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Anxiety DisordersAnxiety Disorders
Thomas G. Bowers, Ph.D.
Penn State Harrisburg
Anxiety DisordersAnxiety Disorders
• Anxiety • Subjective distress, fear, apprehension• Elevated heart rate, rapid breathing, • Highly similar to fearfulness, but thought to be
irrational or unrealistic
Types of Anxiety DisordersTypes of Anxiety Disorders
Phobias
Fear mediated avoidance, thought to be unrealisticSome examples– claustrophobia
Fear of closed spaces– agoraphobia
Fear of public places– acrophobia
Fear of heights
Types of Anxiety DisordersTypes of Anxiety Disorders
Phobias
Some other examples– Specific phobias
Specific unwanted fears– Social phobia
Relatively common
Types of Anxiety DisordersTypes of Anxiety Disorders
Panic Disorder
Sudden and often unexpected attack of anxiety symptoms
Heart palpitations, nausea, choking, dizziness, trembling, apprehension, even terror
Often associated with stress
Types of Anxiety DisordersTypes of Anxiety Disorders
Generalized Anxiety Disorders
Persistent anxiety, chronic, uncontrollable worry
“Free floating”
Types of Anxiety DisordersTypes of Anxiety Disorders
Obsessive-Compulsive Disorder
Persistent and uncontrollable thoughts and feelings of a compulsion to repeat certain acts
Depression also often noted
Types of Anxiety DisordersTypes of Anxiety Disorders
Posttraumatic Stress Disorder (PTSD)
Introduced in 1980 (DSM-III)
Earlier conceptions:
1. “Shell shock” (WWI and WWII)
2. “Combat neurosis” (Korea)
3. Noted in Civil War
Types of Anxiety DisordersTypes of Anxiety Disorders
Posttraumatic Stress Disorder (PTSD)
Extreme response to severe stressor
Increased anxiety, avoidance of stimuli associated with trauma, numbing of emotional responses
Types of Anxiety DisordersTypes of Anxiety Disorders
Acute Stress Disorder (ASD)
New to DSM IV
Recovery in about one month
Types of Anxiety DisordersTypes of Anxiety Disorders
PTSD symptoms
1. Re-experiencing the traumatic event
2. Avoidance of the stimuli associated with the event or a numbing of responsiveness
3. Increased arousal
Etiology of Anxiety Etiology of Anxiety DisordersDisorders
• Varied theoretical views
• Psychoanalytical theories– Anxiety in general represents repressed id
impulses– The repressed impulses are displaced to
object with some symbolic connection– Represents neurotic level of adjustment
Etiology of Anxiety Etiology of Anxiety DisordersDisorders
• Behavioral theories– Anxiety is learned– Avoidance conditioning - classical
conditioning to a previously neutral stimulus condition
– Little Albert Case - conditioned by Watson and Rayner to develop a fear of a white rat
Etiology of Anxiety Etiology of Anxiety DisordersDisorders
• Behavioral theories– Avoidance conditioning can not account for
all of anxiety, however– Modeling theories - vicarious or
observational learning
Etiology of Anxiety Etiology of Anxiety DisordersDisorders
• Cognitive Behavioral Theories– Some patterns of thoughts (as worry) may
be maintained by avoiding even less pleasant emotions
– Uncontrollable environmental conditions also could contribute to misperception
Etiology of Anxiety Etiology of Anxiety DisordersDisorders
• Biological Views– There may be genetic components to
neuroticism– benzodiazepines (also known as minor
tranquilizers) are effective in treating anxiety
– Linked with inhibitory neurotransmitter GABA (gamma-aminobutyric acid)
Etiology of Anxiety Etiology of Anxiety DisordersDisorders
• Biological Views– Linked with inhibitory
neurotransmitter GABA (gamma-aminobutyric acid)
– Increase in GABA levels yields decreased anxiety
Treatment of Anxiety Treatment of Anxiety DisordersDisorders
• Analytical– Long relationship, ‘reparent,’ resolve
fundamental issues
• Behavioral – Desensitization for phobic concerns– Flooding
Treatment of Anxiety Treatment of Anxiety DisordersDisorders
• Cognitive behavioral– Interpretation, reformulation of thought
process– Gradual approximation of behaviors– Modeling– Social support
Treatment of Anxiety Treatment of Anxiety DisordersDisorders
• Biological – benzodiazepines– Use of minor
tranquilizers as Valium, Librium, more recently BuSpar
– Some dependence liability
Treatment of Anxiety Treatment of Anxiety DisordersDisorders
• Biological – Antidepressants as selective serotonin
reuptake inhibitors (SSRI)– Also effective treating depression