Stress, phobia and anxiety

Why is it important to distinguish between stress, anxiety, and phobia

• Because they are similar psychological constructs, but each has distinct triggers and characteristics

What is stress

• A state of physiological or psychological tension triggered by a stimulus that exceeds the ability to cope. It can include both eustress (positive stress) and distress (negative stress)

What is anxiety

• A state of heightened physiological arousal associated with feelings of worry or uneasiness that something is wrong or something unpleasant is about to happen (distress)

What is a specific phobia

• A type of anxiety disorder characterised by excessive and disproportionate fear when encountering a particular stimulus

Give an example that distinguishes fear, stress, and anxiety

• Sitting in a plane with smoke coming from the engines triggers fear (real danger).

• Sitting in a plane with no issues but feeling afraid something might go wrong is anxiety. Stress occurs when the situation exceeds one’s ability to cope

How is stress defined in comparison to anxiety

• Stress is a response to a known stressor, involving a physiological or psychological reaction (e.g., activation of the sympathetic nervous system)

When does distress typically occur in relation to stress

• Distress occurs when an individual feels they do not have adequate resources to cope with a stressor

How does anxiety differ from stress

• Anxiety is broader, may not be in response to a known stressor, and involves feelings of worry, apprehension, and unease, often about future events or potential threats

Can stress involve positive feelings

• Yes, stress can involve eustress (positive) or distress (negative), while anxiety typically involves only negative feelings

Give an example summarising the difference between stress and anxiety

• Stress occurs when facing a specific challenge, like exams (known stressor).

• Anxiety occurs when worrying about what might happen in the future, even without a clear stressor

Where do stress and anxiety lie on the mental health continuum

• On the ‘normal functioning’ part — they are expected parts of daily life and usually don’t interrupt daily functioning

How can stress and anxiety be adaptive

• They can motivate action, such as preparing for a SAC, rather than avoiding it

What triggers stress

• Stress is caused by a stressor and is a state of physiological or psychological tension triggered when demands exceed coping ability

How is anxiety related to stress

• Anxiety is a state of physiological arousal involving persistent fear or worry and can be seen as stress that continues after the stressor is gone

Name some internal biological factors that can influence stress and anxiety

• Genetic vulnerability/predisposition

• Poor sleep

• Substance use/misuse

• Poor response to medication due to genetics

• Lack of exercise

• Disease and injury

Name some internal psychological factors that can influence stress and anxiety

• Personality traits such as poor self-efficacy

• Rumination

• Impaired reasoning and coping skills

Name some external social factors that can influence stress and anxiety

• Loss of a significant relationship

• Lack of support from family and friends (loneliness)

• Poverty

When can anxiety become a mental health disorder

• When it is excessive, persistent over a long period, and disrupts aspects of daily functioning, it falls under anxiety disorders on the mental illness part of the continuum

How are phobias related to anxiety disorders

• Phobias are a subset of anxiety disorders, characterised by amplified anxiety responses

What is a specific phobia

• Excessive, distressing, and persistent fear or anxiety in response to a specific object or situation (e.g., animals, enclosed spaces, flying), which is intense, irrational, and disproportionate

How do people with specific phobia perceive their fear

• They are often aware that their fear is not a normal response but are unable to control it and may go to great lengths to avoid the phobic stimulus

What physiological response occurs in people with a specific phobia

• the body undergoes a stress response similar to the fight–flight–freeze response

What criterion is used to categorise a fear as a phobia disorder

• The fear must significantly disrupt daily functioning at work, home, socially, or with family

What are the four main types of specific phobia

• Animal phobias – fear of animals (e.g., snakes, spiders, rats, dogs)

• Natural environment phobias – fear of heights, storms, water, darkness

• Situation phobias – fear of enclosed spaces, elevators, flying, dentists, driving, tunnels, bridges

• Blood-injection-injury phobia – fear of medical procedures or sight of blood

What are the biological internal factors contributing to phobia

• Neurotransmitter dysfunction (GABA)

• Family history of mental health problems

• Gender (more common in females)

• Role of stress response

• Long-term potentiation (constant pairing of fear + object of fear)

What are the psychological internal factors contributing to phobia

• Developmental stage (specific phobias usually develop in childhood)

• Personality traits (e.g., negativity, high inhibition)

• Traumatic events causing classical conditioning

• Avoidance via negative reinforcement/operant conditioning

• Cognitive biases (memory bias, catastrophic thinking)

What are the social external factors contributing to phobia

• Parental modelling

• Family history of mental health problems

• Specific environmental triggers

• Transmission of threat information

• Stigma related to receiving treatment

• Family involvement and accommodation

Give examples showing the difference between fear and phobia

• Fear: Feeling nervous during takeoff on an airplane, tension when a large dog approaches.

• Phobia: Avoiding flying for a family vacation, refusing a job in a skyscraper, avoiding the park due to fear of dogs.

What are the DSM-5 criteria for diagnosing a specific phobia

• Unreasonable, excessive fear or anxiety about a specific object/situation

• Phobic stimulus provokes an immediate anxiety response

• Fear/anxiety is out of proportion to the actual danger

• Avoidance or extreme distress

• Impacts daily functioning (life-limiting)

• At least 6 months duration

• Not caused by another disorder

key differences: Stress vs Anxiety vs Specific Phobia – Stress

• Sympathetic nervous system dominant

• Response to a known stimulus

• Feelings can be positive (excitement) or negative (apprehension)

• Can be eustress or distress

• Some stress can be adaptive

• May contribute to mental health disorder development

Key differences: Stress vs Anxiety vs Specific Phobia – Anxiety

• Sympathetic nervous system dominant

• Response might be to unknown or generalised stimulus

• Feelings of apprehension, unease, worry

• Distress only

• Some anxiety can be adaptive

• May contribute to mental health disorder development

Key differences: Stress vs Anxiety vs Specific Phobia – Specific Phobia

• Sympathetic nervous system dominant

• Response to a known stimulus

• Feeling of fear is predominant

• Distress only

• Phobia is maladaptive

• Diagnosed mental health disorder