Anxiety Disorders Module 49

1. 1 Anxiety DisordersModule 49

2. 2 Anxiety Disorders Feelings of excessive apprehension and anxiety. OBJECTIVE 48-1| Define anxiety disorder, and explain how this condition differs from normal feelings of stress, tension, or uneasiness.OBJECTIVE 48-1| Define anxiety disorder, and explain how this condition differs from normal feelings of stress, tension, or uneasiness.

3. Generalized Anxiety Disorder Chronic, excessive worry about a number of events of activities, not limited to any specific object or situation and difficult to control Relatively constant state of apprehension, tension and uneasiness � Occurs more days than not for at least 6 months Includes at least 3 of the following: restlessness, feeling of being easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tension, sleep disturbance. May also include: Constant vigilance for possible negative events Mistrust/suspiciousness of others � constantly expecting to be �duped� Trouble getting rid of old items Need for control Person attempts to constantly deal with upcoming negative events. Includes high levels of negative affect, chronic overarousal and sense of uncontrollability - may include: difficulty concentrating difficulty making decisions (fear of making a mistake) show marked vigilance for possible signs of threat in their environment No matter how well things are going, they are constantly apprehensive and upset. Lifetime prevalence: 5% Many people with GAD manage to function. Often occurs with other mood and anxiety disorders. May be explained by ego/id conflict, classical conditioning (association of anxiety with many env. Cues), exposure to unpredictable &/or uncontrollable events -therefore do not develop safety signals for when it is ok to feel safe and relax. - may also be caused by maladaptive assumptions &/or schemas about the world (ex., the world is unsafe and I must constantly work to protect myself). Also people w/ GAD tend to pay more attention to threatening stimuli, and to interpret ambiguous stimuli in a threatening way. Biological explanations include functional deficiency of GABA - seems that GABA, serotonin and norep. All play a role, but how they interact is aa mystery Benzodiazapines and cognitive behavioral therapy often=effective treatment. Sometimes, antidepressants also work.Person attempts to constantly deal with upcoming negative events. Includes high levels of negative affect, chronic overarousal and sense of uncontrollability - may include: difficulty concentrating difficulty making decisions (fear of making a mistake) show marked vigilance for possible signs of threat in their environment No matter how well things are going, they are constantly apprehensive and upset. Lifetime prevalence: 5% Many people with GAD manage to function. Often occurs with other mood and anxiety disorders. May be explained by ego/id conflict, classical conditioning (association of anxiety with many env. Cues), exposure to unpredictable &/or uncontrollable events -therefore do not develop safety signals for when it is ok to feel safe and relax. - may also be caused by maladaptive assumptions &/or schemas about the world (ex., the world is unsafe and I must constantly work to protect myself). Also people w/ GAD tend to pay more attention to threatening stimuli, and to interpret ambiguous stimuli in a threatening way. Biological explanations include functional deficiency of GABA - seems that GABA, serotonin and norep. All play a role, but how they interact is aa mystery Benzodiazapines and cognitive behavioral therapy often=effective treatment. Sometimes, antidepressants also work.

4. A person experiencing his first panic attack is likely to: Call a therapist and schedule an appointment Go to the emergency room Know that his symptoms are signs of a psychological disorder. Use relaxation techniques to calm himself.

5. Panic Disorders Panic Attack: discrete period of intense apprehension, fear or terror, often with feelings of impending doom and physical symptoms. Symptoms may include: shortness of breath, heart palpitations, chest pain, choking or smothering sensations, fear of going crazy or losing control. Panic Disorder: Recurrent, unexpected panic attacks and concern about having panic attacks. Always diagnosed as either: Panic Disorder with agoraphobia, or Panic Disorder without agoraphobia Persons with panic disorder (aka panic attack disorder) worry persistently about having more attacks and have had several attacks - they may make significant changes in behavior as a result of the attacks (I.e., avoid situations in which the attacks have occurred). Persons with panic disorder (aka panic attack disorder) worry persistently about having more attacks and have had several attacks - they may make significant changes in behavior as a result of the attacks (I.e., avoid situations in which the attacks have occurred).

6. 6 Phobia Marked by a persistent and irrational fear of an object or situation that disrupts behavior. OBJECTIVE 48-3| Explain how a phobia differs from fears we all experience.OBJECTIVE 48-3| Explain how a phobia differs from fears we all experience.

7. 7 Kinds of Phobias

8. Obsessive Compulsive Disorders Obsessions: recurrent, intrusive thoughts Compulsions: behaviors intended to reduce anxiety generated by obsessions. Obsessions are experienced as excessive, intrusive and inappropriate - not just worry about life Person recognizes thoughts are his own Person feels they must perform the compulsions Obsessions and compulsions take more than 1 hour per day and interfere with normal functioning Affects 2.4% of populationAffects 2.4% of population

9. Which person has OCD? Bob, who spends 3 hours per day washing his hands to get rid of germs. Bill, who likes everyone to follow the schedules he prepares for them. Hank, who worries about paying his bills. Frank, who is afraid to ride the elevator at work.

10. Anxiety Disorders

11. 11 PET Scan of brain of person with Obsessive- Compulsive Disorder (OCD). High metabolic activity (red) in frontal lobe areas involved with directing attention. Brain Imaging

12. 12 Post-Traumatic Stress Disorder Four or more weeks of the following symptoms constitute post-traumatic stress disorder (PTSD). OBJECTIVE 48-5| Describe the symptoms of post-traumatic stress disorder, and discuss survivor resiliency.OBJECTIVE 48-5| Describe the symptoms of post-traumatic stress disorder, and discuss survivor resiliency.

13. 13 Resilience to PTSD Only about 10% of women and 20% of men react to traumatic situations and develop PTSD.

14. 14 Explaining Anxiety Disorders OBJECTIVE 48-6| Discuss the contributions of the learning and biological perspectives to our understanding of the development of anxiety disorders.OBJECTIVE 48-6| Discuss the contributions of the learning and biological perspectives to our understanding of the development of anxiety disorders.

15. 15 The Learning Perspective

16. 16 The Learning Perspective

17. 17 The Biological Perspective

18. 18 The Biological Perspective

19. From a learning perspective, phobias likely develop as a result of ___________, and ____________ helps to maintain them. A. operant conditioning; observational learning B. classical conditioning; reinforcement C. operant conditioning; reinforcement D. classical conditioning; observational learning

20. Years after he barely survived a terrorist attack that killed his wife and two children, Mr. Puskari suffers recurring flashbacks and frequent nightmares of the event that render him incapable of holding a steady job. Mr. Puskari is most clearly showing signs of: A. obsessive-compulsive disorder. B. generalized anxiety disorder. C. post-traumatic stress disorder. D. dysthymic disorder.