Anxiety DisordersAnxiety Disorders

““The Dark side of Fear”The Dark side of Fear”

Definitions

• Fear: A short-term emotional and physiological reaction to a threatening event

• Anxiety: A longer-term sense of apprehension

Anxiety Disorders

• Anxiety so intense and long-lasting that it disrupts the person’s daily functioning.

Table 12.3 Phobias

Description: An intense, irrational fear of an object or situation.

Key to Phobias

Irrational fear triggered by unconscious mind

DSM-IV Phobia Subtypes

• Specific Phobia: particular stimuli and situations• Social Phobia: negatively evaluated by others or

being embarrassing or humiliated• Agoraphobia: fear of being separated from a safe

place/person (fear of fear)

Generalized Anxiety Disorder

• Description“Free floating anxiety with no trigger”

• Symptoms– 1. Excessive worry (health, money, family, work)

– 2. Insomnia, impatience

– 3. Sweating

– 4. Muscle Tension

– 5. Fatigue

Panic Disorder

• Description: experience of recurrent terrifying panic attacks

• shortness of breath and irregular heartbeat

• dizziness and feelings of unreality

– can occur while sleeping– associated with agoraphobia (“comorbidity”)– concerns about “going crazy”

Obsessive-Compulsive Disorder

• Description: persistent, upsetting, and unwarranted thoughts (obsessions) that motivate repetitive behaviors (compulsions)– obsession causes anxiety, compulsion reduces it– equally common in men and women– often associated with depression

Obsessions

– dirt, germs or toxins– something terrible is happening (fire, death or

illness)– symmetry, order or exactness

Compulsions

– Checking rituals: checking locks, car brakes, appliances, homework, etc.

– Cleaning rituals: hand-washing, bathing, brushing teeth, etc.

– Other: getting in/out of chair, opening/closing doors, etc.

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10

15

30

Percent

0Contamination Harm Exactness

5

20

25

35

40

Checking Cleaning/ washing

Repeating

Obsessions Compulsions

OCD Spectrum

• Somatic Preoccupation – anorexia

– bulimia

– body dysmorphic

• Impluse– shopping

– kleptomania

– gambling

– paraphilias

Germophobe “Howie Mandel”

– doesn’t shake hands– but hugs and kisses “Live with Regis and Kelly”

– antibacterial gel from audience member

Biology of Anxiety Disorders

• Biological Factors– locus coeruleus, norepinephrine, PANIC– orbital frontal/cingulate, OCD– neurotransmitter GABA in generalized anxiety

Locus Coeruleus

Anxiety Disorders and Learning

• Compulsive behavior are learned responses which removes temporarily remove distress (trigger could be a thought)

• Some phobias acquired through learning– biologically prepared to learn certain phobias– snake fears learned via observation

Other Causes

• Psychological Factors– Environmental stressors– Ways of thinking

Somatoform Disorders

Can mental disorder cause blindness?

Somatoform Disorders

• body disorder even though there is no physical cause

• Conversion Disorder:– appear when person is under severe distress.

– disorder enables person to avoid unpleasant situations.

– organically impossible or improbable symptoms

– little concern for this “serious” problem

Other Somatoform Disorders

• Hypochondriasis: strong, unjustified fear of serious physical problem

• Somatization Disorder: dramatic but vague, reports about a multitude of physical problems

• Pain Disorder: severe, often constant pain with no physical cause.

Anxiety Disorder Treatments

• Behavior Therapy– 1. systematic desensitization/exposure therapy– 2. response blocking/prevention (OCD)– 3. flooding/implosion

• Drugs– yes to antidepressants, no to tranquillizers (valium)

• Cognitive– thinking, rumination, worry

• Exercise/Progressive Muscle Relaxation/Yoga

Next

Exposure Therapy

• hierarchy of fearful stimuli • learn relaxation methods• gradual exposure to imagined stimuli in relaxed

state

• substitute real stimuli

JosephWolpe

Virtual Reality Exposure Therapy

Virtually Better

Virtual Heights Virtual Storm

Virtually Better

Virtual Audience Virtual Vietnam

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