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Lecture 5

Psychology 2320A/B Lecture Notes - Lecture 5: Obsessive–Compulsive Disorder, Generalized Anxiety Disorder, Anxiety Disorder

Course Code
Jeff St Pierre

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Lecture 5: Anxiety disorders
February 12th
Description of Anxiety Disorders
Anxiety: a model state characterized by strong negative emotion and bodily
symptoms tension in anticipation of future danger or misfortune
Anxiety disorders involve experiencing excessive and debilitating anxieties;
occur in many forms
Many types of children with anxiety disorders suffer from more than one
Experiencing Anxiety:
Moderate amounts of anxiety are adaptive, we act more effectively an dcope
with potentially dangerous situations
Excessive uncontrollable anxiety can be debilitating
The neurotic paradox is a self defeating behaviour pattern:
Despite knowing there is little to be afraid of, a child is terrified and does
everything possible to escape/avoid he situation
Flight or fight system: immediate reaction to perceived danger or threat
aimed at escaping potential harm
Worry thoughts
Something terrible is going to happen
What if ????
I don’t know what to do?
I cant stand this
Its going to be my fault
I’m going to lose it
I need to make sure things are going to be ok
I have to get out of here
Worry in the body:
Stomach aches
Tense muscles
Feeling like not there
Heart racing
Shallow breathing
Can sleep nightmares
Checking “ on the lookout”
Anxious behaviour

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Avoid, refuse, “shut down”, detach, withdraw, run, turn awar, seeking
reassurance, checking
o Physical and verbal aggression usually reactive
o Dissociation, numbing, self-medicating
anxiety disorders characterized by DSM-IV-TR are divided into 9 categories
that closely define the types of reaction and avoidance
Anxiety versus fear and panic:
Anxiety: future oriented mood state, which may occur in absence of realistic
danger characterized by feelings of apprehension and lack of control over
upcoming events.
Fear: Present-orientated emotional reactions to current danger characterized
by strong escape tendencies and surge in sympathetic nervous system.
Panic: group of physical symptoms of fight/flight response that unexpectedly
occur in the absence of obvious danger or threat.
Separation anxiety disorder:
Separation anxiety is important for a young child’s survival
It is normal from about age 7 months through preschool years
Lack of separation anxiety at this age may suggest insecure attachment or
other problems, but when anxiety persists for at least four weeks and severe
child may have separation anxiety
When anxiety persists for more then 4 weeks and limits the vhilds behaviour
such as going to school and normal recreational activities the child might
have separation anxiety
Children with separation disorder children display age inappropriate
excessive and diabling anxiety about being separated from the people they
are close with
May have repeated nightmares about being taken away form parents
Display excessive demand to be noticed by parents
SAD children may fuss cry, scream or even threaten to kil themselves if their
parents leave
Physical complaints are rapid heart beat dizziness, nausea and stomachaches
Prevalence and comorbidity
SAD is one of the two most common childhood anxiety disorders
Occurs in 4-10% of children but is somewhat more prevalent in girls than in
More than 2/3 of children with SAD have another anxiety disorder

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Children with SAD may also display specific fears of getting lost or of the dark
School reluctance or refusal is common in older children with SAD
Onset course and outcome
SAD has the earliest reported age of onset of anxiety disorders and the
youngest age at referral
Progresses from mild to severe
Associated with major stress such as moving to new neighborhood or
entering a new school
SAD persists into adulthood for more then 1/3 of affected children and
Children with SAD are usually reasonably social skilled but school suffers
from missed classes
As adults more likely to experience: Relationship difficulties, other anxiety
disorders and mental health problems, functional impairment in social and
personal life.
School reluctance and refusal:
School refusal behaviour: refusal to attend classes or difficulty remaining in
school for an entire day
Equally common in boys and girls
Occurs most often between ages 5-11 first occurring during preschool,
kindergarten or first grade and peaking during second grade
Fear of school may be fear of leaving parents but could be other reasons
Serious long-term consequences if it remains untreated.
Generalized Anxiety Disorder
Generalized anxiety disorder:
Excessive uncontrollable anxiety and worry about many events and activities
on most days
What if itis”
Worrying can be episodic or almost continuous
Symptoms include: irritability, lack of sleep restlessness lack of energy
Worry excessively about minor everyday occurrences even when they see
they are making themselves and others unhappy (uncontrollable nature of
Once thought that GAD children did not foucs on one thing to be worried
about called free floating anxiety
Children with GAD pick up every frightening thing in a movie
Accompanied by at least one somatic symptom (eg. headaches, stomach
aches, muscle tension and trembling)
Prevalence and comorbidity:
3-6 % of children
Equally common in boys and girls with slightly higher prevalence in older
adolescent females
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