Anxiety and Stressor problems

Specific Phobia

Excessive, unreasonable, persistent fear triggered by a specific object or situation lasting ≥6 months.

DSM-5 Criteria for Specific Phobia

1) Marked fear about specific object/situation, 2) Almost always provokes immediate fear/anxiety, 3) Actively avoided or endured with distress, 4) Fear out of proportion to actual danger, 5) Persistent ≥6 months, 6) Causes significant distress/impairment, 7) Not better explained by another disorder.

Animal Phobia

Subtype of specific phobia involving fear of animals such as spiders, snakes, and dogs.

Natural Environment Phobia

Subtype of specific phobia that includes fears linked to natural occurrences, such as heights, storms, and water.

Blood-Injection-Injury Phobia

Subtype of specific phobia characterized by a fear of medical procedures, needles, and injuries, which can lead to fainting.

Situational Phobia

Subtype of specific phobia where fear is connected to specific situations, like airplanes or elevators.

Other Phobias

Subtype of specific phobia that encompasses fears such as choking, vomiting, loud noises, or costumed characters for children.

Aetiology of Specific Phobia

Phobias can stem from classical conditioning, disgust-based models, panic-related interpretations, nonassociative models, or biological preparedness.

Treatment for Specific Phobia

Commonly treated with exposure therapy techniques such as systematic desensitization, flooding, and counterconditioning.

One-Session Treatment for Specific Phobia

An intensive exposure therapy session lasting 3 hours, incorporating graded exposure and cognitive restructuring.

Case Study Indicators of Specific Phobia

Look for fear of a single object/situation, avoidance, lack of fear regarding social evaluation, and preserved insight.

Social Anxiety Disorder (SAD)

Severe, persistent fear of social or performance situations due to the fear of negative evaluation.

DSM-5 Criteria for SAD

Includes fear of scrutiny in social interactions, avoidance of social situations, fear that is out of proportion, and persistence ≥6 months.

Prevalence of SAD

Lifetime prevalence of approximately 4%, typically beginning in early to mid-teen years, and persisting over time.

Differentiation of SAD from Other Disorders

SAD fears negative evaluation; differs from specific phobia, agoraphobia, and panic disorder in focus and symptoms.

Aetiology of SAD

Includes genetic and developmental risk factors, such as heritability and behavioral inhibition traits.

Cognitive Biases in SAD

Includes negative prediction bias, critical self-evaluation, self-focused attention, and post-event rumination.

Treatment Comparison for SAD

CBT incorporates exposure therapy and skill training, while medications like SSRIs serve as quick relief; both methods have varying long-term effectiveness.

Case Study Indicators of SAD

Look for fears of public speaking, avoidance behaviors, belief others notice distress, physical symptoms, and significant persistence.

Panic Disorder vs. Panic Attack

Panic disorder encompasses recurrent panic attacks and persistent worry about future attacks; a panic attack is a singular episode of intense fear.

Agoraphobia Definition

Fear/anxiety about situations where escape might be difficult; diagnosed when it involves ≥2 such scenarios.

Relationship Between Panic Disorder and Agoraphobia

About 1/3 of panic disorder patients experience agoraphobia; it can develop from panic disorder or independently.

Biological Factors in Panic Disorder

Includes increased sensitivity in the locus coeruleus, through hyperventilation, and the suffocation alarm theory.

Anxiety Sensitivity in Panic Disorder

Fear of anxiety symptoms leading to heightened anxiety responses; contributes to the likelihood of panic attacks.

Clark's Catastrophic Misinterpretation Model

Describes how panic disorder patients misinterpret bodily sensations, leading to a cycle of anxiety and panic attacks.

Treatment Components for Panic Disorder

Includes CBT strategies such as cognitive restructuring and interoceptive exposure, often combined with medications like SSRIs.

Case Study Indicators for Panic Disorder vs. Agoraphobia

Recurrent panic attacks and avoidance of certain situations suggest panic disorder, while fear of inability to escape indicates agoraphobia.

Generalized Anxiety Disorder (GAD) Definition

Chronic, uncontrollable worrying spanning major and minor life issues; includes physical distress.

DSM-5 Criteria for GAD

Excessive anxiety over ≥2 domains, occurring for ≥3 months, resulting in physical or behavioral impairments.

Differentiation of GAD from Other Disorders

Differences seen when comparing to panic disorder (chronic worry vs. panic attacks), OCD, and major depression.

Aetiology of GAD - Biological & Cognitive

Includes a genetic component and cognitive biases contributing to anxiety maintenance.

Wells' Metacognitive Theory of GAD

Individuals hold contradictory beliefs about worry that can intensify distress surrounding it.

Mood-as-Input Hypothesis and GAD

Individuals interpret their mood state as reflective of task completion, leading to ongoing worry when negative feelings persist.

Psychological Treatment Techniques for GAD

Includes stimulus control, CBT, and metacognitive therapy aimed at reframing worry beliefs.

Medication Options for GAD

SSRIs and SNRIs are first-line treatments, with benzodiazepines used less due to dependence risk.

Case Study Features Suggesting GAD

Chronic worry, perception of uncontrollability, catastrophic thoughts, physical symptoms, and avoidance behaviors.