Anxiety Disorders and Somatoform Disorders

Marion WeeksJenks High School

Anxiety Disorders in generalDiagnosis occurs when overwhelming anxiety

disrupts social or occupational functioning or produces significant distress.

Manifestations of anxietyCognitive:

Thought processes range from generalized worry to overwhelming fear and often focus on various possibilities of impending doom.

Anxiety Disorders in generalBehavioral:

The avoidance of an anxiety-provoking situation may be practiced.

Example, persons may be unwilling to leave home.Somatic:

Numerous physiological complaints are experienced due to activation of the sympathetic nervous system.

Examples: Stomach aches Headaches Shakiness

Specific Anxiety DisordersPanic Disorder

Recurrent and unexpected panic attacks are severeInvolve feelings of terror and physiological

involvementAttacks lead to concern about future attacks or

losing control. Example

Pounding heart Difficulty breathing

May result in individual being fearful of having a panic attack in public or of leaving home.

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Panic Disorder

Minute-long episodes of intense dread which may include feelings of terror,

chest pains, choking, or other frightening sensations.

Anxiety is a component of both disorders. It occurs more in the panic disorder,

making people avoid situations that cause it.

Symptoms

Specific Anxiety DisordersGeneralized anxiety disorder

Characterized by persistent high levels of anxiety and excessive worry with symptoms that present for at least six months.

Physiological responses are similar to, although not as severe as, those experienced in panic disorder, but they are more persistent.

Specific Anxiety DisordersPhobia

A persistent, irrational, unrealistic fear of specific objects or situations.

Exposure to a feared stimulus produces intense fear or panic.

Anxiety dissipates when the phobic situation is not being confronted.

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PhobiaMarked by a persistent and irrational fear

of an object or situation that disrupts behavior.

Specific Anxiety DisordersThree subcategories include:

Simple phobias Claustrophobia (fear of closed spaces) Arachnophobia(spiders)

Agoraphobia The irrational fear of open spaces Leads to a fear of leaving home or other safe

havens. Social phobia

Social situations Public speaking

Specific Anxiety DisordersObsessive-compulsive disorder (OCD)

Involves two patternsObsessions

Thoughts, images, or impulses that recur or persist despite a person’s efforts to suppress them

Compulsions Repetitive, purposeful, but undesired acts performed in

a ritualized manner in response to an obsessionPersons with the disorder acknowledge the

senselessness of their behavior; however, when anxiety rises, the ritualized behavior to relieve the tension cannot be resisted.

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Obsessive-Compulsive Disorder

Persistence of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions) that

cause distress.

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A PET scan of the brain of a person with

Obsessive-Compulsive Disorder

(OCD). High metabolic activity (red) in the frontal

lobe areas are involved with

directing attention.

Brain Imaging

Brain image of an OCD

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Post-Traumatic Stress Disorder

Four or more weeks of the following symptoms constitute post-traumatic

stress disorder (PTSD):

1. Haunting memories2. Nightmares

3. Social withdrawal4. Jumpy anxiety5. Sleep problems

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Resilience to PTSDOnly about 10% of women and 20% of men react to traumatic situations and

develop PTSD.

Holocaust survivors show remarkable resilience against traumatic situations.

All major religions of the world suggest that surviving a trauma leads to the

growth of an individual.

Explaining anxiety disordersThe learning perspective

Generalized anxiety has been linked with a classical conditioning of fear and the attendant stimulus.

Avoidance relieves fear through negative reinforcement.

The cognitive perspectiveObservational learning can produce fear which

results in anxiety. Example

If a parent fears dogs, the child may learn this fear through observation.

Explaining anxiety disordersThe biological perspective

Fears that represent age-old threats, such as heights or spiders, may have contributed to our survival and have an evolutionary basis.

Some people are genetically predisposed to fears and high anxiety.

Disorders tend to run in families.The biopsychosocial perspective

View anxiety as having a biological involvement and learning component, both of which influenced by culture.

Somatoform disordersThese disorders are characterized by

complaints of physical symptoms that have no organic or physiological explanation– they are psychologically based.

Symptoms are not considered voluntary or under conscious control.

Specific somatoform disordersSomatization disorder

Characterized by multiple physical complaints with no organic explanation and an onset before age 30.

Conversion disorderCharacterized by specific physical complaint.

Examples Paralysis of legs Blindness

Patients strongly believe there is impairment, but may show less distress than with a real loss.

Specific somatoform disordersHypochondriasis

Characterized by persistent preoccupation with one’s health and physical condition, despite the fact that genuine symptoms of a disorder are lacking.

Factitious DisorderMunchausen’s Syndrome–

Patients feign physical or emotional illness in order to assume the role as patient

Patients have added sugar to urine samples, used sandpaper, chemicals, or heat to create rashes and lesions, drank animal blood so they could vomit blood, swallowed corrosive chemicals, overdosed on psychoactive drugs

Disease is difficult to diagnose and often requires being “caught” in the act.

Explaining somatoform disordersThese disorders now constitute only 5% of all

disorders treated.Decreasing incidence seems linked to our

growing understanding of physiological and psychological disorders.

The behavioral perspective Suggests that avoidance behavior

Becoming ill to avoid or reduce anxiety-arousing stressReinforced in two ways:

Anxiety is reduced There are interpersonal gains in terms of sympathy and

support.