Anxiety Disorders

By Dr seddigh

HUMS

Anxiety Disorders

Primary disturbance is distressing روانی ,رنج persistent anxiety مستمر or اضطراب maladaptive behaviors انطباقی غیر رفتار that reduce anxiety Anxiety - diffuseمنتشر, vague feelings مبهم of fear احساس

and apprehension– everyone experiences it – becomes a problem when it is irrational, uncontrollable, and

disruptive گسیخته هم ودر کنترل قابل منطقی،غیر غیر

Generalized Anxiety Disorder (GAD) منتشر اضطراب اختالل

More or less constant worry about many issues موقعیتها اکثر در مداوم نگرانی

The worry seriously interferes with functioning جدی عملکرد اختالل

Physical symptoms جسمی عالئم– Headaches سردرد – Stomachaches معده ناراحتی– muscle tension تنشعضالنی – Irritability پذیری تحریک

Model of Development of GADGAD has some genetic componentRelated genetically to major depressionChildhood trauma also related to GAD

Genetic predispositionor childhood trauma

GAD following life change or major event

Hypervigilance

Phobias

Intense, irrational fear that may focus on:– category of objects اشیا– event or situation موقعیتها – social setting اجتماعی مسایل

Phobias It is not phobic to simply be anxious about something

Afraid of it Bothers slightly Not at all afraid of it

Beingclosed in,

in a smallplace

Being alone

ina houseat night

Percentageof peoplesurveyed

100

90

80

70

60

50

40

30

20

10

0Snakes Being

in high,exposedplaces

Mice Flyingon an

airplane

Spidersand

insects

Thunderand

lightning

Dogs Drivinga car

Being in

a crowdof people

Cats

Study of normal anxieties

Specific Phobias

Specific phobias - fear of specific object– animals (e.g., snakes)

– substances (e.g., blood)

– situations (e.g., heights)

– more often in females than males

Some Unusual Phobias

Ailurophobia - fear of catsAlgobphobia - fear of painAnthropophobia - fear of menMonophobia - fear of being alonePyrophobia - fear of fire

Social Phobias

Social phobias - fear of failing or being embarrassed زده in public خجالت– public speaking (stage fright) کردن صحبت– fear of crowds, strangers شلوغی از ترس– meeting new people جدید افراد مالقات– eating in public آشامیدن و خوردن

Considered phobic if these fears interfere with normal behavior طبیعی رفتار با تداخل

Equally often in males and females ♂ = ♀

Development of Phobias

Classical conditioning model کالسیک مدل شدن شرطی

– e.g., dog = CS, bite = UCS

– problems: • often no memory of a traumatic experience• traumatic experience may not produce

phobia

Obsessive-Compulsive Disorder (OCD)

Obsessions - irrational, disturbing thoughts that intrude into consciousness

Compulsions - repetitive actions performed to alleviate obsessions

Checking and washing most common compulsions

Heightened neural activity in caudate nucleus

Panic Disorder

Panic attacks - helpless terror, high physiological arousal

Very frightening - sufferers live in fear of having them

Agoraphobia often develops as a result

Posttraumatic Stress Disorder (PTSD)

Follows traumatic event or events such as war, rape, or assault

Symptoms include:– nightmares– flashbacks– sleeplessness– easily startled– depression– irritability

Somatoform Disorders

Bodily ailments in absence of any physical disease

Examples are conversion disorder and somatization disorder

Psychological Influences on Physical Symptoms

and Diseases

Conversion Disorder

Person temporarily loses some bodily function– blindness, deafness,

paralyzed portion of body

– glove anesthesia

No physical damage to cause problems

Conversion Disorder

Rare in western culture now– relatively common 100 years ago– prominent in Freud’s work/clients

Often see examples in non-Western people exposed to traumatic event– e.g., high rate of psychological blindness in

Cambodian women after Khmer Rouge reign of terror in 1970s

Somatization Disorder

Long history of dramatic complaints re: different medical conditions– complaints usually vague, undifferentiated– e.g., heart palpitations, dizziness, nausea

Often difficult to determine whether complaints are somatization or undetectable physical disease

Somatization Disorder

Kleinman’s theory– somatization and depression are different

manifestations of the same problem– cross-cultural research

• pattern of somatoform disorders affected by cultural beliefs