ANXIETY

1. ANXIETY

2. The Anxiety Disorders • They affect over 50 million people over age 18 in the United States • Many have a median onset as early as 13 years of age • Indirect and direct economic costs associated with treatment of anxiety disorder was $46.6 billion as late as 2004 • May interfere with being able to form and sustain relationships • May interfere with obtaining or sustaining employment

3. The Anxiety Disorders • Panic attack • Panic Disorder without agoraphobia • Panic Disorder with agoraphobia • Obsessive-Compulsive Disorder • Substance induced Anxiety Disorder • Post-traumatic Stress Disorder • Generalized Anxiety Disorder • Anxiety Disorder due to a general medical condition • Anxiety Disorder Not otherwise specified

4. Panic Attack • A discrete period in which there is the sudden onset of intense apprehension, fearfulness, or terror, often associated with feeling of impending doom. During these attacks, symptoms such as shortness of breath, palpitations, chest pain or discomfort, choking or smothering sensations, and fear of “going crazy” or losing control are present.

5. Criteria for Panic Attack • 1) palpitations, pounding heart, or accelerated heart rate • 2) sweating • 3) trembling or shaking • 4) sensations of shortness of breath or smothering • 5) feeling of choking • 6) chest pain or discomfort • 7) nausea or abdominal distress • 8) feeling dizzy, unsteady, lightheaded, or faint • 9) derealization (feelings of unreality) or depersonalization (being detached from oneself) • 10) fear of losing control or going crazy • 11) fear of dying • 12) paresthesias (numbness or tingling sensations) • 13) chills or hot flushes

6. Agoraphobia • Is anxiety about, or avoidance of, places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having a Panic Attack or panic-like symptoms.

8. Specific Phobia • Is characterized by clinically significant anxiety provoked by exposure to a specific feared object or situation, often leading to avoidance behavior.

9. Social Phobia • Is characterized by clinically significant anxiety provoked by exposure to certain types of social or performance situations, often leading to avoidance behaviors.

10. Obsessive-Compulsive • Is characterized by obsessions (which cause marked anxiety or distress) and/or by compulsions (which serve to neutralize anxiety).

11. Posttraumatic Stress • Is characterized by the re-experiencing of an extremely traumatic event accompanied by symptoms of increased arousal and by avoidance of stimuli associated with the trauma.

12. Acute Stress • Is characterized by symptoms similar to those of Posttraumatic Stress that occur immediately in the aftermath of an extremely traumatic event.

13. Generalized Anxiety • Is characterized by at least 6 months of persistent and excessive anxiety and worry.

14. Anxiety due to medical condition • Is characterized by prominent symptoms of anxiety that are judged to be a direct physiological consequence of a general medical condition.

15. Anxiety Disorder NOS • Is included for coding disorders with prominent anxiety or phobia avoidance that do not meet criteria for any of the specific Anxiety Disorders defined in the DSM-IV-TR (or anxiety symptoms about which there is inadequate or contradictory information).

16. Rapid Assessment instruments • Common characteristics: • Brief • Easy to administer • Easy to score • Easy to interpret • Little knowledge of testing procedure needed • Most are self-report • Most are done in 15 minutes

17. Obsessional Beliefs Questionnaire (OBQ) 87 item 7 point, likert-based questionnaire that assesses beliefs considered characteristic of obsessive thinking.

18. THE CONTAMINATION COGNITIONS SCALE (CCS) • assesses the overestimation of threat from potentially contaminated objects.

19. OBSESSIVE-COMPULSIVE INVENTORY (OCI) 42 item self-report measure of the frequency of OCD symptoms and distress experienced from them in the past month.

20. THE OBSESSIVE-COMPULSIVE TRAIT CORE DIMENSIONS QUESTIONNAIRE (OC-TCDQ) 20 item self report measure compromised of two subscales which assess compulsive behaviors in OCD---harm avoidance and incompleteness

21. The Yale-Brown Obsessive-compulsive Scale 10 item, 5-point Likert scale measuring the severity and frequency of obsessions and compulsions experienced during a day.

22. Cognitive-Somatic Anxiety Questionnaire (CSAQ) • 14 item instrument that focuses thoughts ands somatic modes of trait anxiety and is used to assess the presence of general anxiety in situations.

23. The Penn Inventory for Posttraumatic Stress Disorder (PI-PTSD) 26 item, 3-point Likert, self-report measurement that assesses DSM-IV symptoms of PTSD for multiple traumatic experiences. • To obtain scale, contact Melvyn Hammarberg, PhD Department of Anthropology University of Pennsylvania 325 University Museum 33rd and Spruce Street Philadelphia, PA 19104-6398

24. The Los Angeles Symptom Checklist (LASC) • 43 item, 5-point Likert, self-report measure associated with 17 DSM symptoms embedded in the scale and items measuring general distress.

25. The Screen for Posttraumatic Stress Symptoms (SPTSS) 17 item, 11 point Likert, self-report measure used to measure and assess DSM-IV symptoms of PTSD. Useful for those multi-traumatic events and unknown trauma history.

26. The Beck Anxiety Inventory (BAI) • 21 item self report inventory.

27. References • Diagnostic and statistical manual of mental disorders fourth edition. (2000). Arlington, VA.: American Psychiatric Publishing, Inc. • Dziegielewski, S.F. (2010). Dsm-iv-tr in action 2nd edition. Hoboken, New Jersey: John Wiley & Sons

28. References • Mayo Clinic Staff, (2010). Treatments and drugs. Mayo clinic. Retrieved October 25, 2010, from http://www.mayoclinic.com/health/panic-attacks/DS00338/DSECTION=treatments-and-drugs • Autism research asd-carc. (2007). Retrieved from http://www.asdcarc.com/index.php/publisher/articleview/?PHXSESSID=7361595bf597d9853f375f838eff96d3&/1/frmArticleID/421/staticId/1253/#A9