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Anxiety disorders (2).docx

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Richard B Day

October 17 , 2012 Psych 2AP3: Abnormal Psychology – Major Disorders Anxiety Disorders (2) Panic Disorder (PD) - Core: experience of anxiety or steps to avoid being in situations which initiate anxiety - Brief period of really intense anxiety to the point that the individual believe that he or she is dying of a heart attack - motor tension symptoms:  trembling, shaking  paresthesias: numbness, tingling - autonomic hyperactivity symptoms:  tachycardia (very rapid heart rate), chest pain, sweating, dizziness,  nausea, GI complaints  sensations of shortness of breath - other symptoms:  chills, hot flushes  sensations of smothering  derealisation (feeling in a dream); depersonalization (loss of sense of self)  fear of losing control, going mad, dying - more common in severe PD - relationship between panic attacks and the environment:  uncued panic attacks: never know when you’re going to have them, unpredictable  situational predisposed panic attacks: preferentially in certain situations, do not always happen in these situations  situationaly bound panic attacks: always triggered by a particular situation - frequency varies in individuals, median: 1 or max 2 a week Epidemiology - annual prevalence, U.S. = 3% - lifetime prevalence, U.S. = 2-5% - lifetime prevalence, world= 1.5-3% - average age of onset = late 20s, not typically an early life disorder - about 65-75% with disorder are female - course of treatment is variable and unpredictable:  30-35% recover completely with no treatment  50% have mild or occasional symptoms some treatment  15-20% moderate to severe; require continuous treatment Subcategories of PD - panic disorder without agoraphobia: fear of being out in public and having a panic attack  equally common in males, females  67% of cases with PD - panic disorder with agoraphobia:  2-3 times more common in females  33% of cases with PD  meets criteria for agoraphobia:  fears places where escape difficult  restricts travel, or always takes companion  fears attack; embarrassment, no help Agoraphobia - anxiety re places where escape difficult or embarrassing, or help not available in event of panic attack - situations avoided, tolerated with anxiety, or companion required - 0.8% annual, 1.4% lifetime prevalence in U.S. - more common in women; usual onset in 20s or 30s - comorbid
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