Anxiety Flashcards
- Definition of Anxiety Disorders:
Anxiety disorders encompass a range of conditions characterized by excessive and persistent fear or worry. These conditions can include phobias, OCD, PTSD, generalized anxiety disorder (GAD), and others. Anxiety is considered a disruptive fear that is out of proportion to the actual danger and lasts for more than six months.
- Prevalence of Anxiety Disorders:
Anxiety disorders are relatively common, affecting approximately 10% of the population. It is noteworthy that anxiety disorders are more prevalent in women, with about twice as many women affected as compared to men. This gender difference in prevalence is consistent with other mental health conditions such as depression.
- Variations in Prevalence:
The prevalence of anxiety disorders can vary across countries. For instance, in Italy, the prevalence is estimated to be around 2.4%, while in Mexico, it is approximately 29.8% within the past 12 months. These variations may be influenced by cultural factors, access to mental healthcare, and other societal aspects.
- Relationship between Anxiety and Underlying Conditions:
Anxiety and depression, two commonly co-occurring conditions, can sometimes be superficial symptoms of underlying conditions. For example, individuals with schizophrenia may initially be misdiagnosed with depression before receiving a correct diagnosis of schizophrenia. Similarly, women with neurodevelopmental conditions like ADHD or autism may initially receive a diagnosis of anxiety or depression, as these symptoms often manifest before a comprehensive assessment.
- Theoretical Similarities between Anxiety and Depression:
Some theories suggest that anxiety and depression may arise from similar underlying physiological mechanisms. Both conditions may share common pathways in the brain and physiological responses. This overlap can help explain why these conditions often co-occur and share certain treatment approaches.
- Subtypes of Anxiety Disorders:
a) Generalized Anxiety Disorder (GAD):
GAD is one of the most common anxiety disorders. It is characterized by excessive and uncontrollable anxiety and worry about various aspects of life, such as work, school performance, and personal relationships. The duration of these worries must persist for at least six months to meet the diagnostic criteria. Physical symptoms accompanying GAD include restlessness, fatigue, difficulty concentrating, and irritability.
b) Panic Disorder:
Panic disorder involves recurrent and unexpected panic attacks, which are intense episodes of anxiety accompanied by physical symptoms. People with panic disorder may experience persistent worry about having more panic attacks and may exhibit maladaptive behaviors like avoiding exercise or unfamiliar locations.
c) Specific Phobias:
Specific phobias refer to intense and irrational fears of specific objects or situations. Common examples include fear of heights, animals, insects, or flying. These fears can lead to avoidance behaviors and significantly impact an individual’s daily functioning.
d) Agoraphobia:
Agoraphobia involves a marked fear or anxiety about situations or places where escape might be difficult or help may not be readily available. People with agoraphobia may fear being in crowded spaces, using public transportation, or being away from the safety of their home. The fear is primarily related to potential embarrassment or being unable to get assistance if needed.
e) Social Phobia (Social Anxiety Disorder):
Social phobia, also known as social anxiety disorder, is characterized by intense fear and anxiety in social situations where individuals fear being scrutinized or judged by others. It often involves a fear of public speaking, attending social events, or interacting with
unfamiliar people. The avoidance of social interactions can significantly impact an individual’s social and occupational functioning.
f) Hypochondriasis (Illness Anxiety Disorder):
Hypochondriasis, also known as illness anxiety disorder, involves excessive worry and preoccupation with having a serious medical illness. Individuals with this disorder may misinterpret minor physical symptoms as evidence of a severe condition, leading to heightened anxiety and seeking medical reassurance. The somatic symptoms associated with hypochondriasis are either absent or mild.
g) Selective Mutism:
Selective mutism is characterized by consistent difficulties or the inability to speak in specific social situations, despite speaking in other contexts. This condition often emerges in childhood and can be related to social anxiety. It is different from elective mutism seen in individuals with autism or ADHD, as it stems from anxiety rather than an inability to speak.
- Risk Factors for Anxiety Disorders:
Several risk factors contribute to the development of anxiety disorders, including:
- Adverse childhood experiences, such as childhood trauma, physical punishment, or neglect.
- Low socioeconomic status and limited access to resources.
- Family history of anxiety disorders or other mental health conditions.
- Genetic predisposition or variations in certain genes.
- Neurobiological factors and imbalances in brain chemistry.
- Chronic medical conditions or physical health issues.
- Substance abuse or a history of substance use disorders.
Conclusion:
Understanding the various subtypes of anxiety disorders and their associated risk factors is essential for accurate diagnosis and effective treatment. Anxiety disorders can significantly impact individuals’ lives, but with proper intervention, individuals can find relief and regain control. If you or someone you know experiences symptoms of anxiety, it is crucial to seek professional help for a comprehensive evaluation and personalized treatment plan.
Please note that this handout provides a general overview of anxiety disorders based on the provided transcript. For specific diagnostic criteria and detailed information, it is recommended to refer to the DSM-5 or consult a mental health professional.
