Chapter 2 (Anxiety Disorders)

Apprehension about a future threat.

Fear response to a real danger.

Fear response without an actual threat.

Characterized by excessive and inappropriate fear or anxiety.

Inherited predisposition to anxiety.

Belief the world is dangerous, acquired through conditioning.

Biological predisposition, general psychological factors, and specific psychological vulnerability combine to cause anxiety disorders.

Physiological reactions (e.g., increased heart rate) triggered by threat or danger.

Moderate levels of anxiety that improve performance.

Anxiety that's more than required and not in line with the situation, considered a disorder.

The percentage of people who experience panic disorder at some point in their lives is 3.5%.

The percentage of people who experience agoraphobia at some point in their lives is 2.3%.

Panic disorder is slightly more common in females than males.

The proportion of females to males with agoraphobia increases with the severity of the disorder.

Panic disorder often begins during adolescence.

25% of individuals with panic disorder have been unemployed for over 5 years due to the disorder's symptoms.

The presence of agoraphobia is associated with a worse prognosis (outcome) for panic disorder.

Predisposition to anxiety is a general biological vulnerability factor for panic disorder.

A mental disorder marked by intense fear and avoidance of social situations due to worry about being judged or negatively evaluated by others.

The age at which social anxiety disorder symptoms first appear.

The percentage of the population that experiences social anxiety disorder at some point in their life.

Social anxiety disorder is more prevalent in females than males.

The tendency to avoid social situations due to fear and anxiety.

A core fear in social anxiety disorder, involving the belief that others will judge, criticize, or reject them.

A defining characteristic of social anxiety disorder, where the fear of social interaction leads to a desire to avoid social situations.

The emotional discomfort and suffering experienced by individuals with social anxiety disorder.

The fear, anxiety, or avoidance in social anxiety disorder is not caused by the effects of drugs or alcohol.

Social anxiety disorder is differentiated from other mental health conditions, such as panic disorder and autism spectrum disorder.

CBT helps individuals become aware of thoughts that trigger physical sensations, leading to panic. It then teaches them to challenge and change those maladaptive beliefs, reducing anxiety.

When a spouse or significant other stops accommodating a partner's avoidance behaviors, CBT becomes more effective for agoraphobia.

The chapter covers general issues regarding anxiety and related disorders, then focuses on specific disorders like specific phobias, panic disorder, agoraphobia, social anxiety disorder, and generalized anxiety disorder.

The chapter aims to cover the general description of each disorder (diagnostic criteria), its epidemiology, aetiology (causes), and treatment options.

Social Anxiety Disorder involves persistent, intense fear of social situations due to the fear of negative evaluation or scrutiny by others.

Social Anxiety Disorder goes beyond shyness. It triggers intense anxiety and avoidance behaviors when exposed to situations that could lead to social humiliation or embarrassment.

Exposure to social situations that could lead to perceived humiliation or embarrassment triggers anxiety in people with Social Anxiety Disorder.

Social Anxiety Disorder is a pattern of intense fear in social situations where people worry about being judged negatively, which goes beyond normal shyness and often leads to avoidance.

A mental health disorder characterized by excessive and persistent worry and anxiety about various aspects of life. Individuals with GAD experience difficulty controlling their worry, which often interferes with daily functioning.

To be diagnosed with GAD, individuals must experience excessive worry and anxiety for at least 6 months, along with at least three physical symptoms (such as restlessness, fatigue, difficulty concentrating, etc.).

Generalized Anxiety Disorder is a relatively common disorder, affecting around 2-3% of the population in any given year. Women are more likely to be diagnosed with GAD than men.

The exact causes of GAD are complex and not fully understood, but factors that likely contribute include genetics, environmental factors, and psychological vulnerabilities.

Effective treatment for GAD usually involves a combination of therapy and medication. Psychotherapy, such as cognitive-behavioral therapy (CBT), helps individuals learn to manage their worry and anxiety. Medications, such as antidepressants, can help reduce the severity of symptoms.

Generalized Anxiety Disorder (GAD) is characterized by excessive worry and anxiety about various aspects of life, lasting at least 6 months.

Treatment options for GAD include medications like benzodiazepines and antidepressants, as well as psychological therapies like cognitive-behavioural therapy (CBT), mindfulness meditation, and interpersonal psychotherapy.

Cognitive-behavioural therapy (CBT) for GAD aims to identify and challenge negative thoughts, improve tolerance for uncertainty, and teach relaxation techniques.

Mindfulness meditation emphasizes being present-focused rather than dwelling on future worries, helping to manage anxious thoughts.

Benzodiazepines, such as Valium and Xanax, are anxiolytics (anxiety-reducing drugs) used to treat GAD.

Antidepressants, including tricyclics, SSRIs (Selective Serotonin Reuptake Inhibitors), and SRIs (Serotonin Reuptake Inhibitors), can be effective for GAD.

Relaxation training, a traditional approach, helps individuals reduce physical tension associated with anxiety.

Worry exposure involves intentionally engaging with worrisome thoughts in a controlled environment to decrease their intensity.

CBT encourages a designated 'worry time' to help individuals concentrate their worrying into a specific period.

