Anxiety Disorders
Anxiety
•Anxiety is an unpleasant emotional state
characterized by physical arousal and
feelings of tension, apprehension, and
worry
•Puts us on physical alert, preparing us to
defensively “fight” or “flee” potential
dangers,
•Also puts us on mental alert, making us
focus our attention squarely on the
threatening situation
Anxiety Disorders
•
•
In the anxiety disorders, the anxiety is
maladaptive, disrupting everyday activities,
moods, and thought processes
Three features distinguish normal anxiety from
pathological anxiety. Pathological anxiety is:
1. Irrational—it is provoked by perceived threats that are
exaggerated or nonexistent, and the anxiety response
is out of proportion to the actual importance of the
situation.
2. Uncontrollable—the alarm reaction cannot be shut off
even when the person knows it’s unrealistic.
3. Disruptive—it interferes with relationships, job or
academic performance, or everyday activities
Generalized Anxiety
Disorder and Panic
Disorder
Generalized Anxiety Disorder
• An anxiety disorder characterized by
disruptive levels of persistent,
unexplained feelings of apprehension
and tenseness
Generalized Anxiety Disorder
(GAD)
• More or less constant worry about many
issues
• The worry seriously interferes with
functioning
• Physical symptoms
–
–
–
–
headaches
stomach aches
muscle tension
irritability
Symptoms of Generalized
Anxiety
• Must have at least three of the following:
– Restlessness
– Feeling on edge
– Difficulty concentrating/mind going
blank
– Irritability
– Muscle Tension
– Sleep Disturbance
Model of Development
of GAD
• GAD has some genetic component
• Related genetically to major depression
• Childhood trauma also related to GAD
Genetic predisposition
or childhood trauma
Hypervigilance
GAD following life
change or major event
Are Your Worries Excessive?
• Add up your TOTAL Score
• 0-11 points = You are not the fretful type. Worry,
which no doubt makes you uncomfortable, goads
you to take necessary action in your life.
• 12-20 points = You’re a potentially unhealthy
worrier.
• 21-30 points = Danger zone! Agonizing constantly
about small matters isn’t good for you physically
or emotionally.
Panic Disorder
• An anxiety disorder characterized by
sudden bouts of intense, unexplained
panic
• Panic attacks may happen several
times a day
Panic Disorder
• Panic attacks—sudden episode of helpless
terror with high physiological arousal
• Very frightening—sufferers live in fear
of having them
• Agoraphobia often develops as a result
Cognitive-behavioral Theory
of Panic Disorder
• Sufferers tend to misinterpret the physical signs of
arousal as catastrophic and dangerous
• This interpretation leads to further physical
arousal, tending toward a vicious cycle
• After their first panic attack, they become
even more attuned to physical changes,
increasing the likelihood of future panic
attacks
Phobia
Phobia
• An anxiety disorder characterized by
disruptive, irrational fears of specific
objects or situations
• The fear must be both irrational and
disruptive.
• About 10 percent of the general
population will experience a specific
phobia at some point in their lives.
Phobias
Generally, the objects or situations that
produce specific phobias tend to fall into
four categories
1. Natural environment—heights, water,
lightening
2. Situation—flying, tunnels, crowds, social
gathering
3. Injury—needles, blood, dentist, doctor
4. Animals or insects—insects, snakes, bats, dogs
Phobias
• It is not phobic to simply be anxious about something
Study of normal anxieties
100
Percentage 90
of people 80
surveyed 70
60
50
40
30
20
10
0
Snakes Being Mice Flying Being Spiders Thunder Being Dogs Driving Being Cats
in high,
on an closed in, and
and
alone
a car
in
exposed
airplane in a
insects lightning in
a crowd
places
small
a house
of people
place
at night
Afraid of it
Bothers slightly
Not at all afraid of it
Phobias
Some Unusual Phobias
• Watch this video of a girl with a
phobia for pickles.
• Ailurophobia—fear of cats
• Algobphobia—fear of pain
• Anthropophobia—fear of men
• Monophobia—fear of being alone
• Pyrophobia—fear of fire
Social Phobias
• Social phobias—fear of failing or being
embarrassed in public
–
–
–
–
public speaking (stage fright)
fear of crowds, strangers
meeting new people
eating in public
• Considered phobic if these fears interfere
with normal behavior
• Equally found in males and females
Agoraphobia
• Fear of situations the person views as
difficult to escape from
• Fear of leaving one’s home or room in
the house
Phobia
• Play “Three Anxiety Disorders”
(4:08) Segment #37 from Psychology:
The Human Experience.
