ch 11. Anxiety Disorders

Fear: behavioral and physiological (autonomic) reaction to the immediate threat

Anxiety: state of psychological distress that reflects emotional, behavioral, physiological, and cognitive reactions to a vague threat, future-oriented emotion, perceptions of uncontrollability and unpredictability

Worry: cognitive response to threat, person considers and prepares for future danger

Adaptive anxiety: Eustress, Beneficial emotional state, & helps us deal with immediate threats • Helps us prepare for future danger

Maladaptive 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

Stranger anxiety: 6-9 months

Imaginary creatures: 1-2 years

Fear of the dark: age 4

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

Separation Anxiety Disorder (SAD): Developmentally inappropriate/excessive anxiety concerning separation from those to whom the individual is attached, including:

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: age 7-9, severity decreases w/ age

Selective Mutism Failure to speak in a specific situation not attributable to a lack of knowledge, limited language proficiency, and you need to rule out other conditions

[…] of young children in the general population: 1%

Girls are at […] for Selective mutism: 2x risk

Those with selective mutism are at risk for other psychiatric disorders: true

phobia: an intense fear of particular objects or situations. It involves stressing and/or impairing functioning, along with avoidance

Phobias with: blood, injections, and injuries - fear of receiving an injection and seeing blood

Specific situations: 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.

Social Anxiety Disorder: characterized by significant and persistent fear of social or performance, situations in which scrutiny might occur, avoidance of social or performance situations, & endurance with extreme distress. This usually emerges in late childhood or early adolescence

The two most common situations feared: Unstructured interactions, & Presentations

Social Anxiety Disorder is a risk factor for depression, social isolation, and loneliness: true

Panic Disorder: characterized by recurrent, unexpected/random panic attacks, intense episode of distress and autonomic arousal, & it can be a form of impairment

For diagnosis, an individual must have recurrent, unexpected panic attacks followed by: a month of persistent concern about having attacks, & worry/distress about the implications of attacks

anxiety sensitivity: expectancy theory of panic

Agoraphobia: recurrent anxiety about places or situations from which escape or help is not possible without considerable effort/embarrassment

what can develop with or without panic disorder: Panic-like symptoms associated with specific situations which are avoided (negative reinforcement), place may be avoided because of a negative external incident that occurred there, & individuals with low self-efficacy may avoid certain places unless accompanied by someone

Generalized Anxiety Disorder (GAD): main symptom is uncontrollable worry, highly comorbid with depression

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

Another risk: 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