Download Ch. 18 S. 2

Ch. 18 Section 2: Anxiety Disorders
Obj: Descibe the anxiety disorders.
________________ refers to a general state of dread or uneasiness that occurs in
response to a vague or imagined danger. It differs from fear, which is a response
to a real danger or threat. Anxiety is typically characterized by _______________,
inability to relax, and concern about losing control. Physical signs and symptoms
of anxiety may include trembling, sweating, rapid heart rate, shortness of breath,
increased blood pressure, flushed face, and feelings of faintness or lightheadedness. All are the result of overactivity of the _____________________
branch of the autonomic nervous system.
Everyone feels anxious at times-for example, before a big game or an important
test. In such situations, feeling anxious or _________________ is an appropriate
response that does not indicate a psychological disorder. However, some people
feel anxious all or most of the time, or their anxiety is out of proportion to the
situation provoking it. Such anxiety may interfere with effective living, the
achievement of desired goals, life satisfaction, and emotional comfort. When these
problems occur, anxiety is considered a sign of a psychological ______________.
Anxiety based disorders are among the most ________________ of all
psychological disorders in the US.
Types of Anxiety Disorders
Anxiety disorders classified in the DSM-IV include ______________ disorder,
_______________ disorder, generalized anxiety disorder, obsessive-compulsive
disorder, and ______________ disorders. A description of each follows.
Phobic Disorder – The word _______________ derives from the Greek root
phobos, which means “fear.” ______________ phobia, which is the most
common of all the anxiety disorders, refers to a persistent excessive or irrational
fear of a particular object or situation. To be diagnosed as a phobic disorder, the
fear must lead to ___________________ behavior that interferes with the affected
person’s normal life.
When people with simple phobias are confronted with the object or situation they
fear, they are likely to feel extremely anxious. As a result, they tend to __________
what they fear. For example, someone with _______________________ (a fear of
blood) might avoid needed medical treatment. Thus, although most people with
simple phobias never seek treatment for their disorders, a simple phobia can
seriously _______________ a person’s life.
________________ phobia is characterized by persistent fear of social situations
in which one might be exposed to the close _______________ of others and thus
be observed doing something embarrassing or humiliating. Some people with
social phobias fear all social situations; others fear specific situations, such as
public speaking, eating in public, or dating.
People with social phobias generally try to avoid the situations they fear. They may
invent excuses to avoid going to _____________ or other social gatherings, for
example. If avoidance is impossible, the situations are likely to cause great
anxiety. In addition, the avoidance behavior itself may greatly interfere with work
and social life.
Panic Disorder and Agoraphobia – people with panic disorder have recurring
and unexpected panic attacks. A ______________ attack is a relatively short
period of intense fear or discomfort, characterized by shortness of breath,
dizziness, rapid heart rate, trembling or shaking, sweating, choking, nausea, or
other distressing physical symptoms. It may last from a few minutes to a few
____________. People having a panic attack may believe they are dying or “going
crazy.” Not surprisingly, they usually have persistent __________ of another
attack.
For most people who suffer panic disorder, attacks have no apparent cause.
However, many people with panic disorder also have agoraphobia.
_____________________ is a fear of being in places or situations in which escape
may be difficult or impossible. People with agoraphobia may be especially afraid of
crowded public places such as movie theaters, shopping malls, buses, or trains.
Agoraphobia is a common phobia among ______________. In fact, according to
the DSM-IV, people with one or both disorders make up about 50 to 80 percent of
the phobic individuals seen in ________________ practice.
Most people with agoraphobia have panic attacks when they cannot avoid the
situations they fear. They are afraid they will have a panic attack in a public place,
where they will be ___________________ or unable to obtain help. Panic disorder
and agoraphobia both lead to _____________________ behaviors. These
behaviors can range from avoiding crowded places to never leaving home at all.
Thus, these phobias can be very __________________.
__________________________ Anxiety Disorder – according to the DSM-IV,
generalized anxiety disorder (GAD) is an excessive or _____________________
worry about life circumstances that lasts for at least six months. The worries must
be present during most of that time in order to warrant a diagnosis of GAD.
Typically, the worries focus on finances, work, interpersonal problems, accidents,
or illness.
GAD is one of the most common anxiety disorders, yet few people seek
psychological treatment for it because it does not differ, except in intensity and
duration, from the normal worries of everyday ________. It is difficult to distinguish
GAD from other anxiety disorders as well, most often phobic disorders.
Obsessive-____________________ Disorder – Among the most acute of the
anxiety disorders is obsessive-compulsive disorder (OCD). __________________
are unwanted thoughts, ideas, or mental images that occur over and over again.
They are often senseless or repulsive, and most people with obsessions try to
ignore or suppress them. The majority of people with obsessions also practice
compulsions, which may reduce the anxiety their obsessions produce.
_________________________ are repetitive ritual behaviors, often involving
checking or cleaning something.
The following examples are typical of people with ________. One person is
obsessed every night with doubts that he has locked the doors and windows
before going to bed. He feels driven to compulsively ______________ and
recheck every door and window in the house, perhaps dozens of times. Only then
can he relax and go to sleep. In another example, a team of researchers reported
the case of a woman who was obsessed with the idea that she would pick up
germs from nearly everything she touched. She compulsively washed her hands
over and over again, sometimes as many as ____________ times a day.
