CHAPTER 7

ANXIETY DISORDERS

THE EXPERIECE OF ANXIETY

Worry Fear Apprehension Intrusive thoughts Physical symptoms Tension Experience comes more from individual

than situational factors Sufferers often not clear as to origins of

their anxiety

ANXIETY DISORDERS

Generalized anxiety disorder Panic disorder Phobias Obsessive-compulsive disorder Posttraumatic stress disorder

(PTSD)

ANXIETY DISORDERS IN THE U.S.

GENERALIZED ANXIETY DISORDER

Vague, intense concerns and fearfulness

Lasts at least six months Symptoms

Motor tension Autonomic reactivity Apprehension about future Hypervigilance

Duration Protracted, often 20 years or more

Treatment Cognitive, psychodynamic, and behavioral

therapy Anti-anxiety medication

PANIC DISORDER

Recurrent unexpected panic attacks lasting from seconds to hours and days

Physiological arousal Shortness of breath, chest pains Trembling, sweating, dizziness

Feelings of helplessness Fear of recurrent attacks Biological, psychological, and psychosocial

factors play a role Cognitive-behavioral therapy and

antidepressant medication are sometimes effective

PHOBIC DISORDERS

Specific Phobias – Fears related to specific objects, people, or situations

Social Phobias – Intense, incapacitating fear and embarrassment when dealing with others

Agoraphobia – Fear of leaving home With panic attacks Without panic attacks

Treatment for Phobic Disorders Exposure therapy helpful in treatment of

phobias Agoraphobia with panic attacks sometimes

treated with antidepressant medication

FIVE CATEGORIES OF PHOBIAS

Type of Fear Examples of Fears

Separation fearsCrowds, traveling alone, being at home alone

Social fearsEating with strangers, being watched while writing or working

Animal fears Mice, rats, and insects

Nature fears Mountains, the ocean, heights

Mutilation fears Open wounds, surgery, blood

COGNITIVE INTERPRETATION OF SOCIAL PHOBIA

SYMPTOMS ASSOCIATED WITH PANIC DISORDER AND GENERALIZED ANXIETY

DISORDER

PANIC DISORDER COMPARED WITH GENERALIZED ANXIETY DISORDER

COMPARED

Clinical onset of panic disorder is later. The role of heredity appears to be

greater in panic disorder. The ratio of women to men is greater

in panic disorder. Alcoholism is more common in people

suffering from panic disorder. Depression is more common in panic

disorder.

OBSESSIVE-COMPULSIVE DISORDER

Preoccupation with specific ideas or thoughts (obsessive) and unable to resist repeated behaviors (compulsive)

Obsessions Doubt, hesitation, fear of contamination, fear

of one’s own aggression Compulsions

Counting, ordering, checking, touching, and washing

Begins before adulthood, more common in women

Exposure and response prevention therapies and serotonin-related drugs are helpful.

POSTTRAUMATIC STRESS DISORDER (PTSD)

Occurs after extreme stress Natural disaster, serious accident, war-

related situations Symptoms

Flashbacks, recurrent dreams, impaired concentration, emotional numbing lasting more than one month

Treatment Insight psychotherapy Behavior therapy

INTERPRETING AND TREATINGANXIETY DISORDERS

Psychodynamic perspective Therapy aimed at gaining insight into

unconscious roots of loss and abandonment Behavioral perspective

Therapeutic interventions to change behavior include exposure therapy, systematic desensitization, implosive therapy, in vivo exposure, flooding, and modeling

Cognitive perspective Therapy aimed at changing maladaptive

thoughts include cognitive restructuring, thought stopping, and cognitive rehearsal

Biological perspective Genetic and environmental factors Anti-anxiety medications