• The segment includes a discussion on
Generalized Anxiety Disorder.
Development of Phobias
• Classical conditioning may be involved
in the development of a specific phobia
that can be traced back to some sort of
traumatic event.
– People with phobias may have developed
a conditioned response of fear to a
conditioned stimulus
– Problems with this theory:
• often no memory of a traumatic experience
• traumatic experience may not produce phobia
Other Learning Factors
• Observational learning--watching another
experiencing fearfulness--may result in
developing fear.
• Operant Conditioning - Fear of an object
may be negatively reinforced when by
avoiding the feared objects.
Development of Phobias
• Preparedness theory—phobia serves to
enhance survival.
– Humans seem biologically prepared
to acquire fears of certain animals
and situations that were survival
threats in human evolutionary history
Cognitive Therapy for Phobias
• In this video, the therapist tries to get the
person to rethink their phobia. (7 min)
Posttraumatic Stress
Disorder
Posttraumatic Stress Disorder
• An anxiety disorder characterized by
reliving a severely upsetting event in
unwanted recurring memories
(flashbacks) and dreams
Posttraumatic Stress Disorder
(PTSD)
• Follows events that produce intense horror or
helplessness (traumatic episodes)
• Core symptoms include:
– Frequent recollection of traumatic event, often
intrusive and interfering with normal thoughts
– Avoidance of situations that trigger recall of the
event
– Increased physical arousal associated with stress
– There is a high correlation of suicide and drug
abuse in PTSD – See news report on Military
Suicides in Soldiers fighting in Iraq – 2 min.
Potential Causes of PTSD
• - Post Traumatic Stress Syndrome – Studies of
the Hippocampus in PTSD patients find that on
average, their hippocampus is 25% smaller.
• - Some think this is a warning sign that
someone is susceptible to PTSD.
• - Others say it is due to excessive stress
hormones during trauma or an excessive
sensitivity to these hormones after trauma.
• - Coping strategies to avoid PTSD in traumatic
situations – Holocaust Case Study – Read the 7
strategies described on pg. 11 of Myers Guide.
ObsessiveCompulsive Disorder
Obsessive-Compulsive Disorder
• An anxiety disorder characterized by
unwanted, repetitive thoughts and
actions
• Obsessions – repetitive thoughts
• Compulsions – repetitive actions
• The obsessions/compulsions begin to
take control of the person’s life.
Obsessive-Compulsive Disorder
(OCD)
• Obsessions—irrational, disturbing thoughts that intrude
into consciousness
• Compulsions—repetitive actions performed to alleviate
obsessions
– Overt physical behaviors, such as repeatedly checking
or washing your hands
– Covert mental behaviors, such as counting or reciting
certain phrases to yourself
• Potential Biological Causes:
– Heightened neural activity in caudate nucleus
– A deficiency in the neurotransmitter serotonin
Trichotillomannia:
The Disease of Hair Pulling
• What it’s like to live with it – video
• Trich – An explanation – video
Other Obsessions…
• Obsessive Texting - video
Finding Your OCD Score
• Circle the following item numbers if you marked TRUE
for them: 1, 2, 4, 6, 7, 8, 16, 17, 21
• Circle the following item numbers if you marked
FALSE for them: 5, 9, 10, 11, 12, 13, 14, 19, 20, 22
• Now add up your total score. Highest score possible is
a 20 (items 3 & 15 are validity checks)
• The mean (average) score is 11.15 for males and 11.24
for females.
• Remember, even if you scored high on this scale it
doesn’t mean you have OCD. Always ask yourself,
“Do these tendencies I have disrupt my daily life and
relationships?” If the answer is NO you don’t have a
problem.
Obsessive Compulsive Disorder
• Play “Obsessive-Compulsive
Disorder” (2:57) Segment #36 from
Psychology: The Human Experience.
Causes of Anxiety
Disorders
Biological Factors
• Hereditary factors may result in a
predisposition for developing anxiety
disorders
• Brain functions appear to be different
in an anxiety disorder patient
• Evolutionary factors may lead to
anxiety disorders.