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Anxiety Disorders
Thomas G. Bowers,
Ph.D.
Penn State Harrisburg
Anxiety Disorders
• Anxiety
• Subjective distress, fear, apprehension
• Elevated heart rate, rapid breathing,
• Highly similar to fearfulness, but thought to be
irrational or unrealistic
Types of Anxiety
Disorders
Phobias
Fear mediated avoidance,
thought to be unrealistic
Some examples
– claustrophobia
Fear of closed spaces
– agoraphobia
Fear of public places
– acrophobia
Fear of heights
Types of Anxiety
Disorders
Phobias
Some other examples
– Specific phobias
Specific unwanted fears
– Social phobia
Relatively common
Types of Anxiety
Disorders
Panic Disorder
Sudden and often unexpected attack of
anxiety symptoms
Heart palpitations, nausea, choking,
dizziness, trembling, apprehension,
even terror
Often associated with stress
Types of Anxiety
Disorders
Generalized Anxiety Disorders
Persistent anxiety, chronic,
uncontrollable worry
“Free floating”
Types of Anxiety
Disorders
Obsessive-Compulsive Disorder
Persistent and uncontrollable thoughts
and feelings of a compulsion to repeat
certain acts
Depression also often noted
Types of Anxiety
Disorders
Posttraumatic Stress Disorder (PTSD)
Introduced in 1980 (DSM-III)
Earlier conceptions:
1. “Shell shock” (WWI and WWII)
2. “Combat neurosis” (Korea)
3. Noted in Civil War
Types of Anxiety
Disorders
Posttraumatic Stress Disorder (PTSD)
Extreme response to severe stressor
Increased anxiety, avoidance of
stimuli associated with trauma,
numbing of emotional responses
Types of Anxiety
Disorders
Acute Stress Disorder (ASD)
New to DSM IV
Recovery in about one month
Types of Anxiety
Disorders
PTSD symptoms
1. Re-experiencing the traumatic event
2. Avoidance of the stimuli associated with
the event or a numbing of responsiveness
3. Increased arousal
Etiology of Anxiety
Disorders
• Varied theoretical views
• Psychoanalytical theories
– Anxiety in general represents repressed id
impulses
– The repressed impulses are displaced to
object with some symbolic connection
– Represents neurotic level of adjustment
Etiology of Anxiety
Disorders
• Behavioral theories
– Anxiety is learned
– Avoidance conditioning - classical
conditioning to a previously neutral
stimulus condition
– Little Albert Case - conditioned by Watson
and Rayner to develop a fear of a white rat
Etiology of Anxiety
Disorders
• Behavioral theories
– Avoidance conditioning can not account for
all of anxiety, however
– Modeling theories - vicarious or
observational learning
Etiology of Anxiety
Disorders
• Cognitive Behavioral Theories
– Some patterns of thoughts (as worry) may
be maintained by avoiding even less
pleasant emotions
– Uncontrollable environmental conditions
also could contribute to misperception
Etiology of Anxiety
Disorders
• Biological Views
– There may be genetic components to
neuroticism
– benzodiazepines (also known as minor
tranquilizers) are effective in treating
anxiety
– Linked with inhibitory neurotransmitter
GABA (gamma-aminobutyric acid)
Etiology of Anxiety
Disorders
• Biological Views
– Linked with inhibitory
neurotransmitter
GABA (gammaaminobutyric acid)
– Increase in GABA
levels yields
decreased anxiety
Treatment of Anxiety
Disorders
• Analytical
– Long relationship, ‘reparent,’ resolve
fundamental issues
• Behavioral
– Desensitization for phobic concerns
– Flooding
Treatment of Anxiety
Disorders
• Cognitive behavioral
– Interpretation, reformulation of thought
process
– Gradual approximation of behaviors
– Modeling
– Social support
Treatment of Anxiety
Disorders
• Biological
– benzodiazepines
– Use of minor
tranquilizers as
Valium, Librium,
more recently
BuSpar
– Some dependence
liability
Treatment of Anxiety
Disorders
• Biological
– Antidepressants as selective serotonin
reuptake inhibitors (SSRI)
– Also effective treating depression