Title 04 AbPsy - Anxiety Disorders.pdf ✅

Psychological Dimension – argues that the general sense of uncontrollability may develop early as a function of upbringing and other disruptive / traumatic event ● Parenting ○ Overprotective and over intrusive parents are more likely to raise children with anxiety disorders ○ Children must be able to explore and learn about the world ● Anxiety Sensitivity ○ General tendency to respond fearfully to anxiety symptoms ○ Common among people who experience panic ● Conditioning and Cognitive Explanations ○ Associating panic to a neutral stimulus ○ Creates triggers ● Stressful life events can also trigger the biological and psychological vulnerabilities to anxiety Integrative Approach – combination of multiple dimensions ● Triple Vulnerability Theory ○ Generalized Biological Vulnerability ○ Generalized Psychological Vulnerability ○ Specific Psychological Vulnerability ● Correlates a feedback loop that feed on itself COMORBIDITY OF ANXIETY AND RELATED DISORDERS ★ Comorbidity – co-occurrence of 2 or more disorders in a single individual Psychological Disorders ● DSM-IV-TR: 55% of those with anxiety disorder (principal) had at least one additional anxiety of depressive disorder at the time of assessment Physical Diseases ● Associated with thyroid disease, respiratory disease, gastrointestinal disease, arthritis, migraine / headaches, and allergic conditions ● Anxiety most often begins before the physical disorder ● Other studies have found the same relationship between anxiety disorders, particularly panic disorders, and cardiovascular disease Suicide ● 20% of patients with panic disorder had attempted suicide ● The risk of someone with panic disorder is comparable to those with major depression ● Relationship is strongest with panic disorder and PTSD ● People with general anxiety disorder and separation anxiety disorder who engage in self-harm were especially more likely to engage in this behavior multiple times, at least one was a suicide attempt SEPARATION ANXIETY DISORDER DIAGNOSTIC CRITERIA A. Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least three of the following: 1. Excessive distress when anticipating or experiencing separation. 2. Persistent worry about losing major attachment figures or possible harm to them. 3. Persistent worry about experiencing an event (e.g., getting lost, kidnapped) that causes separation. 4. Reluctance or refusal to go out, away from home, to school, work, or elsewhere due to fear of separation. 5. Excessive fear of being alone or without attachment figures at home or in other settings. 6. Reluctance or refusal to sleep away from home or go to sleep without being near an attachment figure. 7. Repeated nightmares involving the theme of separation. 8. Physical complaints (e.g., headaches, stomachaches) when separation is anticipated or occurs. B. Lasts for at least 4 weeks in children and adolescents, and at least 6 months in adults C. The disturbance causes clinically significant distress or impairment in social, academic, occupational, or other important areas of functioning. D. The disturbance is not better explained by another mental disorder, such as refusing to leave home because of excessive resistance to change in autism spectrum disorder; delusions or hallucinations concerning separation in psychotic disorders; refusal to go outside without a trusted companion in agoraphobia; worries about ill health or other harm befalling significant others in generalized anxiety disorder; or concerns about having an illness in illness anxiety disorder. TREATMENT ● Parents are often included to help structure the exercise and address parental reaction to childhood anxiety 2 | @studywithky

possible scrutiny by others. Examples include social interactions (e.g., having a conversation, meeting unfamiliar people), being observed (e.g., eating or drinking), and performing in front of others (e.g., giving a speech). Note: In children, the anxiety must occur in peer settings and not just during interactions with adults. B. The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated (i.e., will be humiliating or embarrassing: will lead to rejection or offend others). C. The social situations almost always provoke fear or anxiety. Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, clinging, shrinking, or failing to speak in social situations. D. The social situations are avoided or endured with intense fear or anxiety. E. The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context. F. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more. G. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. H. The fear, anxiety, or avoidance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition. I. The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder, such as panic disorder, body dysmoφhic disorder, or autism spectrum disorder. J. If another medical condition (e.g., Parkinson’s disease, obesity, disfigurement from bums or injury) is present, the fear, anxiety, or avoidance is clearly unrelated or is excessive Specify if: Performance only: If the fear is restricted to speaking or performing in public. Diagnostic Issues ● This syndrome is found in many cultures, predominantly Asian cultures ○ Taijin Kyofusho: associated with the fear that the individual makes other people uncomfortable ● Sex ratio is nearly 50:50 ○ Females with social anxiety disorder report a greater number of social fears and comorbid depressive, bipolar, and anxiety disorders ○ Males are more likely to fear dating, have oppositional defiant disorder or conduct disorder, Paruresis, and use alcohol and illicit drugs to relieve symptoms of the disorder ● People with SAD are more likely single CAUSES TREATMENT Medication ● Paxil (SSRI) ● Zoloft (SSRI) ● Effexor (SSRI) ● D-cycloserine (DCS) + CBT treatments = enhanced effect of treatment Psychological Treatments ● Cognitive-Behavioral Therapy ○ Emphasizes real-life experiences to disprove automatic perceptions of danger ● Interpersonal Psychotherapy (IPT) ● Family-based treatment ○ Better than individual treatment if parents also have an anxiety disorder PANIC DISORDER DEFINING PANIC DISORDER AND AGORAPHOBIA Panic Disorder – individuals experience severe, unexpected panic attacks ● Often accompanied by agoraphobia ○ Agoraphobia: fear and avoidance of situations in which a person feels unsafe or unable to escape to get home or to a hospital in the event of a developing panic ○ Coined in 1871 by Karl Westpha ○ Means Greek marketplace ● In the DSM-IV, panic disorder and agoraphobia were integrated into one disorder ● Most agoraphobic avoidance behavior is simply a complication of severe, unexpected panic attacks 4 | @studywithky