Fear and anxiety across the continuum

Anxiety

future-oriented apprehension, tension, or sense of dread, while fear is an immediate emotional response to danger or perceived threat in the environment

Anxiety Fight-or-flight response

a set of physical and psychological responses that help us fight a threat or flee from it.

Anxiety

Result from the activation of two systems controlled by the hypothalamus (autonomic/adrenal-cortical)

Anxiety Autonomic nervous system

part of the nervous system that controls bodily functions not consciously directed

Anxiety Adrenal-cortical system

a hormonal system situated in the adrenal cortex and activated by the hypothalamus

Anxiety Cortisol

a stress hormone released by the adrenal glands.

Panic disorder

Abrupt surge of intense fear or intense discomfort during which 4+ of symptoms occur

Panic disorder

At least one of the attacks has been followed by a month or more of persistent concern/worry about additional panic attacks or a significant change in behavior

Panic disorder

Attacks can not be attributed to substance use.

Panic disorder Biological factors

focus on the mechanisms of biology, ex. Influence of neurotransmitters, genetics, hormones, brain structures, and anatomy biology that relate to the dev. Of this disorder

Anxiolytic properties

a medication or substance that reduces or alleviates symptoms of anxiety

Panic disorder

People show dysregulation (too little) of norepinephrine systems in the locus ceruleus, an area of the brain stem that plays a part in the emergency response and may be involved in panic attacks.

Panic disorder Cognitive factors

People prone to panic attacks, Pay very close attention to their bodily sensations and misinterpret them in a negative way

Engage in catastrophic thinking, exaggerating symptoms and their consequences

Panic disorder Anxiety Sensitivity

Tendency to believe that anxiety and its symptoms harm the body

Panic disorder Introceptive awareness

Heightened awareness of bodily cues that signal a coming panic attack

Heightened awareness of bodily cues that signal a coming panic attack

Panic disorder Intreroceptive conditioning

Bodily cues that occurred at the beginning of previous panic attacks become conditioned stimuli signaling new attacks

Bodily cues that occurred at the beginning of previous panic attacks become conditioned stimuli signaling new attacks

Conditioned avoidance response

Behavior that is reinforced because it allows individuals to avoid situations that cause anxiety

Panic disorder

People associate certain situations or cues with symptoms of a panic attack, such that future exposure to those situations or cues triggers symptoms. Sufferers then prevent having symptoms by avoiding those situations or cues. The reduction in anxiety reinforces the avoidance behavior.

Treatments for Panic Disorder Biological treatment

Medication affecting serotonin and norepinephrine systems, SSRI’s, SNRI’s, tricyclic antidepressants

Most people experience a relapse of symptoms when drug therapies are discontinued

Treatments for Panic Disorder Cognitive-behavioral therapy

Recommended as first-line treatment

Practice breathing exercises while experiencing panic symptoms during the session

Challenging catastrophizing thoughts

Teaches people strategies to prevent the recurrence of panic attacks.

Separation Anxiety Disorder

Syndrome of childhood and adolescence marked by abnormal fear or worry of becoming separated from one’s caregiver(s), as well as clinging behaviors in the presence of caregiver(s).

Separation anxiety

A State of extreme distress caused by separation from the primary caregiver, typically experienced in early childhood development.

Can have significant effects on the development pathway of a child if symptoms result in avoidance of places, activities, and experiences crucial for healthy social-emotional dev.

Separation anxiety

Growing research indicates adults experiencing the first onset of SAD, which leads to reclassification as an anxiety disorder.

Separation anxiety

Evidence indicates that the presence of separation anxiety disorder may represent a vulnerability for a wide range of common psychiatric conditions.

Separation anxiety Biological factors

Tendency toward anxiety is heritable

Separation anxiety Behavioral inhibition

temperament trait characterized by

Shy, fearful, and irritable toddlers

cautious, quiet, and introverted as school-age children

Separation anxiety Psychological and sociocultural factors

Parents can influence responses through modeling anxious behaviors

Overprotection by parents and parent anxiety issues are influential.

Separation anxiety treatment CBT

teach skills for coping and for challenging cognitions that feed anxiety, To learn relaxation exercises to practice when separated from parents, To challenge fears about separation and use self-talk to calm themselves

Separation anxiety treatment Biological

Drugs used are antidepressants, antianxiety drugs, stimulants, and antihistamines, Ketamine has also been indicated as a treatment option in the first weeks of treating emergency cases of anxiety

Selective Mutism

Anxiety disorder that typically emerges in early childhood and can last into adulthood if untreated

Children are capable of typical, age-appropriate language but remain silent in situations that provoke anxiety

Selective Mutism

Failure to speak cannot be attributed to a disturbance of language development

Selective Mutism

Development appears to result from interaction of various genetic, temperamental, environmental, and developmental factors.

Generalized Anxiety Disorder

Anxiety disorder characterized by chronic anxiety in daily life.

Generalized Anxiety Disorder

Excessive anxiety about ordinary, everyday situations

People with generalized anxiety disorder could be sensitive to increases in negative emotion or decreases in positive emotion and engage in avoidance of such feelings

Generalized Anxiety Disorder

Natural course is chronic with few complete remissions, waxing and waning course of symptoms, and occurence of substantial comorbidity particularly with depression.

Generalized Anxiety Disorder

Emotional and cognitive factors Characterized by both emotional dysregulations and cognitive deficits

Emotion regulation

balance between understanding and identifying one’s thoughts and feelings while being able to manage the emotional impact on their behavior and function

Generalized Anxiety Disorder

Cognitive risk factors increase vulnerability for internalizing disorders

Generalized Anxiety Disorder

Potential attentional bias toward threat-related stimuli