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Anxiety Disorders

Key Concepts:

Terms in this set (27)

Anxiety Disorders
55% of people with mood disorder diagnosis right now also have anxiety disorder

75% have both in lifetime
Panic Attack
not a diagnosis- discrete period of intense fear or discomfort in which at least 4 of the following 13 symptoms develop and reach a peak within 10 mins
panic attack symptoms
symptoms can pre/post date attack
1). Palpitations or tachy cardia- rapid heart rate
2). Sweating
3).Trembling/shaking
4).Shortness of breath/smothering
5). Feeling of choking
6). Chest pain
7). Nausea or gastro intestinal distress
8). feeling dizzy, unsteady, light headed, or faint
9). Derealization or depersonalization-- sureal activity-watch yourself get anxious
10). fear of losing control or going crazy
11). fear or dying
12). numbness or tingling
13). chills or hot flashes
Specific phobia criteria
need all
A). marked fear or anxiety about a specific object/situation
B). phobic object/ situation almost always provoke fear
C). phobic object/situation actively avoided
D). fear/anxiety out of proportion to actual danger posed by phobic object/situation
E). fear, anxiety or avoidance lasts longer than 6 months
F). fear/anxiety or avoidance causes clinically significant distress or impairment
Types of phobia
Animal
Natural environment type
blood-injury injection type
situational type
other type
Animal type phobia
spiders, snakes, mice, dogs, bears, birds, bees
Natural environment type phobia
heights, storms, water
blood injury injection type phobia
blood, injury, injection=== people faint
situational type
planes, elevator, enclosed spaces
other type phobia
illness choking vomiting
Who gets specific phobias
very young onset
---exception= situational-- Bimodal- either 2-7 or early 20s

6-11% lifetime prevalence
women more likely to experience phobia
---exception- injury 1.1:1 male- 2-3% prevalence
Social Anxiety disorder (social phobia)
A. Excessive fear of performance situation in which a person is exposed to possible scrutiny by unfamiliar people--- fear of acting in embarrassing way

). marked fear or anxiety about a specific object/situation
B). phobic object/ situation almost always provoke fear
C). phobic object/situation actively avoided
D). fear/anxiety out of proportion to actual danger posed by phobic object/situation
E). fear, anxiety or avoidance lasts longer than 6 months
F). fear/anxiety or avoidance causes clinically significant distress or impairment
Who gets SAD?
Adolescent onset
8% yearly prevalence
1% point prevalence
-3:1 female
Biological Theory
Phobia does not seem to be inheritable but there are heritable components to anxiety disorders
Biochemical treatments
phobia needs to have learned component
GABA definency?
GABA- NT that comes back down from anxiety
Alcohol= GABA agonists- decrease anxiety
Benzodiazepines (Xanax, Valium)
drugs that lower anxiety and reduce stress
Faciliate action of GABA in brain
Elusive findings-- dimished GABA in brain of Phobic
severe withdraw- rebound anxiety
Very short term- less than 2 weeks
MAO inhibitors (MAOIs)- Marplan Nardil
helps social phobia
bad side effects
inhibit reuptake of monoamines
SSRIs (Paxil, Prozac, Zoloft)
help social phobia
facilitate action of serotonin
no current evidence for serotonin deficiency
60% improve
5-HT 1A agonist (Buspar)
Social specific
serotonin receptor agonists
best as adjunctive treatment for other meds
---helps how well they respond, not if they do
Beta Blockers (propanol)
heart medication
control heart rate/bp
stop other symptoms?
little effiencey data
nurephineren antagonists---block receptor
psychodynamic theory and treament
poorly designed oedipus complex
--displaced fear onto other object
castration anxiety displaced onto innocent object
--Little Hans
fear of horses
5 yr old phalic stage
horse became hanger to fit fear for dad like features
Psychodynamic treatment and research
treatment
-- standard psychoanalysis
research
--poor outcomes
30-40% got better--30-40% placebo
cant accept underlying reason?
Behavioral theory
development of phobia
-direct exposure to phenomenon
-panic attack in specific situation
-observational/ informational
--hearing/seeing someone else have phobia
learned component
PHOBIAS CLASSICALLY CONDITIONED- MAINTAINED BY AVOIDANCE OF PHOBIC OBJECT OR SITUATION
--little albert--lack of exposure- extinction- need to be in presence of cs
Mowrer's two-factor model
Pairing of stimulus with aversive UCS leads to fear (Classical Conditioning)
Avoidance maintained though negative reinforcement (Operant Conditioning)
behavioral treatment
exposure
-systematic desensitization
---cant be relaxed and tense at the same time
counter-conditioning/systematic desensitization
- type of behavioral therapy based on the principle of classical conditioning
-aims to remove the fear response of a phobia and substitute a relaxation response to the conditioned stimulus gradually using counter conditioning
-There are three phases to the treatment
-The client repeatedly imagines (or is confronted by) this situation until it fails to evoke any anxiety at all, indicating that the therapy has been successful. This process is repeated while working through all of the situations in the anxiety hierarchy until the most anxiety-provoking
-build up in intensity
-progressive relaxation with exposure
-if anxiety felt- start over
graduated exposure
in behavior therapy, a method in which a person suffering from a phobia or panic attacks is gradually taken into the feared situation or exposed to a traumatic memory until the anxiety subsides
-no relaxation
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