anxiety disorders distressing, persistent anxiety or maladaptive behaviors that reduce anxiety
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Anxiety DisordersAnxiety Disorders
Distressing, persistent anxiety or Distressing, persistent anxiety or maladaptive behaviors that maladaptive behaviors that
reduce anxietyreduce anxiety
Manifestations of AnxietyManifestations of Anxiety• CognitiveCognitive
– Thought process range from Thought process range from generalized worry to generalized worry to overwhelming fear (focus on overwhelming fear (focus on impending doom)impending doom)
• BehavioralBehavioral– The avoidance of anxiety-The avoidance of anxiety-
provoking situation provoking situation
• SomaticSomatic– Physiological complaints due Physiological complaints due
to activation of sympathetic to activation of sympathetic nervous system (stomach nervous system (stomach aches, headaches, shakiness, aches, headaches, shakiness, etc.)etc.)
Specific PhobiasSpecific Phobias• Specific phobias = irrational, Specific phobias = irrational,
persistent fear of specific persistent fear of specific objects or situationsobjects or situations
• Simple phobias:Simple phobias:– Claustrophobia = enclosed Claustrophobia = enclosed
spacesspaces– Agoraphobia = open spacesAgoraphobia = open spaces– Arachnophobia = spidersArachnophobia = spiders– Acrophobia = heightsAcrophobia = heights
• Social phobia = fear of social Social phobia = fear of social situations & embarrassmentsituations & embarrassment
Phobias - irrational fears Phobias - irrational fears http://phobialist.com/http://phobialist.com/
• Hematophobia: Hematophobia: BloodBlood
• Gephyrophobia: Gephyrophobia: Crossing a bridgeCrossing a bridge
• Kenophobia: Kenophobia: Empty Empty roomsrooms
• Cynophobia: Cynophobia: DogsDogs• Coulrophobia: Coulrophobia: clownsclowns
• Aerophobia: Aerophobia: FlyingFlying• Entomophobia: Entomophobia:
InsectsInsects• Gamophobia: Gamophobia:
MarriageMarriage• Ophdophobia: Ophdophobia:
SnakesSnakes• Xenophobia: Xenophobia:
StrangersStrangers• Melissophobia: Melissophobia: BeesBees
Anxiety DisordersAnxiety Disorders• Common and uncommon fearsCommon and uncommon fears
Afraid of it Bothers slightly Not at all afraid of it
Beingclosed in,
in a smallplace
Being alone
In a house
at night
Percentageof peoplesurveyed
100
90
80
70
60
50
40
30
20
10
0Snakes Being
in high,exposedplaces
Mice Flyingon an
airplane
Spidersand
insects
Thunderand
lightning
Dogs Drivinga car
Being In a
crowdof people
Cats
Generalized Anxiety Disorder Generalized Anxiety Disorder (GAD)(GAD)
• Persistent high levels of anxiety and Persistent high levels of anxiety and excessive worry excessive worry with symptoms for with symptoms for at least 6 monthsat least 6 months
• Restlessness, Restlessness, difficulty sleeping, difficulty sleeping, lack of concentration, lack of concentration, muscle tension, muscle tension, irritabilityirritability
Panic DisorderPanic Disorder• Recurrent, unexpected panic Recurrent, unexpected panic
attacks attacks – Feelings of terrorFeelings of terror– Pounding heart, difficulty Pounding heart, difficulty
breathingbreathing– Fearful of future attacksFearful of future attacks
• Often accompanied by Often accompanied by secondary conditions, such as secondary conditions, such as agoraphobiaagoraphobia
Posttraumatic Stress DisorderPosttraumatic Stress Disorder• Flashbacks or nightmares Flashbacks or nightmares
following extremely following extremely troubling eventtroubling event
• http://www.youtube.com/http://www.youtube.com/watch?watch?v=6VsVA5p7heQ&feature=rv=6VsVA5p7heQ&feature=related elated
Posttraumatic Stress Disorder in a Community Sample..., Brian Engdahl et al, American Journal of
Psychiatry, 1997, pp. 1576-81.
Obsessive-Compulsive Disorder Obsessive-Compulsive Disorder (OCD)(OCD)
Persistent, unwanted thoughts (obsessions) Persistent, unwanted thoughts (obsessions) cause someone to feel the need (compulsion) cause someone to feel the need (compulsion) to engage in an actionto engage in an action
(did I already do this slide?… I better do it (did I already do this slide?… I better do it againagain
(did I already do this slide?… I better do it (did I already do this slide?… I better do it again) again)
• http://www.youtube.com/watch?v=44DCWslbsNM&feature=related http://www.youtube.com/watch?v=44DCWslbsNM&feature=related • http://www.youtube.com/watch?v=tPFQMRx2l3Y http://www.youtube.com/watch?v=tPFQMRx2l3Y
Common Examples of OCDCommon Examples of OCDCommon Obsessions:Common Obsessions: Common Common
Compulsions:Compulsions:
Contamination fears of germs, Contamination fears of germs, dirt, etc.dirt, etc. WashingWashing
Imagining having harmed self or Imagining having harmed self or othersothers RepeatingRepeating
Imagining losing control of Imagining losing control of aggressive urgesaggressive urges CheckingChecking
Intrusive sexual thoughts or Intrusive sexual thoughts or urgesurges TouchingTouching
Excessive religious or moral Excessive religious or moral doubtdoubt CountingCounting
Forbidden thoughtsForbidden thoughts Ordering/arrangingOrdering/arranging
A need to have things A need to have things "just so""just so" Hoarding or savingHoarding or saving
A need to tell, ask, confessA need to tell, ask, confess PrayingPraying
Anxiety DisordersAnxiety Disorders• Fear of embarrassing oneself in public to the extent Fear of embarrassing oneself in public to the extent
that one is isolated completely.that one is isolated completely.
