
Anxiety Disorders
• Behavioral Interventions
Panic Disorder
systematic desensitization
in vivo desensitization
flooding
Anxiety Disorders
• Behavioral InterventionsObsessive-Compulsive Disorder
exposure and response prevention
Anxiety Disorders
• Behavioral Interventions
Post Traumatic Stress Disorder
prolonged imaginal exposure
Anxiety Disorders
• Cognitive Components
Cognitive schemas
Anxiety Disorders
• Cognitive Components
Anxiety Disorders
• Cognitive Interventions
Anxiety Disorders
• Psychodynamic Components
Freud
repression
Anxiety Disorders
• Psychodynamic Components
Phobias
displacement
Oedipus complex
projection
Anxiety Disorders
• Psychodynamic Components
isolation of affect
undoing
Cheat on wife Buy wife a mink coat
Anxiety Disorders
• Psychodynamic Interventions
resistance
transference
Anxiety Disorders
• Humanistic and Existential Components
maladaptive emotional scheme
A humanistic term for patterns of thought and feeling that emerge around salient emotional experiences (usually in childhood) and are activated in similar situations during adulthood.
Anxiety Disorders
• Humanistic and Existential Interventions
development of a strong therapeutic alliance that allows for the recognition and exploration of painful emotional experiences
Anxiety Disorders
• Multiple Causality in Anxiety Disorders
Integrated cognitive and behavioral approaches
Cognitive-psychodynamic overlap
Combined behavioral-biological
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