Week 9 Flashcards
Changes for DSM-IV-TR to DSM-5 criteria
Main change is the removal of PTSD and OCD from the
Anxiety Disorders section
PTSD is in Trauma- and Stressor-Related Disorders related section
OCD is in the Obsessive-Compulsive and Related Disorders section
Fears in Normal Development
Kerig, et al. 2012, pp. 255-256
Fear is a normal reaction to a threatening event
Fears are common in childhood. Fear and anxiety can be adaptive
Children learn to adapt to, and cope with, fears and anxieties
Anxiety disorders are distinguished from normal fears: Intensity Maladaptiveness Persistence Beyond voluntary control
Anxiety Disorders: Common Features
Characterised by intense, persistent anxiety
Internalised behaviour: suffering is turned inward
Hyperarousal
Achenbach’s (2000) analysis of symptoms in childhood yielded a principle factor of internalizing-externalizing
Prevalence
Anxiety disorders are most common disorders of childhood
Approximately 15-20% of children will develop an anxiety
disorder before adulthood
Australian figures:
7% of children anxiety disorders
(Young Minds Matter study 2013-2014, cited AIHW, 2016)
Wellbeing and Distress in Aboriginal and Torres Strait
Islander peoples:
Greater distress, depression, and anxiety in Aboriginal and
Torres Strait Islander peoples
Dose-response relationship between discrimination and
distress
Gender differences:
Generally, more common in females
Gender ratio increases with age, reaching 1:2 – 1:3 at
adolescence
Comorbidity
High levels of comorbidity
Commonly comorbid with other anxiety disorders
Commonly comorbid with depression
Also comorbid with ADHD, CD
Continuity
Children with anxiety disorders in childhood, likely to have
anxiety (and also depression) in adulthood
70% of children with anxiety disorder, met criteria for anxiety or mood disorder 10 years later
Are Anxiety Disorders and Mood Disorders distinct?
Separate entities or accounted for by an underlying common factor
Maybe it’s both of these things??
If you have multiple anxiety disorders you are more likely to have depression
Clarke and Watson’s (1991) tripartite model
Physiological hyperarousal -> unique anxiety symptoms
Negative affectivity -> will have symptoms of both anx and dep
Low positive affect -> unique depression symptoms
GAD: Characteristics
DSM-5 criteria (refer to p. 39): Excessive anxiety and worry on more days that not - for at least 6 months - about a number of events or activities - Difficult to control the worry
Only one symptom required in children
Clinically significant distress or impairment
Not attributable to substance or medical condition
Not better explained by another mental disorder
6 symptoms
- Restlessness or feeling keyed up or on edge
- Being easily fatigued
- Difficulty concentrating or mind going blank
- Irritability
- Muscle tension
- Sleep disturbance
Etiology - Biological
Temperament:
low threshold for novelty
- interaction with the environment
Family/Genetic Risk
- Heritable
- Interaction with the environment?
- Serotinin
- Dopamine
Neurobiological Factors
- COmplex system
- HPA axis
- Amydala (in the limbic system) should function normlly to send up cortisol, but the HPA Axis can’t cope in anx and is overactive. Increases cortisol.
Etiology - Family
- Parenting style
- Parental expectations
- Family dysfunctions, Family stress (low SES etc)
- Parent-child Attachment relationships
Treatments specific phobia
Behaviour therapy
- Exposure can be real, imagined, observed (modeling) or virtual exposure.
- Graded exposure (hierarchy)
- Systematic desensitization (repeated a lot)
- Flooding (all at once)
would also want to look at positive reinforcements
CBT Treatment for GAD, Social phobia, separation anxiety
examples are Coping CAT and Coping Koala, Barret et al FRIENDS program.
