ch 11. Anxiety Disorders

Fear

Immediate threat triggers behavioral and physiological reactions.

Anxiety

Psychological distress due to vague, future-oriented threats with various reactions.

Worry

Cognitive preparation for future dangers in response to threats.

Adaptive anxiety

Eustress aiding in dealing with threats and preparing for danger.

Maladaptive anxiety

Distress hindering functioning.

Intense

Excessive reaction to a threat.

Chronic

Persistent and long-lasting anxiety.

Anxiety in children

Varies from expected to severe, reflecting cognitive and emotional development.

Stranger anxiety

Occurs at 6-9 months in children.

Separation Anxiety Disorder (SAD)

Excessive anxiety about separation, with specific symptoms and onset at age 7-9.

Selective Mutism

Failure to speak in certain situations, not due to lack of knowledge.

Phobia

Intense fear of specific objects or situations leading to impairment and avoidance.

Social Anxiety Disorder

Fear of social scrutiny or performance situations, leading to avoidance.

Panic Disorder

Characterized by recurrent panic attacks and autonomic arousal.

Agoraphobia

Anxiety about situations with no easy escape, often associated with panic disorder.

Generalized Anxiety Disorder (GAD)

Uncontrollable worry as the main symptom, often comorbid with depression.

Anxiety sensitivity

Expectancy theory of panic attacks.

Genetics in anxiety

Small-moderate role, more genetic in panic disorder than GAD/social anxiety.

Learning Factors in anxiety

Classical conditioning, observational learning, and avoidance maintenance.

Parenting Factors in anxiety

Overcontrolling parenting, insecure attachment, and modeling avoidance behaviors.

aladaptive anxiety

Distress, & interferes with functioning

intense

excessive for threat

Chronic

persistent and long-standing

Anxiety in children

Ranges from expected to severe, indicative of cognitive, emotional, and social development

90%

Percentage of kids have specific fears between ages 2-14

Imaginary creatures

occurs at 1-2 years in children

Fear of the dark

occurs at age 4 in children

Social fears

fear of failure among older children

In any given year […] of children have anxiety

8%

About […] have anxiety before reaching adulthood

20%

Prevalence is higher for

adolescents & girls

Modest homotypic continuity

when a particular psychiatric disorder predicts itself at a later time point

Strong heterotypic continuity

occurs when a particular disorder predicts another disorder at a later time point

Childhood anxiety disorders are associated with later […]

depression and substance use disorder

symptoms of SAD

Anticipated distress/worry about separation, worry about losing attachment figure, fear/avoid of being alone/away from attachment figure, repeated nightmares involving separation themes, complaints of physical symptoms, & symptoms occur for at least 4 weeks, & distressing or impairs functioning

The onset of SAD (severity decreases w/ age)

age 7-9

[…] of young children in the general population

1%

2x risk

Girls are at […] for Selective mutism

true

Those with selective mutism are at risk for other psychiatric disorders

Phobias with blood

fear of receiving an injection, injuries, and seeing blood

Specific situations (phobias)

fear of flying, elevators, and enclosed places

Phobias with the natural environment

fear of thunderstorms, heights, water, etc.

Phobia with other stimuli

fear of choking, illnesses, costumed characters, etc.

Phobia with Animals

fear of snakes, dogs, birds, etc.

Non-normal aspects

Frequency/intensity/duration, & Distress/dysfunction

Common cognitive distortions

Catastrophizing, Overgeneralizing, & Personalizing

How genetics play a small-moderate role

Panic disorder is more genetic than GAD/social anxiety, and there’s less GABA activity

risks for panic disorders

parent w/ anxiety or depressive disorders, or behavioral inhibition & trait anxiety

Learning Factors

Classical conditioning, observational learning/modeling, informational transmission, & maintained through avoidance

Parenting Factors

Overcontrolling, overprotective parenting, high levels of hostility/criticism, insecure attachment in infancy, avoiding anxiety-provoking situations, & modeling

Ways parents promote avoidance in children

Providing continuous re-assurance that child did a good job (GAD), Ordering food for child, making school requests/excuses (Social Anxiety), texts/calls to/from child all day (Separation Anxiety), Buying items child needs for rituals (OCD)

Negative reinforcement

Maintains & exacerbates youth anxiety, & one of the main targets of treatment