Anxiety Disorders Summary

Anxiety Disorders

Anxiety

  • Anxiety involves:
    • Increased heart rate.
    • Worry.
    • Increased breathing.
    • Memory decline.
    • Nausea.
    • Fidgeting.
    • Freezing.
    • Chest tension.
    • Headache.
    • Insomnia.
    • Numbness.
  • Anxiety is a mood state characterized by:
    • Negative affect.
    • Bodily symptoms of tension.
    • Future-oriented focus.
    • Feelings of unpredictability and lack of control over upcoming events.
  • Anxiety transforms "what is" into "what if's".

Fear

  • Fear involves:
    • Negative affect.
    • Strong sympathetic nervous system arousal.
    • Immediate alarm reaction with strong escapist tendencies in response to present danger or life-threatening emergencies.

Panic Attack

  • Panic attack is fear occurring at an inappropriate time.
  • Two types:
    • Expected.
    • Unexpected.
  • Diagnosis requires 4 or more symptoms.

Panic Disorder (PD)

  • Lifetime prevalence in the US: 3.5%.
  • 75% are women.
  • Can involve nocturnal panic and isolated sleep paralysis.

Agoraphobia

  • Lifetime prevalence in the US: 5.3%.
  • Involves fear of being in places or situations where escape is difficult.
  • Interoceptive avoidance can be present.
  • Diagnostic note: if panic disorder criteria are met, agoraphobia should not be diagnosed if avoidance behaviors associated with panic attacks do not extend to avoidance of two or more agoraphobic situations.

Generalized Anxiety Disorder (GAD)

  • Prevalence (2012, Canada): 2%.
  • Lifetime prevalence (Canada): 9%.
  • Cognitive characteristics:
    • Intolerance of uncertainty.
    • Positive beliefs about worry.
    • Poor problem orientation.
    • Cognitive avoidance.
  • Approximately 2/3rds are female.

Specific Phobia

  • Four subtypes:
    • Animal.
    • Natural Environment.
    • Blood-injury-injection.
    • Situational.
    • "Other".
  • 6.4% prevalence in Canada.
  • Tends to be chronic.
  • Caused by:
    • Direct experience (trauma).
    • Vicarious experience.
    • False alarm (panic attack).
  • Onset around age 7.

Social Anxiety Disorder / Social Phobia

  • Relational; involves evaluation from others.
  • Most prevalent disorder in the United States (13.3% lifetime prevalence).
  • Peak onset around 15 years of age.

Selective Mutism

  • High comorbidity with other anxiety disorders.
  • 0.5% prevalence.
  • Lack of speech in specific situations and/or with specific people.
  • Can be linked to trauma or other anxiety disorders.

Treatment for Anxiety Disorders

  • Benzodiazepines.
  • Anti-depressants.
  • Brief psychological treatments.
  • CBT (Cognitive Behavioral Therapy).
  • Mindfulness.
  • Panic control treatment (PCT).
  • Exposure therapies.
  • Virtual reality.