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Anxiety Disorders
Abnormal Psychology
Mr. Quirion
Anxiety
• What distinguishes fear from anxiety?
• Fear is a state of immediate alarm in response to a serious, known threat to one's wellbeing
• Anxiety is a state of alarm in response to a vague sense of being in danger
• Both have the same physiological features – increase in respiration, perspiration, muscle
tension, etc.
Anxiety Disorders
• Most common mental disorders in the U.S.
• In any given year, 18% of the adult population in the U.S. experience an anxiety disorder
• Close to 29% develop one of the disorders at some point in their lives
• Only one-fifth of these individuals seek treatment
• Most individuals with one anxiety disorder also suffer from a second disorder
(comorbidity)
Obsessive-Compulsive Disorder
• OCD is a condition characterized by patterns of persistent, unwanted
thoughts and behaviors.
• The obsessive component consists of thoughts, images or impulses that
recur or persist despite a person’s efforts to suppress them.
Obsessive-Compulsive Disorder
Made up of two components:
Obsessions
Compulsions
• Persistent thoughts, ideas,
impulses, or images that
seem to invade a person's
consciousness
• Repetitive and rigid
behaviors or mental acts that
people feel they must
perform to prevent or reduce
anxiety
Obsessive-Compulsive Disorder
• The compulsive component are repetitive, purposeful acts
performed according to certain private “rules,” in response to
an obsession.
• Many characters on TV and in movies have OCD: Jack
Nicolson in As Good As It Gets; Monica on Friends; Monk
• Others?
Obsessive-Compulsive Disorder
Diagnosis is called for when symptoms:
 Feel excessive or unreasonable
 Cause great distress
 Take up much time
 Interfere with daily functions
Normal Routines
When do normal routines become
abnormal?
Obsessive-Compulsive Disorder
 Between 1% and 2% of U.S. population suffer from
OCD in a given year; as many as 4% over a lifetime
 It is equally common in men and women and among
different racial and ethnic groups
 It is estimated that more than 40% of those with
OCD seek treatment
 https://www.youtube.com/watch?v=dSZNnz9SM4g
OCD: The Psychodynamic Perspective
Anxiety disorders develop when children come to fear their id
impulses and use ego defense mechanisms to lessen their anxiety
• Id impulses = obsessive thoughts
• Ego defenses = counter-thoughts or compulsive actions
OCD: The Cognitive Perspective
Cognitive theorists begin by pointing out that everyone has
repetitive, unwanted, and intrusive thoughts
People with OCD blame themselves for normal (although repetitive and
intrusive) thoughts and expect that terrible things will happen as a result
OCD: The Cognitive Perspective
If everyone has intrusive thoughts, why do only some
people develop OCD?
People with OCD tend to:
 Be more depressed than others
 Have very high standards of conduct and morality
 Believe thoughts are equal to actions and are capable of
bringing harm
 Believe that they can, and should, have perfect control over
their thoughts and behaviors
OCD: The Biological Perspective
Two recent lines of research provide more direct evidence:
 Abnormal serotonin activity
Evidence that serotonin-based antidepressants reduce OCD
symptoms;
 Abnormal brain structure and functioning
Frontal cortex may be too active, letting through troublesome
thoughts
Generalized Anxiety Disorder
• Generalized anxiety disorder is a psychological problem characterized by
persistent and pervasive feelings of anxiety, without any external cause.
• May experience times when your worries don't completely consume you, but you still feel
rather anxious
• May feel on edge about many or all aspects of your life
• May have a general sense that something bad is about to happen, even when there's no
apparent danger.
• May not remember when you last felt relaxed or at ease.
• GAD often begins at an early age, and the signs and symptoms may develop slowly.
Quotes About GAD
• “I always thought I was just a worrier. I’d feel keyed up
and unable to relax. At times it would come and go, and
at times it would be constant. It could go on for days. I’d
worry about what I was going to fix for a dinner party, or
what would be a great present for somebody. I just
couldn’t let something go.”
Quotes About GAD
• “I’d have terrible sleeping problems. There were times I’d wake up
wired in the middle of the night. I had trouble concentrating,
even reading the newspaper or a novel. Sometimes I’d feel a little
lightheaded. My heart would race or pound. And that would make
me worry more. I was always imagining things were worse than
they really were. When I got a stomachache, I’d think it was an
ulcer.”
Quotes About GAD
• “I was worried all the time about everything. It didn't
matter that there were no signs of problems, I just got
upset. I was having trouble falling asleep at night, and I
couldn't keep my mind focused at work. I felt angry at my
family all the time.”
Generalized Anxiety Disorder
• Patients with GAD report feeling “free-floating anxiety”
• It is more commonly found in Western cultures instead of Eastern
cultures…why?
• The disorder usually first starts to appear in childhood or adolescence
• Only 25% of GAD sufferers are currently in treatment
GAD Causes
• Biological: Having close relatives with GAD increases likelihood of
developing the disorder to 15%
• Biological: GAD responds to medications that increase GABA (an inhibitory
neurotransmitter)
• Sociocultural: GAD is most likely to develop in people faced with social
conditions that truly are dangerous
• There are higher rates of GAD in lower SES groups
GAD: Cognitive Therapies
Therapists begin by educating clients about the role of worrying in GAD and
have them observe their bodily arousal and cognitive responses across life
situations….such as?
In turn, clients become increasingly skilled at identifying their worrying and their
misguided attempts to control their lives by worrying
With continued practice, clients are expected to see the world as less
threatening, to adopt more constructive ways of coping, and to worry less
Research has begun to indicate that a concentrated focus on worrying is a
helpful addition to traditional cognitive therapy
Phobias
Phobias
• http://www.phobia-fear-release.com/phobia-list.html
• http://images.mentalfloss.com/sites/default/files/styles/insert_main_wide_
image/public/phobia_mentalfloss.jpg
Phobias
Fear is a normal and common experience
How do common fears differ from phobias?
• More intense and persistent fear
• Greater desire to avoid the feared object or situation
• Distress that interferes with functioning
Specific Phobias
 Persistent fears of specific
objects or situations
 When exposed to the object or
situation, sufferers experience
immediate fear
 Most common: Phobias of
specific animals or insects,
heights, enclosed spaces,
thunderstorms, and blood
Specific Phobias
• Each year close to 9% of all people in the U.S.
have symptoms of specific phobia
• Many suffer from more than one phobia at a time
• Women outnumber men at least 2:1
• Vast majority of people with a specific phobia do
NOT seek treatment
What Causes Specific Phobias?
A behavioral-evolutionary explanation: Preparedness
Hypothesis
Some specific phobias are much more common than others
Theorists argue that there is a species-specific predisposition to
develop certain fears
Called “preparedness” because human beings are theoretically more
“prepared” to acquire some phobias than others
Model explains why some phobias (snakes, spiders) are more
common than others (meat, houses)
How Are Specific Phobias Treated?
Systematic desensitization
• Teach relaxation skills
• Create fear hierarchy
• Pair relaxation with the feared objects or situations
Since relaxation is incompatible with fear, the relaxation
response is thought to substitute for the fear response
Two types:
In vivo desensitization (live)
Covert desensitization (imagined)
How Are Specific Phobias Treated?
Other behavioral treatments
:
Flooding
Forced non-gradual exposure
Modeling
Therapist confronts the feared object while the fearful person
observes
The key to success is ACTUAL contact with the feared object or
situation