People who experience obsessions are usually aware that the obsessions are
______________________. This distinguishes obsessions form _____________.
Although obsessions are a sign of a less serious psychological disorder than
delusions, they still can make people feel extremely anxious, and they can
seriously interfere with daily life. Compulsions may alleviate some of the anxiety
associated with obsessions, but the compulsions themselves are _________consuming and usually create additional interference with daily life.
______________ Disorders – Stress disorders include post-traumatic stress
disorder (PTSD) and acute stress disorder. The two disorders have similar
symptoms, but they differ in how quickly they occur after the traumatic event that
triggers the disorder. They also differ in how long they last.
Post-_____________________ stress disorder refers to intense, persistent
feelings of anxiety that are caused by an experience so traumatic that it would
produce stress in almost anyone. Experiences that may produce PTSD include
rape, severe child abuse, assault, severe accident, airplane crash, natural
__________________, and war atrocities.
It appears to be a common syndrome in people who have experienced extensive
trauma. For example, more than one third of the victims of Hurricane Andrew in
1992 developed PTSD.
People who suffer from PTSD may exhibit any or all of the following symptoms.
 _________________, which are mental reexperiences of the actual trauma
 __________________ or other unwelcome thoughts about the trauma
 _____________________ of feelings
 Avoidance of stimuli associated with the trauma
 Increased tension, which may lead to sleep disturbances, irritability, poor
concentration, and similar problems.
The symptoms may occur six months or more after the traumatic event, and they
may last for years or even _________________. The more severe the trauma, the
worse the symptoms tend to be.
_______________ stress disorder is a short-term disorder with symptoms similar
to those of PTSD. Also like PTSD, acute stress disorder follows a traumatic event.
However, unlike with PTSD, the symptoms occur immediately or at most within a
month of the event. The anxiety also lasts a shorter time-from a few days to a few
weeks. Not everyone who experiences a _________________, however, will
develop PTSD or acute stress disorder.
Explaining Anxiety Disorders
Several different ________________________ for anxiety disorders have been
suggested. As is true for most of the psychological disorders discussed in this
chapter, the explanations fall into ________ general categories: psychological
views and biological views.
_______________________ Views – for anxiety disorders, as well as the other
disorders discussed later in this chapter, psychoanalytic views are presented even
though they are no longer widely ________________. These views are included
because they influenced later theories and had a major ______________ on the
classification of psychological disorders until recently, as discussed earlier.
According to psychoanalytic theory, anxiety is the result of “________________”
childhood urges that have been repressed, or hidden from consciousness. If
repressed urges do surface, psychoanalysts argue, they may do so as obsessions
and eventually lead to compulsive behaviors. For example, if one is trying to
repress “_____________” sexual thoughts, then repetitive hand ______________
may help relieve some of the anxiety.
Learning theorists believe that _______________ are conditioned, or learned, in
childhood. This may occur when a child experiences a traumatic event – such as
being lost in a crowd or frightened by a bad ____________ – or when a child
observes phobic behavior in other people. If a parent screams or faints when a
child picks up a spider, for example, the child may learn that spiders are things to
be feared and develop a fear of them. __________________ theorists argue that
such conditioned phobias may remain long after the experiences that produced
them have been forgotten.
Learning theorists also believe that people will learn to reduce their anxiety by
avoiding the situations that make them anxious. For example, a student who feels
anxious speaking in front of others in class may learn to keep quiet because it
reduces his or her feelings of anxiety. However, by intentionally avoiding the
anxiety-producing behavior, the student has no chance to learn other ways of
________________ with or unlearning the anxiety. As a result, the anxiety may
worsen or be generalized to other situations that involve speaking in front of
others.
_________________ theorists, on the other hand, believe that people make
themselves feel anxious by responding negatively to most situations and coming to
believe they are _________________ to control what happens to the. This creates
great anxiety.
____________________ Views – Research indicates that heredity may play a role
in most psychological disorders, including anxiety disorders. For example, one
study showed that if one pair of identical twins exhibited an anxiety disorder, there
was a 45 percent chance that the other _____________ would also exhibit the
disorder. This was true even of twins raised in different families. By contrast, the
chances of fraternal twins both developing anxiety disorders was only about 15
percent. Similarly, ________________ children are more likely to have an anxiety
disorder if a biological parent has one than if an adoptive parent does. Both types
of studies suggest that genes play at least some role in the development of anxiety
disorders.
How did ______________ get involved? Some psychologists believe that people
get involved? Some psychologists believe that people are genetically inclined to
fear things that were threats to their _________________. These psychologists
argue that people who rapidly acquired strong fears of real dangers – such as
large animals, ______________, heights, and sharp objects – would be more likely
to survive and reproduce. To the extent that the tendency to develop such fears is
controlled by genes, they conclude, the tendency would be passed on to future
generations, causing the disorders to be relatively common today.
Interaction of Factors – Some cases of anxiety disorder may reflect the
_____________________ of biological and psychological factors. People with
panic disorder, for example, may have a biologically based tendency to overreact
psychologically to physical sensations. The initial physical symptoms of panic –
such as rapid heart rate and shortness of breath – cause these people to react
with fear, leading to even worse panic symptoms. They may think they are having
a _____________ attack and experience severe psychological stress. Anxiety
about having another panic attack becomes a psychological _________________
itself – one that originated in a biological reaction.
Regardless of their ______________, anxiety disorders are both common and
disabling. In serious cases, they lead to tremendous restrictions and
_____________________ in lifestyle, relationships, and work. They can also lead
to great personal distress. Fortunately, most people who suffer from anxiety
disorder respond well to ____________________________.