OT 882 Anxiety, Occupational Performance and Experience

Anxiety

an unpleasant, subjective feeling of apprehension, nervousness, and fear. May range from uneasiness to terror.

Prefrontal cortex

which part of the brain is involved in interpretation of information that provokes fear/anxiety

Hypothalamic-pituitary-adrenocortical (HPA) axis

Which part of the brain activates the autonomic nervous system (ANS) - sympathetic and parasympathetic branches

Genetics, biology, cognitive and psychological, environment

Why does anxiety become a disorder for some people?

increase in cortisol and decrease in GABA and serotonin

What changes to neurotransmitters affect anxiety disorder?

Selective mutism and separation anxiety

What two disorders recently got added to the anxiety disorders category in the DSM-5

3/4

_____ of Canadians who used mental health resources consulted for mood and anxiety disorders annually

30-54 and then 55+

What age has the highest prevalence for mood and anxiety disorders?

GAD

What is the broadest and one of the most common anxiety disorders?

13.3%

What is the lifetime prevalence of GAD in Canada?

Generalized Anxiety Disorder (GAD)

characterized by generalized and persistent excessive anxiety and worry, accompanied by somatic symptoms such as muscle tension. Thinking about the "what ifs", fear the worst in situations. Worry may not be realistic.

Panic Disorder

Unexpected and recurrent panic attacks. Sudden episode of intense fear, with heart palpitations, chest pains, nausea, trouble breathing, peak within 10 minutes of onset.

minimum four panic attacks in a four-week period

What is the criteria to be diagnosed with panic disorder?

1-2%

What is the lifetime prevalence rates for panic disorders?

Social Anxiety Disorder

Fear of situations in which there is potential for embarrassment or humiliation in front of others. The anxiety becomes worse when the individual anticipates/fears that they will do something embarrassing. Aware that this anxiety is excessive and unreasonable.

8-14%

What is the lifetime prevalence for social anxiety disorder?

Women

for GAD and SAD which sex has a higher prevalence?

fear of speaking in front of people

more generalized anxiety and complex fears (eating in public/using public washrooms)

What are the two subtypes of social anxiety disorder?

Childhood or adolescence, but onset in adulthood is not uncommon

When does GAD typically begin to manifest in individuals?

Begins in late adolescence or young adulthood, but children and older adults can also be affected

When does panic disorder typically begin to manifest in individuals?

Childhood or early adolescence. Rarely develops in later adulthood.

When does SAD typically begin to manifest in individuals?

psychopharmacology, cognitive behavioural therapy, biofeedback/neurofeedback

What are three evidence-based treatments for anxiety disorders?

Self-evaluations: sense that the process and outcome is out of your control

Thought processes: evaluations may/may not be rooted in reality

Actions: many demands are placed on this determinant

Affect and mood and interpersonal processes may also be impacted

What are the psychosocial factors associated with anxiety?

Physical, cognitive, sensory, and affective components

What impact does anxiety have on occupational performance (4 components)?

Occupational profile; occupational function and meaning; goals and readiness

What are the three categories of assessments that have an occupational and functional focus for anxiety?

Role inventory, interest checklist

What assessments could be done to look at occupational profile?

Time use log; AOI; OQ; EMAS; COPM

What assessments could be done to look at occupational function and meaning?

Goal attainment scale (GAS); readiness rule

What assessments could be done to look at goals and readiness?

Time use log; AOI; OQ; EMAS; COPM; GAS

Which assessments could also be used as outcome measures?

1. employment and education

2. psychoeducation

3. creative occupations/activities

4. time use/occupational balance

5. skills/habit development

6. group/family approaches

7. animal-assisted therapy

What are the 7 identified categories for OT mental health interventions?