Social phobiaSocial phobia• Recurrent thoughts that lead to ritual behaviors.Recurrent thoughts that lead to ritual behaviors.
OCDOCD• Constant anxiety and worry for no particular cause.Constant anxiety and worry for no particular cause.
Generalized Anxiety DisorderGeneralized Anxiety Disorder• Fear of being in wide, open, public spaces like a Fear of being in wide, open, public spaces like a
stadium or shopping mall.stadium or shopping mall.
AgoraphobiaAgoraphobia• Re-occurring flashbacks or nightmares of a prior Re-occurring flashbacks or nightmares of a prior
traumatic event.traumatic event.
PTSDPTSD
Anxiety DisordersAnxiety Disorders
• PET Scan of brain of PET Scan of brain of person with person with Obsessive/ Obsessive/ Compulsive disorderCompulsive disorder
• High metabolic High metabolic activity (red) in activity (red) in frontal lobe areas frontal lobe areas involved with involved with directing attentiondirecting attention
Prevalence of Anxiety Disorders in the Prevalence of Anxiety Disorders in the U.S.U.S.
Specific Phobia
19.2 Million
Social Phobia
15 Million
GAD6.8 Million
Panic Disorder6 Million
OCD2.2 Million
Explaining Anxiety DisordersExplaining Anxiety Disorders• BiologicalBiological
– Fears may have an evolutionary basis (contribute Fears may have an evolutionary basis (contribute to survival)to survival)
– Genetic predisposition Genetic predisposition to fears and anxiety to fears and anxiety (tend to run in families)(tend to run in families)
– Lack of GABA Lack of GABA neurotransmitterneurotransmitter
• CognitiveCognitive– Irrational beliefs regarding Irrational beliefs regarding
feared stimulus feared stimulus (exaggeration)(exaggeration)
Explaining Anxiety DisordersExplaining Anxiety Disorders• Behavioral (learning)Behavioral (learning)
– Classical conditioning Classical conditioning of fearof fear
– Avoidance relieves Avoidance relieves fear (negative fear (negative reinforcement)reinforcement)
• Biopsychosocial Biopsychosocial modelmodel– Anxiety has a Anxiety has a
biological involvement biological involvement and learning and learning component, both of component, both of which are influenced which are influenced by cultureby culture
Somatoform DisordersSomatoform Disorders
Complaints of physical symptoms with Complaints of physical symptoms with no physiological explanation (they are no physiological explanation (they are
psychologically based)psychologically based)
• Somatization disorderSomatization disorder = multiple = multiple physical complaints with no physical physical complaints with no physical explanation, onset before age 30explanation, onset before age 30
• Conversion disorderConversion disorder = specific severe = specific severe physical complaint (paralysis, physical complaint (paralysis, blindness) with no physical causeblindness) with no physical cause– La belle indifferenceLa belle indifference
Glove Anesthesia
A conversion disorder in which a person can’t feel their hand (B). Neurologically this is impossible because the sensory nerves of the hand and arm are organized as shown in (A) rather than (B).
Body Dysmorphic DisorderBody Dysmorphic Disorder
• Excessive Excessive preoccupation preoccupation w/minor or w/minor or imagined flaw in imagined flaw in physical physical appearanceappearance
HypochondriasisHypochondriasis• Persistent Persistent
preoccupation with preoccupation with one’s health despite one’s health despite the fact that the fact that genuine symptoms genuine symptoms of the disorder are of the disorder are lackinglacking
Hypochondriasis
Occurs equally in men and women.
Typical age of onset is 20-30.
Prevalence rate 1%–5%.
$20 billion a year spent on unnecessary medical procedures.
Explaining Somatoform Explaining Somatoform DisordersDisorders
• Psychoanalytic – unresolved childhood conflicts, experiences
• Behavioral– Reinforcement
(anxiety is reduced)– Interpersonal gains in
terms of sympathy & support
• Sociocultural factors
Dissociative DisordersDissociative Disorders
Disruption or disturbances in memory, consciousness, or identity due to
psychological factors
Psychogenic (dissociative) Amnesia• Person loses memory due to stress or
psychological trauma (no physical cause)
Psychogenic (Dissociative) Fugue
• Confusion over personal identity & assumes new identity (usually travel away from home & start new life)
Case Study: Dissociative Fugue
• Jennifer Wilbanks developed a fear of her upcoming wedding. Over several weeks she bought bus tickets, cut her hair and took the bus to Las Vegas and finally ended up in New Mexico. She confabulated an abduction story but finally admitted to her bus ride. (Neither Wilbanks nor Mason will answer mail or emails for an interview). She was a worker in a doctor's office.
Depersonalization Disorder
• Most common dissociative disorder• Feelings of unreality about self• “This is not my body…I am trapped in
someone else’s body”
Dissociative Identity Disorder• Person has several personalities rather than
one integrated personality (a.k.a. Multiple Personality)
• http://www.youtube.com/watch?v=NDUw-yCRBUM&feature=related
• http://www.youtube.com/watch?v=xRY7Oj-dl3o
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