PSY 602 Chapter Notes - Chapter 6: Separation Anxiety Disorder, Social Anxiety Disorder, Generalized Anxiety Disorder
21 Nov 2016
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Developmental Psychopathology Textbook Notes
Chapter 6, Anxiety and Related Disorders
Introduction
- Anxiety disorders are internalizing; different subtypes which are hard to separate, high rates of co-occurrence,
separate disorders may be difference expressions of 1+ disposition of internalizing disorders (ex. culture)
- Anxiety: future-oriented emotion, perceptions of uncontrollability over adverse situations and elevated
apprehension; fear relates to present and is an alarm reaction
- Anxiety and fear are viewed as a complex pattern of 3 types of reactions; overt behavioral responses (running
away), cognitive responses (thoughts of being harmed) and physiological responses (heart rate)
- Girls exhibit more fear especially with age (gender role differences), fears decline with age and is prevalent at 7,
starts with fear of strangers (-1); fear of imaginary threats in preschool, physical safety in young children, social
situations and competence in adolescents
- DSM Classification: different subtypes (ex. OCD, panic, separation, social), apprehension and avoidant behaviors
- Empirical Classification: Achenbach describes an anxious/depressed syndrome within internalizing, shows that
depression and anxiety symptoms tend to occur together
- 2.5-5% and up to 25%, likely meet criteria for 1+ anxiety disorder, continue through young adulthood, more girls
Specific Phobias
- Phobias: fears are excessive, can’t be reasoned away, beyond control, lead to avoidance, interfere with functioning
- Specific Phobia: fear or anxiety of a specific object or situation; immediate response, avoidance/extreme anxiety,
out of proportion to actual risk, persistent (6+ months)
- Tension, panic, disgust, thoughts of catastrophic events, nausea, high heart rate, change lifestyle of self/others
- Most commonly diagnosed, 3-4%, more in girls, more than 1 phobia and meet criteria for more than 1 disorder
especially other anxiety disorders and depressive/somatoform disorders (physical symptoms without illness)
- Begin in early/middle childhood and may either persist or fade with time
Social Anxiety Disorder (Social Phobia)
- Persistent fear of acting in an embarrassing or humiliating way in social or performance situations, with peers and
adults, duration of 6+ months
- Behavioral component manifested by avoidance of situations involving social interaction, focus thoughts on
negative attributes, leads to low self worth, loneliness, lesser educational achievement, etc
- Selective Mutism: don’t talk in specific social situations (ex. talks to parents but not peers), onset at around 2.5-4,
diagnoses in school (5); shy, withdrawn, clingy due to environmental and genetic influences, more socially anxious
- 1-2% of children, 3-4% of adolescents, middle to late adolescence being typical onset, more in girls
- Stranger anxiety and separation anxiety (6m-3y), self consciousness develops and leads to social anxiety, by early
adolescence youth are required to perform tasks involving peer evaluation, higher social demands
Separation Anxiety
- Anxiety regarding separation from a major attachment figure and/or home; clingy, nightmares, stomach aches,
reluctance to leave home, think about death to family members, etc
- 3-12% of youth, higher in younger children, most likely combined with generalized anxiety disorder
School Refusal
- Not a DSM diagnosis but one of the 8 symptoms of separation anxiety, can also be a phobia or social anxiety
- Classify based on function that the behavior serves (functional analysis) rather than symptoms (ex. to get attention,
to avoid peers, to avoid bus, to get special rewards such as being allowed to watch TV)
- Different from truancy as school refusers are likely to be gone for extended periods and parents know and truancy
has nothing to do with anxiety
- 1-2%, equal in boys and girls, occur at major transition points; treatment difficult in adolescents/depressed youth
- Application of cognitive behavioral interventions (exposure, coping skills, parent/teacher training)
Generalized Anxiety Disorder
- Excessive anxiety about a number of events or activities; restless, easily fatigued, difficulty concentrating,
irritability, muscle tension and disturbed sleep
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Document Summary
Anxiety disorders are internalizing; different subtypes which are hard to separate, high rates of co-occurrence, separate disorders may be difference expressions of 1+ disposition of internalizing disorders (ex. culture) Anxiety: future-oriented emotion, perceptions of uncontrollability over adverse situations and elevated apprehension; fear relates to present and is an alarm reaction. Anxiety and fear are viewed as a complex pattern of 3 types of reactions; overt behavioral responses (running away), cognitive responses (thoughts of being harmed) and physiological responses (heart rate) Ocd, panic, separation, social), apprehension and avoidant behaviors. Empirical classification: achenbach describes an anxious/depressed syndrome within internalizing, shows that depression and anxiety symptoms tend to occur together. 2. 5-5% and up to 25%, likely meet criteria for 1+ anxiety disorder, continue through young adulthood, more girls. Phobias: fears are excessive, can"t be reasoned away, beyond control, lead to avoidance, interfere with functioning.
