Module 49: Anxiety Disorders and OCD

Anxiety

Interaction of thoughts, feelings, behaviors, and physiological responses involving worry and fear

Thought component of anxiety

Worry, fear, negative predictions like “what if I fail?”

Feeling component of anxiety

Emotions such as nervousness, fear, and distress

Behavioral component of anxiety

Avoidance or escape from feared situations

Physiological component of anxiety

Increased heart rate, sweating, muscle tension

Yerkes-Dodson Law

Performance is best at moderate levels of arousal; too little or too much anxiety reduces performance

Low arousal effect

Poor performance due to lack of motivation

Optimal arousal effect

Best performance with moderate stress

High arousal effect

Poor performance due to overwhelm

Key feature of anxiety disorders

Persistent, excessive, and impairing anxiety

Provoking situations

Triggers that cause anxiety

Persistent anxiety

Anxiety that does not go away easily

Excessive anxiety

Out of proportion to the situation

Impairment

Interferes with daily life

Avoidance

Staying away from anxiety-provoking situations

Suffering through

Enduring anxiety with distress

What differs between anxiety disorders

The specific object or situation that is feared

Specific phobia

Intense fear of a specific object or situation

Social anxiety disorder

Fear of social evaluation or judgment

Panic disorder

Recurrent unexpected panic attacks

Generalized anxiety disorder (GAD)

Chronic, excessive worry about many aspects of life

Agoraphobia

Fear of being in situations where escape may be difficult

OCD

Disorder involving obsessions and compulsions

Panic attack

Sudden episode of intense fear with physical symptoms

Core feature of GAD

Uncontrollable, persistent worry

Core feature of social anxiety

Fear of embarrassment or judgment

Anxiety disorders prevalence

Most common type of mental disorder

Comorbidity

Co-occurrence of multiple disorders

Common comorbidity

Anxiety disorders often occur with depression

Obsessions

Intrusive, unwanted thoughts, urges, or images that cause distress

Goal of obsession response

Person tries to ignore, suppress, or neutralize thoughts

Contamination obsessions

Fear of germs, dirt, or illness

Repeated doubt obsessions

Fear of making mistakes like leaving door unlocked

Ordering obsessions

Need for symmetry or exact arrangement

Violent obsessions

Intrusive thoughts about harming others

Sexual obsessions

Unwanted inappropriate sexual thoughts

Compulsions

Repetitive behaviors or mental acts performed to reduce anxiety

Purpose of compulsions

Reduce anxiety or prevent feared event

Reality of compulsions

Not realistically connected or clearly excessive

Checking compulsion

Repeatedly checking things like locks or appliances

Cleaning compulsion

Excessive washing or cleaning

Repeating compulsion

Repeating actions multiple times

Ordering compulsion

Arranging items in a specific way

Thought suppression

Trying to avoid thinking about something, which increases the thought

White bear effect

Trying not to think about something makes it more frequent

OCD cycle

Obsession → Anxiety → Compulsion → Temporary relief → Repeat

Exposure and Response Prevention (ERP)

Treatment involving exposure to anxiety and prevention of compulsions

Exposure in ERP

Facing anxiety-provoking situations

Response prevention in ERP

Resisting the urge to perform compulsions

Goal of ERP

Break the anxiety-compulsion cycle

Avoidance effect on anxiety

Maintains and strengthens anxiety over time

Why compulsions persist

They temporarily reduce anxiety, reinforcing behavior