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Anxiety Disorders

Chapter 5

Anxiety Disorders

Fear vs. anxiety

Anxiety Disorders

Fear vs. anxiety

Is anxiety useful? Fun??

Anxiety Disorders

Fear vs. anxiety

Is anxiety useful? Fun??

Anxiety disorder: too severe, too frequent, lasts too long, or too easily triggered

Anxiety Disorders

Fear vs. anxiety

Is anxiety useful? Fun??

Anxiety disorder: too severe, too frequent, lasts too long, or too easily triggered

Most common mental disorder: 18% prevalence, 29% lifetime prevalence. Only ~20% seek help

Anxiety Disorders

Fear vs. anxiety

Is anxiety useful? Fun??

Anxiety disorder: too severe, too frequent, lasts too long, or too easily triggered

Most common mental disorder: 18% incidence, 29% lifetime prevalence. Only ~20% seek help

Significant comorbidity: other anxiety disorders, depression

Anxiety Disorders

Fear vs. anxiety

Is anxiety useful? Fun??

Anxiety disorder: too severe, too frequent, lasts too long, or too easily triggered

Most common mental disorder: 18% incidence, 29% lifetime prevalence. Only ~20% seek help

Significant comorbidity: other anxiety disorders, depression

Most anxiety disorders more common in women than men

Generalized Anxiety Disorder

Generalized Anxiety Disorder

Generalized Anxiety Disorder

PsychPortal video

Generalized Anxiety Disorder

Etiology and treatments

Generalized Anxiety Disorder

Etiology and treatments

Sociocultural view: threatening environment. Treatment: Remove?

Generalized Anxiety Disorder

Etiology and treatments

Sociocultural view: threatening environment. Treatment: Remove?

Psychodynamic view: prevented from or punished for expressing id impulses, and/or weak defense mechanisms. Treatment: Become more comfortable with and/or control id impulses

Generalized Anxiety Disorder

Etiology and treatments

Sociocultural view: threatening environment. Treatment: Remove?

Psychodynamic view: prevented from or punished for expressing id impulses, and/or weak defense mechanisms. Treatment: Become more comfortable with and/or control id impulses

Humanistic view: did not receive unconditional positive regard. Treatment: Offer acceptance

Generalized Anxiety Disorder

Etiology and treatments

Sociocultural view: threatening environment. Treatment: Remove?

Psychodynamic view: prevented from or punished for expressing id impulses, and/or weak defense mechanisms. Treatment: Become more comfortable with and/or control id impulses

Humanistic view: did not receive unconditional positive regard. Treatment: Offer acceptance

Cognitive view: irrational assumptions. Treatment: challenge assumptions and increase rational thinking

Generalized Anxiety Disorder

Etiology and treatments

Sociocultural view: threatening environment. Treatment: Remove?

Psychodynamic view: prevented from or punished for expressing id impulses, and/or weak defense mechanisms. Treatment: Become more comfortable with and/or control id impulses

Humanistic view: did not receive unconditional positive regard. Treatment: Offer acceptance

Cognitive view: irrational assumptions. Treatment: challenge assumptions and increase rational thinking

Biological view: not enough GABA messages sent, and/or anxiety circuit in brain. Treatment: sedative drugs, relaxation training, biofeedback

Phobias

Phobias

Phobias

Specific phobia – etiology and treatment

Behavioral view: fears are learned through conditioning or modeling and maintained through avoidance

Phobias

Specific phobia – etiology and treatment

Behavioral view: fears are learned through conditioning or modeling and maintained through avoidance. Treatment: Exposure, through systematic desensitization or flooding

Phobias

Specific phobia – etiology and treatment

Behavioral view: fears are learned through conditioning or modeling and maintained through avoidance. Treatment: Exposure, through systematic desensitization or flooding

Agoraphobia

Agoraphobia

Phobias

Phobias

Social Anxiety Disorder – etiology and treatment

Cognitive view: unrealistic expectations, negative view of self, anticipate the worst, avoid situations

Phobias

Social Anxiety Disorder – etiology and treatment

Cognitive view: unrealistic expectations, negative view of self, anticipate the worst, avoid situations.

Treatment:

Biological: medications

Behavioral: exposure, social skills training

Cognitive: challenge unrealistic thoughts

Panic Disorder

Panic Disorder

Panic Disorder

Etiology and treatment

Panic Disorder

Etiology and treatment

Biological view: inherited problems with brain function (excess norepinephrine) or structure (overreactive amygdala).

Panic Disorder

Etiology and treatment

Biological view: inherited problems with brain function (excess norepinephrine) or structure (overreactive amygdala). Treatment: Antianxiety or antidepressant medications

Panic Disorder

Etiology and treatment

Biological view: inherited problems with brain function (excess norepinephrine) or structure (overreactive amygdala). Treatment: Antianxiety or antidepressant medications

Cognitive view: misinterpretation of physical events.

Panic Disorder

Etiology and treatment

Biological view: inherited problems with brain function (excess norepinephrine) or structure (overreactive amygdala). Treatment: Antianxiety or antidepressant medications

Cognitive view: misinterpretation of physical events. Treatment: Educate about body, teach accurate interpretations, teach relaxation

Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD)

Etiology and treatment

Obsessive-Compulsive Disorder (OCD)

Etiology and treatment

Psychodynamic view: obsessions are the id’s impulses, and compulsions are the ego’s defense mechanisms. Treatment: Uncover and resolve early childhood fears and conflicts

Obsessive-Compulsive Disorder (OCD)

Etiology and treatment

Psychodynamic view: obsessions are the id’s impulses, and compulsions are the ego’s defense mechanisms. Treatment: Uncover and resolve early childhood fears and conflicts

Behavioral view: certain behaviors just happen and then get reinforced and repeated. Treatment: Exposure and response prevention (ERP)

Obsessive-Compulsive Disorder (OCD)

Etiology and treatment

Psychodynamic view: obsessions are the id’s impulses, and compulsions are the ego’s defense mechanisms. Treatment: Uncover and resolve early childhood fears and conflicts

Behavioral view: certain behaviors just happen and then get reinforced and repeated. Treatment: Exposure and response prevention (ERP)

Cognitive view: tendency to want to neutralize thoughts; tendencies for perfection and control. Treatment: Challenge distorted/unrealistic thinking

Obsessive-Compulsive Disorder (OCD)

Etiology and treatment

Psychodynamic view: obsessions are the id’s impulses, and compulsions are the ego’s defense mechanisms. Treatment: Uncover and resolve early childhood fears and conflicts

Behavioral view: certain behaviors just happen and then get reinforced and repeated. Treatment: Exposure and response prevention (ERP)

Cognitive view: tendency to want to neutralize thoughts; tendencies for perfection and control. Treatment: Challenge distorted/unrealistic thinking

Biological view: low serotonin (and others); overactive anxiety brain circuit. Treatment: antidepressant medications

Obsessive-Compulsive Disorder (OCD)

Other disorders in this category:

Body Dysmorphic disorder

Hoarding Disorder

Hair-Pulling Disorder (trichotillomania)

Excoriation (Skin-Picking) Disorder

Conclusions

Anxiety disorders are best understood through a diathesis-stress model – some biological vulnerability or predisposition combined with psychological or social factors

Conclusions

Anxiety disorders are best understood through a diathesis-stress model – some biological vulnerability or predisposition combined with psychological or social factors

Accordingly, a combination of treatments may work best

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