Anxiety Disorders Oct. 10 2012
Fear, Anxiety, and Panic- major symptom
Fear and anxiety – adaptive emotions, MAJOR SYMPTOM
- Threatening situation that is in the environment.
- Fear- immediate stress
- Anxiety- threats that are more nebulous. Fearing in the future. Concerned what is going
to happen. Sometimes we cant pin point
- Ex: project due in a week and you’re feeling anxious, its running through your mind
- Anxiety usually is social threats. What other people will think of us
- Fear is the emotions that let us avoid dangerous situations.
- Anxiety is an imp. Emotion for social functioning. – Motivate us to get along with others
- Becomes problematic when its irrational
Autonomic arousal – fight-flight response activation of the synesthetic nervous system.
Hypothalamus pumping. Adrenaline
Increased HR, BP, GSR (sweating response), muscle tension
Decreased gastric activity- activity is moved away to this and goes to larger muscles.
- Rapid breathing, butterflies in stomach
Experiential aspects- subjective feelings, fear panic, irritable, easily angered, tense
Cognitive symptoms- affects way we think- cause us to be anxious. Excessive thoughts,
very vigilant, very focused that they’re most fearful of and don’t notice other things.
Worrisome, feeling of loss of control
Behavioral symptoms- avoidance, escape
** Best treatment is exposure
Evolutionary basis of anxiety – genetic variability, have to find a fine balance of anxiety
you don’t want too little or too much.
- People differ in their tendency to become anxious.
- Excessive, irrational, uncontrollable
- Interferes with functioning
Anxiety Disorders are the most common group of mental disorders
– 25% lifetime prevalence
– High personal and societal costs. - Loss productivity in the work place—costs being on
Major DSM-IV Anxiety Disorders
- Number of specific diagnosis. Anxiety is the chapter and there are specific disorders in it.
- Phobias (including Specific Phobias, Social Phobia, and Agoraphobia)
- Obsessive-Compulsive Disorder
- Post-Traumatic Stress Disorder (and Acute Stress Disorder)
- Ggeneralized Anxiety Disorder Specific Phobia
- Most phobias start in childhood
- 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
- (Severe enough to be a disorder, have to have 1 or 2 of the characteristics) Interferes
significantly with functioning (dysfunction), or marked distress about having phobia
- Some people have mild phobias- ex fear of snakes but in the city it can be quite avoidable.
Types of Specific Phobias (5) subtypes
Animal (e.g., snakes, spiders)
Natural Environment (e.g., heights, storms, water)
- Decrease in heart rate, they’ll pass out, not enough oxygen to the brain. For this one you
want to increase muscle tension and arousal
Situation (e.g., airplanes, elevators, enclosed places)
Other (e.g., fear of vomiting, clowns - coulrophobia) fear of unusual things
Specific Phobias (cont’d)
- Lifetime prevalence 7 – 15%- of pop severe enough to have a phobia
- 2: 1 woman: men
- Typically begin in childhood, early adolescence
- May or may not involve traumatic experience
- Phobias persisting into adulthood rarely remit
- Persistent, irrational fear linked to social or performance situations
- Fear of negative evaluation (being humiliated or embarrassed)- fear of social reaction.
What would people think of me?
o E.g., fear of public speaking, urinating in public washrooms, eating in front of
- Person recognizes fear is excessive
- Behavioral inhibition, avoidance
- Significantly interferes with functioning.
Social Phobia (cont’d)
- Lifetime prevalence 3 – 13%
o Men = women—only type of phobia where its equal
o Typically begins in mid-teens
- Chronic course- doesn’t go away by itself
- Severity may fluctuate with stress
- Comorbid (having more than one diagnosis) conditions very common – specific phobias,
depression, alcohol dependence, agoraphobia—these are secondary problems. They
develop as a result from the initial phobia.
o 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
o The event created intense fear, horror, or a sense of helplessness.
Three clusters of symptoms in PTSD
- Re-experiencing of the trauma
o Distressing images, thoughts, perceptions
o Dreams, flashbacks
- Avoidance and numbing- dissociation
o Avoiding activities, people, places- can be a stimulus and bring back memories.
o Feelings of detachment, estrangement, depersonalization (not being yourself),
o Loss of memories of trauma – amnesia
- Symptoms of increased arousal- anxiety symptoms
o Hyper vigilance, irritability, startle response
o Difficulty sleeping, concentrating
o Symptoms last more than 1 month- TO BE DIAGNOSED WITH PTSD
o Ex: Romeo Dallaire- United forces in the genocide of Rwanda- as the general he
saw this coming, and wrote back to Canada saying that he needs more people to
help. And they didn’t respond, he helplessly watched people being butchered – he
developed PTSD when he came home. He was living in a park in Ottawa. And
o Now become a spokesperson in the military
- Associated feat