Defining Anxiety And Anxiety Disorders

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