Anxiety Disorders Flashcards
Fear vs anxiety
Fear: Response to real and present danger. Helps organize responses to threat like “fight or flight”
Anxiety: apprehension about anticipated events
- Physiological changes
- Difficult to control thoughts in state of anxiety
- Halo effect
- Useful up to a certain point then it becomes problematic
Classification of anxiety disorders
- Emerged as distinct group of disorders in DSM-III
- Previously part of “neuroses” (emotional disturbance with awareness). Awareness dropped in DSM-5. Now merely necessary for fear and worry to be “disproportionate to the situation”
- Splitting movement has divided anxiety disorders. Share core symptom 0 intense worry disproportionate to actual environmental danger
Rise of interest in anxiety
- Asylums primarily housed psychotic individuals and those deemed too dangerous to remain in community. Anxiety didn’t really fit into that equation
- Freud’s emphasis on neuroses helped reshape 20th century as the age of anxiety
Panic disorder
- Characterized by recurrent, unexpected panic attacks - similar to a heart attack. Usually occurs without warning and finishes within ten minutes
- Preponderance of physical symptoms: palpitations; pounding heart; sweating; trembling/shaking;shortness of breath; feeling of choking; chest pain or discomfort; nausea; feeling dizzy/faint
- Derealisation (unreality) or depersonalization (detachment from oneself)
- Person may obsessively worry about another attack; may lead to avoidance strategies… avoidance works
Specific (simple) phobia
- Persistent, excessive, narrowly defined fears associated with specific object or situation
- Phobias are “irrational or unreasonable”
- Must always occur when exposed to source
- Daily life consumed on some level with avoidance, fear, dread
Agoraphobia
- Extreme fear about situations where escape is difficult or embarrassing - crowded shops, theatres, tunnels
- Unlike other phobias, not closeness to a specific object but distance from safety thats the problem
Generalized anxiety disorder
- “Chronic worriers”, distress/impairement in occupational or social functioning
- Worry not fixed, may not even have clear source
- Accompanied by minor disturbances in sleep, irritability, concentration, restlessness
- Chronic, low0key, long lasting
- Controversial because lower diagnostic reliability, far more common in women (roles, stereotypes?), overlapL a distinct disorder or just a symptom?, if low key is this really a distinct syndrome?
Evolutionary explanations
Evolutionary: anxiety and phobias adaptive in some situations, would have granted selective advantatages
Freud explanations
Freud: anxiety a ‘warning sign’ about id’s impulses. We get anxious when we’re about to do something we “shouldn’t do.”
Behavioural explanations
Behavioural: learned behaviours acquired through conditioning and reinforcement. Avoidance rewards person by not experiencing negative reaction.
Life event explanations
Life events: people who experience agoraphobia more likely to have faced “dangerous” situations, like crime, conflict, serious argument
Genetic explanations
Perhaps panic disorder results from brain defect –when faced with biologically dangerous situations (hyperventilation) misinterprets signals as genuinely life threatening
Comorbidity
- 50% of people that meet criteria for one anxiety disorder meet criteria for another
- Anxiety and mood disorders (based on emotion), high degree of comorbidity (61% of people with MD qualify for anxiety disorder)
- Those with anxiety disorders roughly 3x more likely to be diagnosed with substance abuse disorder
- Some argue that “splitting movement” is behind the high level of comorbidity between disorders. Artificial divisions create overlapping disorders, “pure” cases of most types ver rare
Benzo boom and backlash
- Anxiolytics - benzodiazepine boom, including Valium, Xanax, Ativan. Work on immediate symptoms, but don;t alter thinking about future events. Physiologically addictive, prompting withdrawl. After 1970s and 1980s benzo backlash, SSRIs branded as anti-depressants in 1990s. “Age of depression” replaces “age of anxiety”
- Popularity for recreational and self medicating purposes sparks second benzo backlash
Diagnostic growth
Anxiety disorders at forefront of increase in prevalence of psychopathology
- Medicalization of “uncomfortable” feelings in ill ones
- Blurred lines between wellness and disturbance, when does discomfort become disroder
- Environmental shifts to produce stress
- Does greater awareness (of ourselves and the world) mean greater anxiety? Can this be stopped?
- Medications produce clear effect - we can see them “work” and this validates diagnoses
