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Western University
Psychology 2310A/B
Rod Martin

Anxiety Disorders Fear, Anxiety, and Panic Fear and anxiety – adaptive emotions - we need to have a certain amount of fear and anxiety in order to survive - fear is the emotion that keeps us from doing dangerous things - its fear that causes us to avoid e.g., jumping off the edge of a cliff Autonomic arousal – fight-flight response Increased HR, BP, GSR, muscle tension Decreased gastric activity Experiential aspects Cognitive symptoms Behavioral symptoms Evolutionary basis of anxiety – genetic variability - Anxiety have an evolutionary basis - it is adaptive to have these emotions and there is probably a certain amount of genetic variation in the population - people who don‟t experience these emotions are the basis for „psychopath‟ and antisocial disorder Pathological when: Excessive, irrational, uncontrollable Interferes with functioning Anxiety Disorders are the most common group of mental disorders – 25% lifetime prevalence High personal and societal costs. Major DSM-IV Anxiety Disorders (Specific Diagnoses of anxiety disorders in the DSM) Panic Disorder Phobias (including Specific Phobias, Social Phobia, and Agoraphobia) Obsessive-Compulsive Disorder Post-Traumatic Stress Disorder (and Acute Stress Disorder) Generalized Anxiety Disorder Specific Phobia Persistent, excessive, unreasonable fear cued by a specific object or situation Provokes anxiety response (panic) Recognized by the sufferer as excessive, unreasonable Phobic situation is avoided or endured with intense distress Interferes significantly with functioning, or marked distress about having phobia - Is the person really upset about having this phobia? Types of Specific Phobias Animal (e.g., snakes, spiders) Natural Environment (e.g., heights, storms, water) Blood-Injection-Injury Situation (e.g., airplanes, elevators, enclosed places) Other (e.g., fear of vomiting, clowns) Specific Phobias (cont’d) Lifetime prevalence 7 – 15% 2:1 women:men Typically begin in childhood, early adolescence May or may not involve traumatic experience Phobias persisting into adulthood rarely remit Social Phobia Persistent, irrational fear linked to social or performance situations Fear of negative evaluation (being humiliated or embarrassed) e.g., fear of public speaking, urinating in public washrooms, eating in front of others Person recognizes fear is excessive Behavioral inhibition, avoidance Significantly interferes with functioning. Social Phobia (cont’d) Lifetime prevalence 3 – 13% Men = women - men are just as likely as women to get a social phobia disorder Typically begins in mid-teens Chronic course (it continues, doesn‟t go away) Severity may fluctuate with stress Comorbid conditions very common – specific phobias, depression, alcohol dependence, agoraphobia Onset of social phobia usually precedes other conditions. Post-Traumatic Stress Disorder (PTSD) Person experienced or witnessed a traumatic event involving actual or threatened death, serious injury, or other personal harm The event created intense fear, horror, or a sense of helplessness. Three clusters of symptoms in PTSD Re-experiencing of the trauma Distressing images, thoughts, perceptions Dreams, flashbacks Avoidance and numbing Avoiding activities, people, places Feelings of detachment, estrangement, depersonalization, emotional numbness Loss of memories of trauma – amnesia Symptoms of increased arousal Hypervigilance, irritability, startle response Difficulty sleeping, concentrating Symptoms last more than 1 month. PTSD (Cont’d) Associated features: survivor guilt, relationship conflicts, employment difficulties, impulsivity, aggression, social isolation, som
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