DSM

1. DSM Diagnostic and Statistical Manual of Mental Disorders

2. mental disorder • distress • impairment in normal functioning: • occupational • social-interpersonal relationships • self-care

3. phobia • irrational and persistent fear severity based on: • degree of panic • degree of avoidance behavior

4. phobia specific phobia object or situation social phobia in the presence of others

5. GAD generalized anxiety disorder constant, numerous, exaggerated worries (at least 6 months)

6. panic attack discrete period of intense fear in the absence of real danger w/ 4+: Heart palpitations Sweating Trembling Shortness of breath Chest pain Lightheadedness Fear of losing control or going crazy Fear of dying derealization or depersonalization

7. panic attack uncued unexpected, out of the blue cued occur on exposure to, or in anticipation of, a situational trigger (e.g. phobia)

8. panic disorder • repeated panic attacks • fear of future panic attacks • w/ or w/o agoraphobia

9. agoraphobia • fear of places or situations in which: • escape would be difficult or embarrassing • help would be difficult

10. ocd • germs • something bad will happen • symmetry • religion • #s obsessions repetitive, unwelcome thoughts compulsions • washing • counting • checking • touching • rituals repetitive, almost irresistible action

11. ocd genetics MZ concordance = 87% environment A beta-hemolytic streptoccocal infection triggers autoimmune attack to basal ganglia

12. treatment for anxiety disorders cognitive-behavior therapy Benzodiazepines GABA agonists SSRIs Selective Serotonin Reuptake Inhibitors

13. benzodiazepines Valium Librium Xanax Also used for sleeping pills & anti-seizure meds

14. epidemiology comorbidity family studies – concordant for varied anxiety disorders