phobic anxiety disorders. what is a phobia ? persistent irrational fear of an object, activity or...
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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
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
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
Panic Attacks
Shortness of breathChokingPalpitationsSweatingDizziness, unsteady feelings, faintnessNausea, abdominal distressNumbness, tingling sensationFlushes or chillsTrembling or shakingFear 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”
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 SeminarsAvoidance 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.
Treatment
Psychological Treatment
Cognitive Behaviour Therapy
Social skills training
Relaxation training
Exposure
Drug Treatment