Anxiety Disorders
Distressing, persistent anxiety or
maladaptive behaviors that reduce
anxiety
Manifestations of Anxiety
• Cognitive
– Thought process range from
generalized worry to
overwhelming fear (focus on
impending doom)
• Behavioral
– The avoidance of anxietyprovoking situation
• Somatic
– Physiological complaints due to
activation of sympathetic
nervous system (stomach aches,
headaches, shakiness, etc.)
Specific Phobias
• Specific phobias = irrational,
persistent fear of specific
objects or situations
• Simple phobias:
–
–
–
–
Claustrophobia = enclosed spaces
Agoraphobia = open spaces
Arachnophobia = spiders
Acrophobia = heights
• Social phobia = fear of social
situations & embarrassment
Phobias - irrational fears
http://phobialist.com/
• Hematophobia: Blood
• Gephyrophobia:
Crossing a bridge
• Kenophobia: Empty
rooms
• Cynophobia: Dogs
• Coulrophobia: clowns
• Aerophobia: Flying
• Entomophobia:
Insects
• Gamophobia:
Marriage
• Ophdophobia: Snakes
• Xenophobia:
Strangers
• Melissophobia: Bees
Anxiety Disorders
• Common and uncommon fears
100
Percentage 90
of people 80
surveyed
70
60
50
40
30
20
10
0
Snakes
Being Mice Flying Being Spiders Thunder Being Dogs
in high,
on an closed in, and
and
alone
exposed
airplane in a
insects lightning In a
places
small
house
place
at night
Afraid of it
Bothers slightly
Not at all afraid of it
Driving Being
Cats
a car
In a
crowd
of people
Generalized Anxiety Disorder (GAD)
• Persistent high levels of anxiety and excessive
worry
with symptoms for
at least 6 months
• Restlessness,
difficulty sleeping,
lack of concentration,
muscle tension,
irritability
Panic Disorder
• Recurrent, unexpected panic
attacks
– Feelings of terror
– Pounding heart, difficulty breathing
– Fearful of future attacks
• Often accompanied by secondary
conditions, such as agoraphobia
Posttraumatic Stress Disorder
• Flashbacks or nightmares
following extremely troubling
event
• http://www.youtube.com/watc
h?v=6VsVA5p7heQ&feature=r
elated
Posttraumatic Stress Disorder in a Community
Sample..., Brian Engdahl et al, American Journal of
Psychiatry, 1997, pp. 1576-81.
Obsessive-Compulsive Disorder (OCD)
Persistent, unwanted thoughts (obsessions) cause
someone to feel the need (compulsion) to engage in
an action
(did I already do this slide?… I better do it again
(did I already do this slide?… I better do it again)
•
•
http://www.youtube.com/watch?v=44DCWslbsNM&feature=related
http://www.youtube.com/watch?v=tPFQMRx2l3Y
Common Examples of OCD
Common Obsessions:
Contamination fears of germs, dirt,
etc.
Imagining having harmed self or
others
Imagining losing control of
aggressive urges
Common
Compulsions:
Washing
Repeating
Checking
Intrusive sexual thoughts or urges
Touching
Excessive religious or moral doubt
Counting
Forbidden thoughts
Ordering/arranging
A need to have things "just so"
Hoarding or saving
A need to tell, ask, confess
Praying
Anxiety Disorders
• Fear of embarrassing oneself in public to the extent that
one is isolated completely.
Social phobia
• Recurrent thoughts that lead to ritual behaviors.
OCD
• Constant anxiety and worry for no particular cause.
Generalized Anxiety Disorder
• Fear of being in wide, open, public spaces like a stadium
or shopping mall.
Agoraphobia
• Re-occurring flashbacks or nightmares of a prior
traumatic event.
PTSD
Anxiety Disorders
• PET Scan of brain of
person with
Obsessive/
Compulsive disorder
• High metabolic
activity (red) in
frontal lobe areas
involved with
directing attention
Prevalence of Anxiety Disorders in the
U.S.
Social
Phobia
15 Million
Panic
Disorder
6 Million
Specific
Phobia
19.2 Million
GAD
OCD 6.8 Million
2.2 Million
Explaining Anxiety Disorders
• Biological
– Fears may have an evolutionary basis (contribute to
survival)
– Genetic predisposition
to fears and anxiety
(tend to run in families)
– Lack of GABA
neurotransmitter
• Cognitive
– Irrational beliefs regarding
feared stimulus
(exaggeration)
Explaining Anxiety Disorders
• Behavioral (learning)
– Classical conditioning
of fear
– Avoidance relieves
fear (negative
reinforcement)
• Biopsychosocial model
– Anxiety has a
biological involvement
and learning
component, both of
which are influenced
by culture
Somatoform Disorders
Complaints of physical symptoms with no
physiological explanation (they are
psychologically based)
• Somatization disorder = multiple physical
complaints with no physical explanation,
onset before age 30
• Conversion disorder = specific severe
physical complaint (paralysis, blindness)
with no physical cause
– La belle indifference
Glove Anesthesia
A conversion
disorder in which a
person can’t feel
their hand (B).
Neurologically this is
impossible because
the sensory nerves
of the hand and arm
are organized as
shown in (A) rather
than (B).
Body Dysmorphic Disorder
• Excessive
preoccupation
w/minor or imagined
flaw in physical
appearance
Hypochondriasis
• Persistent
preoccupation with
one’s health despite
the fact that genuine
symptoms of the
disorder are lacking
Hypochondriasis
Occurs equally in men and
women.
Typical age of onset is 2030.
Prevalence rate 1%–5%.
$20 billion a year spent on
unnecessary medical
procedures.
Explaining Somatoform Disorders
• Psychoanalytic –
unresolved childhood
conflicts, experiences
• Behavioral
– Reinforcement (anxiety
is reduced)
– Interpersonal gains in
terms of sympathy &
support
• Sociocultural factors
Dissociative Disorders
Disruption or disturbances in memory,
consciousness, or identity due to psychological
factors
Psychogenic (dissociative) Amnesia
• Person loses memory due to stress or
psychological trauma (no physical cause)
Psychogenic (Dissociative) Fugue
• Confusion over personal identity & assumes
new identity (usually travel away from
home & start new life)
Case Study: Dissociative Fugue
• Jennifer Wilbanks developed a fear of
her upcoming wedding. Over several
weeks she bought bus tickets, cut her
hair and took the bus to Las Vegas and
finally ended up in New Mexico. She
confabulated an abduction story but
finally admitted to her bus ride.
(Neither Wilbanks nor Mason will answer
mail or emails for an interview). She was
a worker in a doctor's office.
Depersonalization Disorder
• Most common dissociative disorder
• Feelings of unreality about self
• “This is not my body…I am trapped in
someone else’s body”
Dissociative Identity Disorder
• Person has several personalities rather than one
integrated personality (a.k.a. Multiple Personality)
• http://www.youtube.com/watch?v=NDUwyCRBUM&feature=related
• http://www.youtube.com/watch?v=xRY7Oj-dl3o
Theoretical Causes of Dissociative
Disorders
• Psychodynamic 
extremely traumatic
event is repressed so
that a split in
consciousness results
• Behaviorists  people
who have experienced a
trauma simply find not
thinking about it to be
rewarding (negative
reinforcement)