Interpersonal psychotherapy (IPT) focuses on improving interpersonal relationships, which can contribute to managing GAD.

Anxiety is a feeling of apprehension or worry about a future threat, often accompanied by physical symptoms like sweating or rapid breathing.

Anxiety disorders are characterized by excessive and inappropriate fear or anxiety that interferes with daily life.

Panic disorder involves recurring unexpected panic attacks, intense periods of fear that involve physical symptoms like heart palpitations and dizziness.

Agoraphobia is the fear of situations where escape might be difficult or help unavailable if panic or other debilitating symptoms occur.

Social anxiety disorder involves intense fear of social situations due to worry about being judged or negatively evaluated by others.

Generalized anxiety disorder is characterized by excessive and persistent worry and anxiety about various aspects of life.

Treatment approaches for anxiety disorders include cognitive-behavioral therapy (CBT), medication (such as antidepressants or anti-anxiety medications), and relaxation techniques.

A combination of biological, general psychological, and specific psychological vulnerabilities leading to anxiety disorders.

Phobias are a type of anxiety disorder characterized by intense, irrational fear of specific objects or situations.

There are several types of phobias including specific phobias, social phobia (Social Anxiety Disorder), and agoraphobia.

A persistent and intense fear of a specific object or situation that is out of proportion to the actual danger it poses.

Fear of situations where escape might be difficult or help unavailable in case of panic or other debilitating symptoms.

Characterized by excessive and persistent worry and anxiety about various aspects of life.

Effective treatments for GAD usually involve a combination of therapy and medication.

CBT helps individuals become aware of their thoughts that trigger physical sensations, leading to panic. It then teaches them to challenge and change those maladaptive beliefs, reducing the anxiety.

This theory explains how agoraphobia develops through a combination of classical conditioning (fear of panic attacks) and operant conditioning (avoidance behavior being reinforced by reduction of anxiety).

In agoraphobia, avoiding situations that trigger anxiety, such as crowded places, is negatively reinforced because it removes the unpleasant feeling of fear or panic. This avoidance strengthens the behavior, making it more likely to occur in the future.

Stimulus generalization occurs when the fear associated with specific situations extends to similar situations. For instance, someone with agoraphobia might initially fear crowds, but then generalize this fear to other situations involving large groups of people, like public transportation or social gatherings.

The main categories of treatment for Panic Disorder and Agoraphobia include medications, psychoeducation, and cognitive-behavioral therapy (CBT), which often includes graded exposure to feared situations.

Psychoeducation involves helping individuals understand panic disorder and agoraphobia, dispel common misconceptions about these conditions, and learn about their causes, symptoms, and treatment options.

Graded exposure is a key component of CBT for agoraphobia. It involves gradually approaching feared situations in a systematic way, starting with less anxiety-provoking situations and gradually progressing to more challenging ones.

Panic Control Therapy (PCT) is a form of CBT that focuses on helping people understand and manage the physical sensations associated with panic attacks. It involves exposure to these sensations in a safe setting and the use of coping strategies, such as relaxation and deep breathing, to control symptoms.

PCT has shown to be very effective in reducing panic symptoms, improving quality of life, and preventing relapse. These benefits tend to persist beyond the end of treatment.

A theory explaining the development of phobias, suggesting that fear is acquired through classical conditioning (associating neutral stimuli with a negative experience) and maintained through operant conditioning (avoiding the phobic object to reduce fear).

The tendency to learn certain phobias more easily than others, suggesting an evolutionary predisposition to fear specific objects (like snakes, spiders, heights) that were historically dangerous.

The study of the distribution of phobias within a population, highlighting that specific phobias are more common in childhood and early adolescence than in adults, and people often don't seek treatment.

The study of the causes of phobias, which involve a combination of factors including genetic predisposition, conditioning experiences, environmental factors, and psychological vulnerabilities.

Classical conditioning is a learning process where a neutral stimulus (e.g., a spider) becomes associated with a negative experience (pain or fear), leading to a learned phobia of that stimulus.

Operant conditioning explains how avoidance behaviors, which reduce anxiety in the short term, are strengthened and maintained. Avoiding the phobic object removes the fear and reinforces the avoidance behavior.

Treatment for specific phobias often involves a combination of cognitive-behavioral therapy (CBT), exposure therapy, and medication (when needed). CBT helps challenge negative thoughts about the phobic object, while exposure therapy gradually exposes the individual to the feared object or situation in a safe environment.

A model developed by Wells (1999) explaining Generalized Anxiety Disorder (GAD) as arising from negative thoughts and assumptions about one's worrying, leading to further anxiety and dysfunctional behavior.

Medications that reduce anxiety, like benzodiazepines (Valium, Xanax) and antidepressants (tricyclics, SSRIs, SRIs).

A CBT strategy where individuals allocate specific time for worrying, helping to control worry and prevent it from disrupting other activities.

IPT addresses interpersonal problems that may contribute to GAD, focusing on improving relationships and communication.

Individuals with GAD often struggle to tolerate uncertainty and may engage in excessive worry to try and control the unknown.