What is anxiety?
- Negative mod state characterized by bodily symptoms of physical tension and apprehension about the future
Can anxiety be good for us?
Anxiety can enhance social, physical and intellectual performance
It drives behavior if there is a healthy/moderate amount at the appropriate time
What is the difference between fear and anxiety?
- Fear is the emotional response to real or perceived imminent threat while anxiety is anticipation more often associated with surges of autonomic arousal necessary for fight or flight, thoughts of immediate danger, and escape behaviors
- Anxiety is more often associated with muscle tension and vigilance in preparation for future danger and cautious or avoidant behaviors
What is a panic attack?
Abrupt surge of intense fear or discomfort that reaches a peak within minutes
What are the symptoms of a panic attack?
- Palpitations, pounding or accelerated heart
- Sweating
- Trembling
- Shortness of breath
- Feeling of choking
- Chest pain
- Nausea
-Dizziness - Chills or heat sensation
- Numbness or tingling
- Derealization or depersonalization
- Fear of going crazy
- Fear of dying
What are some anxiety disorders?
- Separation Anxiety Disorder
- Selective Mutism
- Social Anxiety Disorder
- Agoraphobia
- Specific Phobia
- Panic Disorder
- Generalized Anxiety Disorder
- Substance/Medication-induced Anxiety
What is social anxiety disorder?
- Become overly concerned about the approval of other people.
- Avoid social situations to avoid being scrutinized by others.
- Rejection sensitivity.
What are some myths about social anxiety
- Happier being by themselves.
- Don’t see anyone.
- Can’t be the center of attention.
What are some causes of social anxiety?
- Research showing people with SAD who saw a number of pictures of faces were more likely to remember critical expressions.
- More quickly identified angry faces than controls. Controls identified accepting expressions.
- Evolutionary past- protective reasons to fear hostile social groups.
- Temperament is associated with SAD.- Easily agitated and crying when presented with age-appropriate stimuli that other infants.
What are the statistics surrounds social anxiety disorder?
- As many as 12% of the general population suffer from SAD at some point in their lives.
- Second only to specific phobia, which is the most prevalent anxiety disorder.
- 50:50 sex ration.
- White Americans are more likely to be Dx than African Americans, Hispanic Americans and Asian Americans.
- Research suggests Asian cultures show the lowest rates of social anxiety.
What are some medication for SAD (social anxiety disorder)?
- Beta Blockers are still used despite what the textbook states.
- SSRIs show effectiveness compared to placebo.
- Combining SSRIs and psychotherapy has mixed results.
What does cognitive therapy do?
It disproves automatic perceptions of danger/rejection
What is a phobia
Irrational fear of a specific object or situation that interferes with an individual’s ability to function.
What is the criteria for Specific Phobia?
- Marked fear of anxiety about a specific object of situation.
- The phobic object or situation almost always provokes immediate fear or anxiety and is avoided or endured with intense fear or anxiety.
- The fear or anxiety is out of proportion to the actual danger and sociocultural context.
- The fear, anxiety or avoidance causes clinically significant distress or impairment in social, occupational or other important areas of functioning.
- The disturbance is not better explained by the symptoms of another mental disorder.
How can specific phobia develop?
Sometimes because of an experience one had.
Which phobias go in for treatment the most?
- Only severe cases come in for treatment- they typically avoid phobic situation/object.
- Situational phobias: driving, flying or small enclosed places come in for treatment the most.
What is Exposure Therapy
- Designed to treat fears and other negative emotional responses by introducing patients under carefully controlled conditions, to the situations that contributed to such problems.
- Involves systematic confrontation with a feared stimulus, either through imagination or in vivo (live).
- Imaginal exposure can be used prior to implementing in vivo exposure when a patient’s fears are so severe that the patient is unable to participate in live exposure.
What is systematic desensitization?
- Training the patient to physically relax
- Establishing an anxiety hierarchy of the
stimuli involved - Counter-conditioning relaxation as a response to each feared stimulus beginning first with the least anxiety- provoking stimulus and moving then to the next least anxiety-provoking stimulus until all of the items listed in the anxiety hierarchy have been dealt with successfully.
What is an example of continuum systematic desensitization?
Example of the bridge
- Talking about driving over a bridge
- looking at pictures of a bridge
- Video of driving over a bridge
- Walking over a small bridge
- Driving over a bridge
What are the symptoms of generalized anxiety disorder?
- Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
- The individual finds it difficult to control the worry.
- The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months)
1. Restlessness or feeling keyed up or on edge.
2. Being easily fatigued.
3. Difficulty concentrating or mind going blank.
4. Irritability.
5. Muscle tension.
6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep). - The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).
- The disturbance is not better explained by another mental disorder.
What are the symptoms in children of generalized anxiety disorder?
Only one item is required in children.
- Restlessness or feeling keyed up or on edge.
- Being easily fatigued.
- Difficulty concentrating or mind going blank.
- Irritability.
- Muscle tension.
- Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).
What is generalized anxiety disorder?
- Worrying mostly about minor events.
- Do you worry about minor things 100% of
people with GAD respond yes. - 50% of people with other presentations of anxiety report yes.
What are the benzodiazepines?
The most frequently prescribed psychotropic (affect the mind, emotions, and behavior.) medications in the U.S.
Depressant w/Sedative, hypnotic, anxiolytic, effects.
What are the withdrawal symptoms of benzodiazepines?
Benzo should be short term only
- Memory loss
- Seizures
- Disruption in menstrual cycle
- Increase in psychological symptoms
- Psychological symptoms not seen prior to use.
- Death in pre-clinical studies.
