Anxiety disorders.IB psychology Seoul Foreign

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Definitions and diagnosis There are many types of anxiety disorders that include panic disorder,

obsessive compulsive disorder, post traumatic stress disorder, social anxiety disorder, specific phobias, and generalized anxiety disorder.

Anxiety is a normal human emotion that everyone experiences at times. Many people feel anxious, or nervous, when faced with a problem at work, before taking a test, or making an important decision. Anxiety disorders, however, are different. They can cause such distress that it interferes with a person's ability to lead a normal life.

An anxiety disorder is a serious mental illness. For people with anxiety disorders, worry and fear are constant and overwhelming, and can be crippling.

What Are the Types of Anxiety Disorders? There are several recognized types of anxiety disorders, including:

Panic disorder : People with this condition have feelings of terror that strike suddenly and repeatedly with no warning. Other symptoms of a panic attack include sweating, chest pain, palpitations (irregular heartbeats), and a feeling of choking, which may make the person feel like he or she is having a heart attack or "going crazy."

Obsessive-compulsive disorder (OCD) : People with OCD are plagued by constant thoughts or fears that cause them to perform certain rituals or routines. The disturbing thoughts are called obsessions, and the rituals are called compulsions. An example is a person with an unreasonable fear of germs who constantly washes his or her hands.

Post-traumatic stress disorder (PTSD) : PTSD is a condition that can develop following a traumatic and/or terrifying event, such as a sexual or physical assault, the unexpected death of a loved one, or a natural disaster. People with PTSD often have lasting and frightening thoughts and memories of the event, and tend to be emotionally numb.

Social anxiety disorder : Also called social phobia, social anxiety disorder involves overwhelming worry and self-consciousness about everyday social situations. The worry often centers on a fear of being judged by others, or behaving in a way that might cause embarrassment or lead to ridicule.

Specific phobias : A specific phobia is an intense fear of a specific object or situation, such as snakes, heights, or flying. The level of fear usually is inappropriate to the situation and may cause the person to avoid common, everyday situations.

Generalized anxiety disorder : This disorder involves excessive, unrealistic worry and tension, even if there is little or nothing to provoke the anxiety.

Diagnostic criteriaA. At least 6 months of "excessive anxiety and worry" about a

variety of events and situations. Generally, "excessive" can be interpreted as more than would be expected for a particular situation or event. Most people become anxious over certain things, but the intensity of the anxiety typically corresponds to the situation.

B. There is significant difficulty in controlling the anxiety and worry. If someone has a very difficult struggle to regain control, relax, or cope with the anxiety and worry, then this requirement is met.

C. The presence for most days over the previous six months of 3 or more (only 1 for children) of the following symptoms:

1. Feeling wound-up, tense, or restless

2. Easily becoming fatigued or worn-out

3. Concentration problems

4. Irritability

5. Significant tension in muscles

6. Difficulty with sleep

D. The symptoms are not part of another mental disorder.

E. The symptoms cause "clinically significant distress" or problems functioning in daily life. "Clinically significant" is the part that relies on the perspective of the treatment provider. Some people can have many of the aforementioned symptoms and cope with them well enough to maintain a high level of functioning.

F. The condition is not due to a substance or medical issue

Source: American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th Ed., Text Revision). Washington DC: American Psychiatric Association.

Specific PhobiasThese common conditions are characterized by marked fear of specific objects or situations (DSM-IV). Exposure to the object of the phobia, either in real life or via imagination or video, invariably elicits intense anxiety, which may include a (situationally bound) panic attack. Adults generally recognize that this intense fear is irrational. Nevertheless, they typically avoid the phobic stimulus or endure exposure with great difficulty. The most common specific phobias include the following feared stimuli or situations: animals (especially snakes, rodents, birds, and dogs); insects (especially spiders and bees or hornets); heights; elevators; flying; automobile driving; water; storms; and blood or injections.

Approximately 8 percent of the adult population suffers from one or more specific phobias in 1 year (Table 4-1). Much higher rates would be recorded if less rigorous diagnostic requirements for avoidance or functional impairment were employed. Typically, the specific phobias begin in childhood, although there is a second “peak” of onset in the middle 20s of adulthood (DSM-IV). Most phobias persist for years or even decades, and relatively few remit spontaneously or without treatment.

The specific phobias generally do not result from exposure to a single traumatic event (i.e., being bitten by a dog or nearly drowning) (Marks, 1969). Rather, there is evidence of phobia in other family members and social or vicarious learning of phobias (Cook & Mineka, 1989). Spontaneous, unexpected panic attacks also appear to play a role in the development of specific phobia, although the particular pattern of avoidance is much more focal and circumscribed.

Etiology: Biological level of analysis. According to the biological level of analysis, specific phobias should be

explainable in terms of evolutionary adaptation, genetic susceptibility, the action of neurotransmitters in specific regions of the brain, and the role of hormones.

The Fight of Flight response. The fight or flight response is generally considered to be the basis of the

anxiety reaction. It seems to prepare the human body for action to deal with a threatening situation through activating the sympathetic nervous system.

Make a note of two studies that support the biological approach.

As with all biological studies ‘twin studies’ are widely used. Is this research reliable?

Describe the main weaknesses of the biological approach.

Etiololgy: The cognitive level of analysis.

Bandra self-efficacy theory has been used to account for the causes of phobias, focusing on an individuals expectations