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Abnormal Psychology
Leading Researcher Perspectives
Edited by Elizabeth Rieger
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Chapter 2
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Anxiety disorders arise when
the frequency or intensity of
anxiety interferes with
everyday activities. The
threat posed by the Global
Financial Crisis elicited a
variety of anxiety responses.
Herb Jurkiewicz
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Figure 1 The fight or flight response
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Figure 2 Characterisation of Barlow’s (2002) triple vulnerability leading to an
anxiety disorder
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Figure 3 The relationships between three dimensions of emotion
across the anxiety disorders and depression as found by Brown
and Barlow (2009)
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Figure 4 The interaction of vulnerabilities giving rise to panic disorder
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Susie O’Neill was
distressed by her shyness.
A main aspect of social
anxiety is that the fear of
social interaction results in
a desire to avoid social
situations.
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iStock
Compulsive washing is a common symptom of obsessive-compulsive
disorder (OCD). Compulsive washing typically entails excessive
handwashing, showering or toilet routines.
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Figure 5 The aetiology of posttraumatic stress disorder (PTSD)
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Avoiding the pursuit of
success as a way of
controlling worry about
the possibility of failure
and disappointing
others, as illustrated by
Calvin’s classroom
interaction with Susie in
Calvin and Hobbes.
Calvin and Hobbes, © 1988 Watterson. Distributed by Universal
Press Syndicate. Reprinted with permission. All rights reserved.
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Figure 6 Mean interference scores (in milliseconds) for colour-naming
negative words in the anxious, depressed and control groups
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Proposed changes for anxiety
disorders in DSM-V
Specific Phobia:
• Since ‘excessive and unreasonable’ is difficult to define, one
suggested revision for the DSM-V is the proposal that the
phrase be operationalised as ‘fear or anxiety being
disproportionate to the actual danger posed’.
• Since no previous editions of the DSM have specified a
minimum period, the DSM-V may include a minimum period
that the symptoms must have been present in order for the
individual to meet diagnostic criteria.
Agoraphobia:
• Agoraphobia is going to become a distinct disorder that may
or may not occur with panic disorder.
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Proposed changes for anxiety
disorders in DSM-V (continued)
Social Phobia:
• An alternative typology being considered for inclusion in the
DSM-V is the distinction between performance social phobia (if
the anxiety is limited to performing or speaking in public) versus
generalised social phobia (if the anxiety is evident in most social
situations).
OCD:
• It has been proposed to list the disorder in a separate category,
namely, ‘Anxiety and Obsessive-Compulsive Spectrum
Disorders’.
• It has also been proposed that the DSM-V should include an
‘Absent Insight’ specification for individuals who are completely
convinced that their OCD beliefs are true.
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Proposed changes for anxiety
disorders in DSM-V (continued)
PTSD:
• The individual’s subjective response at the time of the traumatic
event (i.e., one of intense fear, helplessness or horror) is
proposed to be deleted.
• It is suggested that avoidance be redefined to only include
active avoidance of thoughts and situations in recognition that
these symptoms are distinct from more passive forms of
avoidance, such as disinterest and withdrawal from usual
activities.
• It is proposed that these latter symptoms be included in a new
cluster that involves negative alterations in cognitions (e.g.,
negative evaluations about oneself and one’s future) and mood
(e.g., persistent negative emotional states such as anger, guilt
or shame).
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Proposed changes for anxiety
disorders in DSM-V (continued)
GAD:
•
•
•
•
•
Excessive worry and anxiety across at least two life areas is
proposed as the primary diagnostic criterion for GAD, while difficulty
controlling worry and anxiety has been removed.
Excessive anxiety and worry must be present more days than not
for a period of at least three months, rather than six months.
Only two of the current six associated physical symptoms have
been retained—in ‘feelings of restlessness and being keyed up or
on edge’ and ‘muscle tension’.
The presence of behavioural symptoms has been introduced,
including significant time spent avoiding or planning for potential
threat, procrastinating or seeking reassurance because of worrying.
It has been suggested that the disorder may be renamed
‘Generalised Anxiety and Worry Disorder’.
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Chapter 2 Summary
• Anxiety is characterised by distressing emotions, physical
symptoms, cognitions (typically, thoughts of danger) and
escape or avoidance behaviours.
• Anxiety disorders arise when the frequency or intensity of
anxiety interferes with the individual’s capacity to function
in everyday life.
• Cognitive-behavioural approaches dominate the
understanding and treatment of anxiety disorders.
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Chapter 2 Summary (continued)
• The main anxiety disorders identified in the DSM-IV-TR are:
– specific phobia—a marked and persistent fear that is
excessive and unreasonable in response to a specific object
or situation
– panic disorder—presence of recurrent, unexpected panic
attacks
– social phobia—a marked and persistent fear of social and
performance situations
– obsessive-compulsive disorder—the occurrence of obsessions
(e.g., persistent thoughts regarding contamination) and
compulsions (e.g., washing and checking)
– posttraumatic stress disorder—the predominant psychiatric
disorder to occur after trauma exposure
– generalised anxiety disorder—characterised by pervasive
patterns of worry about a range of everyday topics that are
experienced as uncontrollable.
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