Anxiety Disorders Flashcards
Summary of Anxiety Disorders
The Complexity of Anxiety Disorders
- Anxiety is a future-oriented state charactersied by negative affect in which a person focuses on the possiblity of uncontollable danger or misfortune; in constrast, fear is a present-oriented state characterised by strong escapist tendencies and a surge in the sympathetic branch of the autonomic nervous system in response to current danger.
- A panic attack represents the alarm response of real fear, but there is no actual danger.
- Panic attacks may be:
1. Unexpected (without warning)
2. Expected (always occurring in a specific situation).
Panic and anxiety combine to create different anxiety and related disorders. Several disorders are grouped under the heading Anxiety Disorders.
Generalised Anxiety Disorder
In generalised anxiety disorder (GAD), anxiety focuses on minor, everyday events and not on one major worry or concern.
Both genetic and psychological vulnerabilities seem to contribute to the development of GAD.
Although medicinal and psychological treatments may be effective in the short-term, pharmacological treatments are no more effective in the long-term than placebo treatements.
Successful treatment may help individuals with GAD focus on what is really threatening to them in their lives.
Panic Disorder and Agoraphobia
In panic disorder (PD), which may or may not be accompanied by agoraphobia (a fear and avoidance of situations considered to be ‘unsafe’), anxiety is focused on the next panic attack. For some people, agoraphobia develops in the absence of panic attacks or panic-like symptoms.
We all have some genetic vulnerability to stress, and many of us have had a neurobiological overreaction to some stress event - that is, a panic attack. Individuals who develop PD then develop anxiety over the possibility of having another panic attack.
Both medicinal and psychological treatments have proven successful in the treatment of PD. One psychological method - panic control treatment (PCT) - concentrates on exposing patients to clusters of sensations that remind them of their panic attacks. For agoraphobia, therapeutically supervised exposure to feared situations is most effective.
Specific Phobia
In phobic disorders, the individual avoids situations that produce severe anxiety, panic or both. In specific phobia, the fear is focused on a particular object or situation.
Phobias can be acquired by experiencing some traumatic event, they can also be learned vicariously or even taught.
Treatment of phobias is rather straightforward, with a focus on structured and consistent exposure-based exercises.
Social Anxiety Disorder (Social Phobia)
Social anxiety disorder is a fear of being around others, particularly in situations that call for some kind of ‘performance’ in front of other people.
Although the causes of social anxiety disorder are similar to those of specific phobias, treatment has a different focus, which includes rehearsing or role-playing socially phobic situations. In additions, pharmacological treatments have been effective.
Several disorders are also grouped under the heading Trauma- and Stressor-Related Disorders.
Post-Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder (PTSD) focuses on avoiding thoughts or images of past traumatic experiences.
The precipitating cause of PTSD is obvious - a traumatic experience. But mere exposure to trauma is not enough. The intensity of the experience seems to be a factor in whether an individual develops PTSD, biological vulnerabilities, as well as social and cultural factors, appear to play a role as well.
Treatment involves exposing the victim to the trauma again and re-establishing a sense of safety of safety to overcome the debilitating effects of PTSD.
Adjustment Disorders
Adjustment disorder is the deveopment of anxiety or depression in response to stressful, but not traumatic, life events.
Attachment Disorders
Children experiencing inadquate, abusive or absent caregiving in early childhood fail to dvelop normal attachment relationships with caregivers, resulting in two different disorders.
Reactive attachment disorder describes children who are inhibited and emotionally withdrawn and unable to form attachment with caregivers.
Disinhibited social engagement disorder describes children who inappropriately approach all strangers, behaving as if they had always had strong loving relationshps with them.
Several disorders are grouped under the heading of Obsessive-Compulsive and Related Disorders.
Obsessive-Compulsive Disorder
Obsessive-compulsive disorder (OCD) focuses on avoiding frightening or repulsive instrusive thoughts (obsessions) or performing behaviours directed at limiting their occurrence or distress they cause.
As with all anxiety disorders, biological and psycholigical vulnerabilities seem to be involved in the development of OCD.
Pharmacological treatment seems to be only modestly successful in treating OCD. The most effective treatment approach is a psychological treatment called exposure and ritual prevention (ERP).
Body Dysmorphic Disorder
In body dysmorphic disorder (BDD), a person who looks normal is obsessively preoccupied with some imagined defect in appearance (imagined ugliness).
These patients typically have more insight into thier problem and may seek out plastic sugery as a remedy.
Psychological treatment approaches are similar to those for OCD and are approximately equally successful.
Hoarding Disorder
Hoarding disorder is characterised by the excessive acquisition of things, difficulty discarding anything and living with excessive clutter under conditions best characterised as gross disorganisation.
Treatment approaches are similar to those of OCD but are less successful.
Trichotillomania (Hair Pulling Disorder) and Excoriation (Skin Picking Disorder)
Repetitive and compulsive hair pulling resulting in significatnt noticeable loss of hair or repetitive and compulsive picking of the skin leading to tissue damage characterise trichotillomania and excoriation disorders respectively.
