Lesson 5: Anxiety Disorders PDF

Lesson 5: Anxiety Disorders  FEAR ANXIETY vs PANIC Important Concepts: Anxiety – a future-oriented negative mood state characterized by bodily symptoms of physical tension and by apprehension about the future (American Psychiatric Association, 2013; Barlow, 2002...

Lesson 5: Anxiety Disorders  FEAR ANXIETY vs PANIC Important Concepts: Anxiety – a future-oriented negative mood state characterized by bodily symptoms of physical tension and by apprehension about the future (American Psychiatric Association, 2013; Barlow, 2002 Fear – the central nervous system’s physiological and emotional response to a serious threat to one’s well-being. Panic – an abrupt experience of intense fear or acute discomfort, accompanied by physical symptoms that usually include heart palpitations, chest pain, shortness of breath, and, possibly, dizziness ANXIETY DISORDERS (DSM 5-TR) A. Separation Anxiety Disorder B. Selective Mutism C. Specific Phobia D. Social Anxiety Disorder E. Panic Disorder F. Agoraphobia G. Generalized Anxiety Disorder Anxiety Disorder due to Another Medical Condition Other Specified Anxiety Disorder Unspecified Anxiety Disorder 1. Separation Anxiety Disorder 2. Selective Mutism 3. Specific Phobia TYPES OF PHOBIA 1) Blood-injection-injury Phobia – fear of needles, invasive medical procedures - vasovagal fainting - higher chance of being inherited than other phobias 2) Situational Phobia – fear of public transportation or enclosed spaces 3) Natural Environment Phobia - fear of situations or events occurring in nature (lightning, thunder, height, storms, water) 4) Animal Phobia – fear of animals and insects 4. Social Anxiety Disorder 4. Social Anxiety Disorder 5. Panic Disorder 5. Panic Disorder 6. Agoraphobia 6. Agoraphobia 7. Generalized Anxiety Disorder 7. Generalized Anxiety Disorder  Theoretical Explanations of Anxiety Disorders A. SOCIO-CULTURAL PERSPECTIVE GAD is most likely to develop in people who are faced with ongoing societal conditions that are dangerous. People in highly threatening environments are indeed more likely to develop the general feelings of tension, anxiety, and fatigue and the sleep disturbances found in this disorder (Slopen et al., 2012; Stein & Williams, 2010) Poverty B. PSYCHODYNAMIC PERSPECTIVE when a child is overrun by neurotic or moral anxiety, the stage is set for generalized anxiety disorder. Overprotected children, shielded by their parents from all frustrations and threats, have little opportunity to develop effective defense mechanisms. A history of parental overprotection and intrusiveness (Separation Anxiety Disorder) C. HUMANISTIC PERSPECTIVE arises when people stop looking at themselves honestly and acceptingly D. COGNITIVE PERSPECTIVE Maladaptive assumptions Basic Irrational Beliefs (Albert Ellis) ○ “It is a dire necessity for an adult human being to be loved or approved of by virtually every significant other person in his community.” ○ “It is awful and catastrophic when things are not the way one would very much like them to be.” ○ “If something is or may be dangerous or fearsome, one should be terribly concerned about it and should keep dwelling on the possibility of its occurring.” ○ “One should be thoroughly competent, adequate, and achieving in all possible respects if one is to consider oneself worthwhile.” Metacognitive Theory (Adrian Wells) Intolerance of Uncertainty Theory Avoidance Theory Anxiety Sensitivity E. BIOLOGICAL EXPLANATION GABA inactivity Too much of noradrenaline (also called norepinephrine) The biology of panic: panic reactions are produced in part by a brain circuit consisting of areas such as the amygdala, hippocampus, ventromedial nucleus of the hypothalamus, central gray matter, and locus coeruleus Preparedness (Phobia) F. BEHAVIORAL EXPLANATION Classical Conditioning Vicarious learning THE TRIPLE VULNERABILITY THEORY Generalized biological vulnerability – inherited traits (being uptight and anxious) - Generalized psychological vulnerability - growing up believing that the world is dangerous and out of control, and you might not be able to cope when things go wrong based on your early experiences. - Specific psychological vulnerability – learning from early experiences, being taught by parents to fear certain things or situations TREATMENT A. SEPARATION ANXIETY DISORDER To treat separation anxiety disorder, parents are coached to react appropriately when their children experience separation anxiety B. SELECTIVE MUTISM Shaping C. SPECIFIC PHOBIA Systematic Desensitization Flooding Modelling D. AGORAPHOBIA Exposure therapy Support groups CBT E. SOCIAL ANXIETY DISORDER CBT DCS (D-cycloserine) Social Skills Training F. PANIC DISORDER Drug Therapy (benzodiazepines and antidepressants) CBT Panic Control Treatment (PCT) G. GAD Drug therapy Relaxation training