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Anxiety Disorders

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Typically a normal response but becomes abnormal when its ... See 6-second Quieting Exercise on pg. 230. Anxiety-Phobias. Phobia: excessive, irrational fear ... – PowerPoint PPT presentation

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Title: Anxiety Disorders


1
Anxiety Disorders
  • PSY 436
  • Instructor Emily E. Bullock, Ph.D.

2
ANXIETY
  • Anxiety An emotional state characterized by
    physiological arousal, unpleasant feelings of
    tension, and a sense of apprehension or
    foreboding. (text p.169)
  • Typically a normal response but becomes abnormal
    when its level is out of proportion to a threat
    or associated with no specific trigger
  • Anxiety Disorder A class of psychological
    disorders characterized by excessive or
    maladaptive anxiety reactions

3
DSM-IV-TR Anxiety Disorders
  • Panic Disorder without Agoraphobia
  • Panic Disorder with Agoraphobia
  • Agoraphobia without History of Panic Disorder
  • Specific Phobia
  • Social Phobia
  • Obsessive-Compulsive Disorder
  • Posttraumatic Stress Disorder
  • Acute Stress Disorder
  • Generalized Anxiety Disorder
  • Anxiety Disorder due to general medical condition
  • Substance-Induced Anxiety Disorder
  • Anxiety Disorder NOS

4
Anxiety Disorders to be Covered in this Class
  • Panic Attacks
  • Panic Disorder with and without Agoraphobia
  • Phobias
  • Specific
  • Social
  • Obsessive-Compulsive Disorder (OCD)
  • Posttraumatic Stress Disorder (PTSD)
  • Generalized Anxiety Disorder (GAD)

5
Anxiety-Panic
  • Panic Attack discrete period of intense fear or
    discomfort in the absence of real danger that is
    accompanied by somatic or cognitive symptoms
  • Panic Disorder presence of recurrent, unexpected
    panic attacks followed by at least 1 month of
    persistent concern related to having another
    panic attack or significant behavioral change
    related to the attack
  • Agoraphobia anxiety about being in places or
    situations from which escape might be difficult
    or in which help may not be available in the
    event of having a panic attack

6
Anxiety-Panic
  • Panic Disorder without Agoraphobia
  • Panic Disorder with Agoraphobia
  • Agoraphobia without History of Panic Disorder

7
Prevalence of Panic Disorder by Gender
8
Panic Disorder Treatments
  • Drug Therapy-Antidepressants
  • Cognitive-Behavioral Therapies/Treatments
  • Self Monitoring
  • Exposure
  • Development of coping responses
  • Relaxation Exercises
  • See 6-second Quieting Exercise on pg. 230

9
Anxiety-Phobias
  • Phobia excessive, irrational fear
  • Do you have a phobia? Is it a problem for you?

10
Anxiety-Specific Phobia Criteria
  • Marked and persistent fear that is excessive or
    unreasonable, cued by the presence or
    anticipation of a specific object or situation
  • Exposure to the phobic stimulus provokes an
    immediate anxiety response
  • Person recognizes that the fear is excessive or
    unreasonable
  • Phobic situation is avoided or endured with
    intense anxiety
  • Phobia interferes significantly with the persons
    normal routine
  • Duration is 6 months

11
Anxiety-Social Phobia Criteria
  • A marked and persistent fear of one or more
    social or performance situations in which the
    person is exposed to unfamiliar people or to
    possible scrutiny by others. Individual fears
    that they will act in a way that will be
    humiliating or embarrassing
  • Exposure to the phobic stimulus provokes an
    immediate anxiety response
  • Person recognizes that the fear is excessive or
    unreasonable
  • Feared social or performance situation is avoided
    or endured with intense anxiety

12
Anxiety-Social Phobia Criteria(cont.)
  • Phobia interferes significantly with the persons
    normal routine
  • Duration is 6 months
  • Not due to physiological effects of a substance
    of general medical condition

13
Phobic Disorders
  • Treatment Approaches
  • Learning-Based
  • Systematic desensitization
  • Fear-stimulus hierarchy
  • Gradual exposure
  • Flooding

14
AnxietyObsessive-Compulsive Disorder (OCD)
Criteria
  • Obsessions
  • Recurrent and persistent thoughts, impulses, or
    images that are intrusive and inappropriate and
    cause marked anxiety or distress
  • Obsessions are not simply excessive worries about
    real-life problems
  • Attempts to ignore and suppress obsessions or
    neutralize them with some other thought or action
  • Recognizes the obsessions are a product of their
    own mind (not thought insertion)

15
AnxietyOCD Criteria
  • Compulsion
  • Repetitive behaviors or mental acts that the
    person feels driven to perform in response to an
    obsession or according to rules that must be
    applied rigidly
  • Behaviors or mental acts are aimed at preventing
    or reducing distress or preventing some dreaded
    event or situation

16
AnxietyOCD Other Criteria
  • Person recognizes Obsessions or compulsions are
    excessive or unreasonable
  • Cause marked distress, time consuming (more than
    1 hour a day) or significantly interfere with
    routine
  • Content of obsession or compulsion is not
    restricted to another Axis I Diagnosis (e.g.,
    eating disorder)
  • Not due to physiological effects of a substance
    or general medical condition

17
OCD Treatments
  • Exposure with response prevention
  • Drug Therapy-SSRIs
  • Combination of drug and Cognitive Behavioral
    Therapy show best results for most anxiety
    disorders

18
Anxiety--Posttraumatic Stress Disorder (PTSD)
Criteria
  • Exposure to a traumatic event
  • Traumatic event is persistently reexperienced
  • Persistent avoidance of stimuli associated with
    the trauma and numbing of general responsiveness
  • Persistent symptoms of increased arousal (not
    present before trauma)
  • Duration of disturbance more than 1 month
  • Disturbance causes clinically significant
    distress or impairment

19
PTSD Treatments
  • Drug Therapy-antidepressants for associated
    symptoms of depression and anxiety
  • PTSD-specific cognitive-behavioral treatment
    protocols (often in group therapy formats)
  • EMDR

20
Anxiety-Generalized Anxiety Disorder
  • Generalized Anxiety Disorder persistent feelings
    of anxiety that are not triggered by any specific
    object, situation, or activity

21
Anxiety-Generalized Anxiety Disorder Criteria
  • Excessive anxiety and worry, occurring more days
    than not for at least 6 months, about a number of
    events or activities
  • Person finds it difficult to control the worry
  • Associated Symptoms
  • Anxiety and worry not confined to another Axis I
    diagnosis (e.g., Social phobia)
  • Cause clinically significant distress or
    impairment
  • Not due to the direct physiological effect of a
    substance or general medical condition

22
Generalized Anxiety Disorder Treatments
  • Cognitive Behavioral Therapy
  • Relaxation skills
  • Drug Therapy-Paxil

23
Ethnic Differences in Anxiety Disorders
  • Evidence from a nationally representative sample
    of U.S. adults showed that rates of anxiety
    disorders were generally comparable across racial
    and ethnic groups.

24
Review
  • Panic Attacks
  • Panic Disorder with and without Agoraphobia
  • Phobias
  • Specific
  • Social
  • Obsessive-Compulsive Disorder (OCD)
  • Posttraumatic Stress Disorder (PTSD)
  • Generalized Anxiety Disorder (GAD)
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