Anxiety disorders Flashcards
Anxiety
a pattern of frequent, persistent worry and apprehension about a perceived threat in the environment; the threat is minor or non-existent but the person perceives it as highly threatening
Phobias
an extreme and irrational fear towards a stimulus and is disproportionate to the actual danger
Common symptoms of Anxiety
-Muscle tension
-Restlessness
-Feeling constantly ‘on edge’
-Difficulty concentrating (due to being preoccupied with their worry)
-Tiredness and irritation (due to sleep disturbance)
Generalised Anxiety Disorder (GAD)
a long-term condition wherein feelings of anxiety may be generalised over multiple situations and things (money, health, family, work etc), rather than a specific stimulus (phobia)
Symptoms of panic attacks
-Can last for minutes or hours
-Fear of dying or losing control
-Sensation of shortness of breath or choking
-Nausea
-Feeling dizzy or light-headed
-Sweating
-Accelerated heart rate
Case study on anxiety
Kimya (female aged 39)
-Kimya is afraid of birds, not knowing what caused her extreme anxiety
-She can’t even look at photographs of birds; the thought of looking at or touching birds makes her sick
-She finds the sounds of wings flapping rather upsetting
-She avoids places where she might be exposed to birds: beaches, town centres, or woodlands, limiting her social life
Agoraphobia
-fear of public places
-individuals will actively avoid such situations, or experience severe distress while enduring them
-depending on the nature of the phobic stimulus, the anxiety can cause significant impairment to social and working life
Characteristics of agoraphobia
fear of two or more of the following:
*standing in line or in a crowd
*being in open spaces
*using public transport
*being outside the home by oneself
*being in enclosed spaces
Haemophobia
-an irrational fear of blood that can also extend to needles, injections or other invasive medical procedures
-individuals experience an increased heart rate; combined with a drop in blood pressure, they can end up fainting
Animal phobias
-commonly include dog, insect, bird and spider phobias
-individuals feel distress and panic attacks when faced with them
Koumpounophobia
-fear of buttons
-individuals can’t touch and/or look at them
Measures of anxiety
-The Blood-Injury Phobia Inventory (BIPI)
-Generalised Anxiety Disorder 7 (GAD-7)
Blood-Injury Phobia Inventory (BIPI)
-measures haemophilia
-a self-report measure that lists 18 situations involving blood and injections to find cognitive, physiological, and behavioural responses
-asked to rate on a scale of 0-3 the frequency of each symptom (0=never, 1=sometimes, 2=almost always, 3=always)
Example of a situation and response in BIPI
-situation: when I see someone injured and bleeding on the road
-response:
*Cognitive: I think I’m going to faint
*Physiological: my heartbeat speeds up
*Behavioural: I escape from the situation immediately
Generalised Anxiety Disorder 7 (GAD-7)
-the questionnaire is a screening test often used by general practitioners to enable further referral to a psychiatrist
-has 7 items which measure the severity of anxiety
-score between 0-3 to measure the frequency of symptoms (0=not at all, 1=several days, 2=more than half the days, 3=nearly every day)
- total score for the seven items ranges from 0 to 21 (0–4: minimal anxiety, 5–9: mild anxiety, 10–14: moderate anxiety, 15–21: severe anxiety)
Example of items on the GAD-7
*Feeling nervous, anxious or on edge
*Being so restless that it is hard to sit still
*Feeling afraid as if something awful might happen
Evaluation of GAD-7 and BIPI
-High concurrent validity with other measures thus valid and reliable instruments for assessing anxiety and blood phobia respectively (Mas et al., 2010(BIPI); Spitzer et al.,2006(GAD-7))
-Response bias: inaccurate response can distort results e.g. the person had a ‘bad’ day (had a finger cut)
Issues and debates on measures of anxiety:
Reductionism
-these psychometric tests rely on a single quantitative measure of what is a rather complex experience for patients. They do not take qualitative data into account e.g. what it is like to have a phobia
Issues and debates on measures of anxiety:
Cultural bias
cross-cultural differences influence BIPI and GAD-7 results e.g. cultures that promote well-being and give reassurance to those around will have low diagnostic rates of social phobia
Explanations of Phobia
-behavioural (classical conditioning)
-psychoanalytic
-biomedical (genetic)
-cognitive
A behavioural explanation of anxiety was given by
Watson & Rayner, 1920
Behavioural explanation for anxiety
Phobia may be a result of a classical conditioning where when a neutral stimulus is paired with a frightening stimulus, future association with the neutral stimulus will produce a fearful conditioned response
Watson & Rayner’s study
-Wanted to check whether fear could be learned via classical conditioning and whether it could be transferable to other objects and individuals
-Used the principles of classical conditioning to create a phobia in a young and healthy 11-month-old infant, ‘Little Albert’
-Albert was shown a range of stimuli: white rat, rabbit, dog, monkey, masks, cotton wool, etc, to which he reacted neutrally
-The white rat was then chosen as the neutral stimulus (NS)
-They placed a metal bar above and behind Albert’s head and struck it loudly with a hammer
-This was the unconditioned stimulus (US) as it produced an unconditioned response of fear (UCR) in the boy
-When Albert was shown the rat he began to reach for it, but just as his hand touched the animal the researchers made a loud noise by striking the hammer against the metal bar
-This made the infant very distressed. Watson and Rayner repeatedly paired the loud noise with the presentation of the white rat over several trials one week after the initial trial
-Eventually, Albert only had to see the rat and he began to demonstrate a fearful response (crying, trying to move away from it). The white rat had become a conditioned stimulus (CS), producing a conditioned response of fear (CR)
-When presented with a rabbit he also had a similarly distressed reaction
A psychoanalytic explanation of phobia was given by
Freud, 1909