Psychological Theories of Anxiety and Depression
- Learning Theory: Learning theory suggests that certain aspects of phobias and anxiety disorders emerge from conditioning, where fear is learned through association. This theory proposes that individuals can develop fears or phobias by accidentally or intentionally being conditioned to associate a neutral stimulus with a fearful or aversive experience. An example of this is the “Little Albert” experiment conducted in the 1920s. In this experiment, a young boy named Albert was conditioned to fear a white rat by pairing its presence with a loud noise. The study demonstrated how fear can be learned through conditioning processes.
- Preparedness Theory: Preparedness theory suggests that humans have an inherent predisposition to fear certain objects or stimuli due to evolutionary factors. According to this theory, certain fears, such as fear of snakes or spiders, may be more readily acquired and generalized compared to fears of other objects or stimuli. This is thought to be because these fears were advantageous for survival in ancestral environments where encountering snakes or spiders posed a greater threat. Preparedness theory helps explain why some fears appear to be more common and easily acquired than others.
- Cognitive Theory: Cognitive theories propose that anxiety and depression can be explained by cognitive biases and distorted thinking patterns. One influential cognitive theorist, Aaron Beck, suggested that anxiety can be attributed to specific cognitive biases, such as attentional biases and catastrophic thinking. According to this theory, anxious individuals have a tendency to focus their attention on potential threats and interpret ambiguous situations in a negative and threatening manner. These cognitive biases contribute to the development and maintenance of anxiety disorders.
Genetics and PTSD
- Genetics: Anxiety disorders have a genetic component, meaning that genetic factors play a role in their development. Twin studies have provided evidence for the heritability of anxiety disorders. Identical twins, who share 100% of their genetic material, are more likely to both have a diagnosis of an anxiety disorder compared to fraternal twins, who share approximately 50% of their genetic material. Genome-wide association studies have identified specific genetic variants associated with anxiety disorders, including variants in genes related to the stress response and the regulation of certain hormones.
- Post-Traumatic Stress Disorder (PTSD): PTSD is a psychiatric disorder that can develop following exposure to a traumatic event. The diagnostic criteria for PTSD include the experience of a traumatic event, persistent re-experiencing of the trauma (e.g., flashbacks, nightmares), efforts to avoid reminders of the trauma, and symptoms of increased arousal. While PTSD is commonly associated with military combat, it can also result from other traumatic experiences, such as physical or sexual abuse, natural disasters, or accidents.
Factors influencing the risk and resilience for developing PTSD have been investigated:
- Pre-Military Risk Factors: These include factors present before military service, such as coming from an unstable family environment, experiencing severe punishment during childhood, exhibiting social behavior problems, and having a history of depression. These pre-existing factors can contribute to an individual’s vulnerability to developing PTSD following exposure to trauma.
- Military Risk Factors: Factors occurring during military service, such as exposure to combat or war zones, are known to increase the risk of developing PTSD. The intensity and duration of traumatic experiences during military service can have a significant impact on the likelihood of developing PTSD.
- Post-Military Risk Factors: After military service, individuals may continue to face stressors that increase their risk of developing or maintaining PTSD. These stressors can include recent stressful life events, difficulties with readjustment to civilian life, and challenges in maintaining social support networks.
- Protective Factors: Certain factors can promote resilience and protect against the development of PTSD. These protective factors include higher levels of education, positive relationships and social support, and a sense of purpose or meaning in life.
Brain Correlates and Treatments
- Brain Correlates: Research into the brain correlates of anxiety and PTSD is ongoing. Studies have suggested that individuals with PTSD may exhibit alterations in brain structures and functions associated with fear processing and regulation. For example, some studies have found a reduction in hippocampal volume in individuals with PTSD, which may be related to memory impairments. The limbic system, involved in emotion and memory, may also be overactive in individuals with PTSD. Cortisol, a stress hormone, has been implicated in PTSD, with low cortisol levels associated with a higher risk of developing PTSD following trauma.
- Treatments: There are various treatment approaches for anxiety disorders and PTSD. Some common interventions include:
- Cognitive-Behavioral Therapy (CBT): CBT is a widely used and effective treatment for anxiety disorders. It focuses on identifying and challenging cognitive biases and distorted thinking patterns that contribute to anxiety. CBT also incorporates behavioral techniques, such as exposure therapy, where individuals gradually confront feared situations or stimuli to reduce anxiety.
- Medications: Medications may be prescribed to alleviate symptoms of anxiety disorders and PTSD. Benzodiazepines, such as Valium and Ativan, are sedative medications that can provide short-term relief for acute anxiety. Selective serotonin reuptake inhibitors (SSRIs), commonly used for depression, are also effective in treating anxiety disorders.
Treatment Recommendations:
The choice of treatment depends on the severity of anxiety or PTSD symptoms. Treatment recommendations may include:
- Mild Anxiety: For mild anxiety, watchful waiting or self-help strategies may be sufficient. These can include relaxation techniques, stress management, and lifestyle changes.
- Moderate Anxiety: Moderate anxiety may benefit from individual or group therapy, such as CBT, which focuses on addressing cognitive biases and developing coping skills. Medications may also be considered in consultation with a healthcare professional.
- Severe or Treatment-Resistant Anxiety: For severe anxiety or cases where symptoms are resistant to other treatments, a combination of therapy (e.g., CBT) and medications may be recommended. Collaborative treatment planning with a mental health professional is essential in these cases.
