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Chapter 6


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Konstantine Zakzanis

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Chapter 6 Anxiety DisordersAnxiety is an unpleasant feeling of fear and apprehension It can occur in many psychopathologiesAn anxiety disorder is diagnosed when feelings of anxiety are clearly presentDSM proposes 6 categoriesoPhobiasFearavoidance of objects or situations that do not present any real dangeroPanic disorderRecurrent panic attacks involving a sudden onset of physiological symptoms dizziness rapid heart rate etc accompanied by terror and feeling of impending doom sometimes accompanied with agoraphobia a fear of being in public placesoGeneralized anxiety disorderPersistent uncontrollable worry often about minor thingsoObsessivecompulsive disorderExperience of uncontrollable thoughts impulses or images obsessions and repetitive behaviours or mental acts compulsionsoPosttraumatic stress disorderAftermath of traumatic experience in which the person experiences increased arousal avoidance of stimuli associated with the event and anxiety in recalling the eventoAcute stress disorderSymptoms are the same as those of posttraumatic stress disorder but last for 4 weeks or lessOften someone with one anxiety disorder meets the diagnostic criteria for another disorder as well comorbidity becauseoSymptoms of the various anxiety disorders are not entirely disorder specificoThe etiological factors that give rise to various anxiety disorders may be applicable to more than one disorder16 and 9 of men suffer from anxiety disorders mostly women 1524 yearsPhobiasPhobia a disrupting fear mediated avoidance that is out of proportion to the danger actually posed and is recognized by the sufferer as groundlessExamples fear of heights closed spaces snakes or spidersThe person suffers intense distress and social or occupational impairment because of the anxietyFor other phobia disorders the suffix phobia is preceded by a Greek word for the feared object or situationoClaustrophobia fear of closed spacesoAgoraphobia fear of public placesoAcrophobia fear of heightsoErgasiophobia fear of writingoPnigophobia fear of chokingoTaphenphobia fear of being buried aliveoAnglophobia fear of EnglandPsychoanalysts believe that the content of the phobias has important symbolic valueBehaviouristignore the content of the phobia and focus on its function insteadThere are 2 types of phobias SpecificSocial PhobiasSpecific PhobiasSocial Phobia unwarranted fears caused by the presence or anticipation of a specific object or situation Chapter 6 Anxiety DisordersPage 7DSMIV subdivides these phobias according to the source of the fearoBloodoInjuriesInjectionsoSituationsoAnimalsoNatural EnvironmentRecent empirical research involving a national representative sample suggests that fear can be grouped into 1 of 5 factorsoAgoraphobiaoFears of heights of wateroThreat fear bloodneedle stormsthunderoFear or being observedoSpeaking fearsoBut then these were classified under the higherorder categoriesspecificsocial fearsSpecific fear focused on in a phobia can vary cross culturallyoPaleng fear of the coldThey worry that loss of body heat may be life threateningoTaijinkyofusho fear of other peopleFear of embarrassing others Social PhobiasSocial Phobia persistent irrational fears linked generally to the presence of other peopleThey try to avoid particular situations where they might be evaluated fearing they will reveal signs of anxiousness or behave in an embarrassing wayPeople with generalized type have an earlier age of onset more comorbidity with other disorders depression alcohol abuse and more severe impairmentsSocial phobias are fairly common11 in men and 15 in womenOften occur in conjunction with generalized anxiety disorder specific phobias panic disorder avoidant personality disorder and mood disordersOnset is usually during adolescent when social awareness and interaction with others is importantThere was a link between social phobia and dropping out of schoolEtiology of PhobiasPsychoanalytic TheoriesFreudoPhobias are against the anxiety produced by repressed id impulses oAnxiety is deplaced from the feared id impulse and moved to an object or situation that has some symbolic connection to itArietioRepression stems from a particular interpersonal problem of childhood rather than from an id impulseBehavioural TheoriesLearning is the way in which phobias are acquiredTypes of learning 3Avoidance Conditioning oPhobias reactions are learned avoidance responsesoWatsonRayner Phobias develop from 2 related sets of learningVia classical conditioning a person learns to fear a neutral stimulus when its paired with a painful or frightening event The person learns to reduce the conditioned fear by avoidingescaping itVia operant conditioning response is maintained by its reinforcing consequence of reducing the fearChapter 6 Anxiety DisordersPage 7
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