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Chapter 6

PSYB32 Chapter 6: Abnormal Psychology CH6 Anxiety Disorder

Course Code
Konstantine Zakzanis

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Abnormal Psychology
Ch. 6: Anxiety, Obsessive-Compulsive, and Post-traumatic Stress Disorders
Anxiety: an unpleasant feeling of fear and apprehension accompanied by increased physiological
arousal. In learning theory, it is considered a drive that mediates between a threatening situation and
avoidance behaviour. Anxiety can be assessed by self-report, by measuring physiological arousal, and
by observing overt behaviour.
Anxiety is regarded as having two distinguishable components: the physiological and the cognitive.
The physiological component is the heightened level of arousal and physiological activation
It is the heightened level of arousal and tension as reflected by symptoms such as higher heart
The cognitive component is the subjective perception of the anxious arousal and the associated
cognitive processes: worry & rumination.
Another characteristic is that anxiety tends to be future-focused; the emphasis on things that could
b/c many things people worry about actually never happen, anxiety and worry can be
reinforced by the avoidance of feared outcomes and possible experiences that never happen.
Persistent uncontrollable worry about many themes is the main component of generalized
anxiety disorder.
The different elements of anxiety are reflected in conceptualizations of a form of anxiety that most
students can relate to: test anxiety: feeling of tension, apprehension, and worry in actual or
anticipated testing situations. Test anxiety usually involves physiological symptoms and cognitive
symptoms (e.g., worry).
Sarasons Reactions to Tests Scale has two subscales tapping the physiological component (i.e., tension
& bodily symptoms) and two subscales taping the cognitive component (i.e., worry and test-
irrelevant thinking: a component of test anxiety involving an inability to concentrate due to mind-
wandering, which is the tendency for the mind to wander when it is difficult to concentrate).
The underlying roots of test anxiety have yielded a number of insights that can be applied broadly to
other types of anxiety.
Test anxiety can be highly weakening if it gets out of control
The root of test anxiety and many other types of anxiety is a sense of the self as deficient and
Students with test anxiety tend to be self-critical and have negative thoughts about themselves,
during the test itself.
Anxiety often is overwhelming and is associated with a lacking sense of self. For example, at the root of
GAD is the sense that anxiety pervades many aspects of life and the person feels totally unable to do
anything to control it.

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It is normal and even adaptive to experience some degree of anxiety, especially when in potential life-
threatening situations that jeopardizes someones survival.
To be considered abnormal and dysfunctional and require clinical intervention; the anxiety must be
chronic, relatively intense, associated with role impairment, and causing significant distress for self or
While the core element remains uncontrollable worry, a key change considered for the diagnostic criteria
symptoms needed to qualify for a diagnosis. There was a debate that everyday worries could qualify
for a diagnosis of GAD.
Situational factors must be taken into account -- it is normal to feel highly anxious in a situation that is
upsetting and a threat to personal survival.
What tends to distinguish chronically anxious people is their tendency to perceive threat and to be
concerned and worried when there is no objective threat or the situation is ambiguous.
Anxiety disorders: disorders in which fear or tension is overriding and the primary disturbance: phobic
disorders, panic disorder, GAD, OCD, acute stress disorder, and PTSD. These disorders form a major
diagnostic category and cover most of what used to be referred to as the neuroses.
They are diagnosed when subjectively experienced feelings of anxiety are present.
As a group, the anxiety disorders are the most common psychological disorders and a majority of
Canadians who met criteria for an anxiety disorder report that it interfered with their home, school,
work and social life.
Survey of physicians in Alberta found that about 1 in 5 people have some form of anxiety
The Ontario Mental Health Supplement study, a gender difference exists, with 16% of women
and 9% of men having suffered from anxiety disorders.
The highest one-year prevalence rate (i.e., 1 in 5) was found in women 15-24 years of age.
Anxiety disorders were more common in women than in men across all age groups.
Somers, Golderm Waraich & Hsu noted that, “The prevalence of anxiety disorders eclipses the capacity
of specialized mental health services”. These disorders have an early age of onset, typically during
Kessler surveyed existing U.S. data to provide the picture of lifetime morbid risk (LMR).
The survey found that estimates of LMR were highest for a major depressive episode, social
phobia, PTSD, GAD, and panic disorder.
The most prevalent disorders were specific phobias, major depressive episode and social
The two disorders with the earliest median age of onset (15-17 yrs. old) were phobias and
separation anxiety.
Despite recent DSM-5 changes, separation anxiety was not included among the types of anxiety (phobia,
panic disorder, GAD).

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Separation anxiety: a disorder in which the child feels intense fear and distress when away from
someone on whom he/she is very dependent; said to be a huge cause of school phobia.
It is the anxiety that results from not having contact or the possibility of losing contact with
attachment figures.
It is seen as a type of anxiety that is prevalent among children of various ages but not among
older people.
Now there is increasing focus on an adult form of separation anxiety disorder; adults who cannot stand to
be alone and are cognitively preoccupied with losing contact with loved ones.
In an Australia clinic found that 1 in 4 adults’ patients were diagnosed with an adult form of
separation anxiety disorder.
A common theme of each anxiety disorders is they have dysfunctional levels of anxiety reflect cognitive
appraisal processes contributing to the perception of anxiety, and physiological factors that render
particular people more vulnerable to anxiety.
6.1 Phobias
Phobia: an anxiety disorder in which there is intense fear and avoidance of specific objects and
situations, recognized as irrational by the individual.
Define phobia as a disrupting, fearing mediated avoidance that is out of proportion to
the danger actually posed and is recognized by the sufferer is unjustified.
i.e., extreme fear of heights, snakes, closed spaces, or spiders – provided that there is
no objective danger – accompanied by sufficient distress to disrupt one’s life is likely to be
diagnosed as a phobia.
Many specific fears do not cause enough hardship to compel an individual to seek treatment. The term
phobia”, implies that the person suffers intense distress and social or occupational impairment b/c of
the anxiety.
A study of the fears and phobias of women in Calgary, found that about 5% of women with a phobia
were “incapacitated” by their phobias.
Some phobias are:
Claustrophobia, fear of closed spaces
Agoraphobia, fear of public places
Acrophobia, fear of heights
Ergasiophobia, fear of working
Pnigophobia, fear of choking
Taphephobia, fear of being buried alive
Mysophobia, the fear of contamination and dirt that plagues many people
New phobias tend to emerge in keeping with societal changes or emerge according to changing life
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