PSYC3102 Lecture Notes - Lecture 4: Anxiety Disorder, Intrusive Thought, Mental Disorder
Lecture 4 – Anxiety Disorders
Nature of anxiety
●We all have experience with anxiety; when it is a disorder there is a preoccupation with,
or persistent avoidance of, thoughts or situations that provoke fear or anxiety
●The diagnosis of anxiety-related disorders depends on the pattern of symptoms
(nature, frequency, severity, duration)
●Anxiety-related disorders – negatively impact various areas of life (social/occupational
functioning)
●Fear
○Experienced in the face of
real, immediate danger
○Usually builds quickly in
intensity
○Helps behavioral
responses to real threats
●Anxiety
○Associated with the anticipation
of future problems
○Involves more general or diffuse
emotional reactions
○The emotional experience is out
of proportion to the threat
●Often characterised by excessive worry
○Cognitive activity associated with anxiety
○Negative thoughts that seem to spiral out of control
●Anxiety can be helpful as a warning of threats; prompts us to prepare
●It is mostly unhelpful as it can restrict living, which usually occurs when it is very intense
and distressing; this can warrant an anxiety-related disorder diagnosis
Prevalence
●One of the most common mental disorders in Australia
○14.4% 12-month prevalence
●Women are more susceptible than men
○18% vs 11% over a 12-month period
●Prevalent across all age groups but rates decrease with age
●PTSD and social phobia are the most prevalent anxiety disorders
○6.4% and 4.7% respectively
Features of anxiety-related disorders
●Physiological symptoms
●Avoidance symptoms
●Disturbances in attention
○Intrusive thoughts
○Attentional biases – focus on threats
○Re-experiencing symptoms
●Subjective feeling of anxiety
Anxiety disorders
Anxiety disorders
●Specific Phobia
○Essential features
■Marked fear or anxiety about a specific object or situation
■Exposure to the phobic stimuli invariably provokes immediate fear or
anxiety
■Phobic stimuli is actively avoided or endured with intense fear or anxiety
■Fear or anxiety is out of proportion to the actual danger posed
○Prevalence
■7-9% prevalence rate
■Females more affected – 2:1
■Rates vary across stimuli
○Specifiers
■Animal e.g. spiders, snakes, insects, dogs
■Natural environment e.g. storms, thunder, heights, water
■Blood-injection injury e.g. seeing blood, seeing injury, receiving an
injection, needles
■Situational e.g. public transport, tunnels, bridges, elevators, airplanes,
enclosed places
■Other e.g. choking, vomiting, loud sounds, costume characters
●Social Anxiety Disorder (Social Phobia)
○Essential features
■Marked fear or anxiety about one or more social or performance
situations in which the person is exposed to possible scrutiny by others
■Fears that they will act in a way or show anxiety that will be negatively
evaluated (humiliation, embarrassment, rejection, offend)
○Prevalence
■4.7% in community sample
○Clinical features
■Belief that others see them as inept, stupid, foolish
■Often demonstrate a vicious cycle
■Hypersensitive to criticism
■Non-assertive
■Low self-esteem
■Common safety behaviours
●Avoiding eye contact
●Talking to “safe” people
●Covering face with hair/hands
■“Observer perspective” vantage point for social memories
●Seeing memories from the perspective of someone else
■Information processing biases
●Interpretations of social events
●Lower likelihood of detecting positive responses of others
●Anticipatory and post-event processing
●Panic Disorder
○Essential features
■Recurrent unexpected panic attacks
●An abrupt surge of intense fear or discomfort, in which four or
more of the following develop rapidly, and peaks within minutes:
○Palpitations/pounding heart
○Sweating
○Trembling/shaking
○Sensation of shortness of breath
○Feelings of choking
○Chest pain or discomfort
○Nausea or abdominal distress
○Dizziness/lightheadedness
○Chills/Hot flushes
○Paresthesias (numbness/tingling)
○Derealisation (unreality)/Depersonalization (detached)
○Fear of losing control or going crazy
○Fear of dying
■At least one attack has been followed by one month or more of the
following:
●Persistent concern about additional attacks or their
consequences
●Significant maladaptive change in behaviour (avoidance)
■Rule out specific phobia/other conditions/attacks that are the direct
result of a substance
○Prevalence
■2.6% (NSMHW, 2007)
■3-5% of population experience panic attacks without meeting criteria for
panic disorder
●*Panic attacks ≠ panic disorder
●Agoraphobia
○Can be a standalone diagnosis but often comes with Social Anxiety Disorder
○Essential features
■Marked fear or anxiety about two or more of the following:
●Using public transport
Document Summary
We all have experience with anxiety; when it is a disorder there is a preoccupation with, or persistent avoidance of, thoughts or situations that provoke fear or anxiety. The diagnosis of anxiety-related disorders depends on the pattern of symptoms (nature, frequency, severity, duration) Anxiety-related disorders negatively impact various areas of life (social/occupational functioning) Experienced in the face of real, immediate danger. Associated with the anticipation of future problems. Involves more general or diffuse emotional reactions. The emotional experience is out of proportion to the threat. Negative thoughts that seem to spiral out of control. Anxiety can be helpful as a warning of threats; prompts us to prepare. It is mostly unhelpful as it can restrict living, which usually occurs when it is very intense and distressing; this can warrant an anxiety-related disorder diagnosis. One of the most common mental disorders in australia. 18% vs 11% over a 12-month period. Prevalent across all age groups but rates decrease with age.
