KHA 305 Lecture Notes - Lecture 2: Specific Phobia, Psychoeducation, Agoraphobia
30 Jun 2018
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Clinical psychology week 2: Anxiety Disorders
Introduction to anxiety:
- Prevalence: the number of people that have been diagnosed with a disorder in
a given time
oWithin a specific population
- Etiology/Aetiology: the underlying causes for a given condition
- Comorbidity: the presence of two or more conditions
- Differential diagnosis: consideration of a number of similar conditions which
may be indicated by a set of signs and symptoms
oBefore coming to a firm conclusion
oIn order to rule them out you must actively consider them
oTo avoid bias of common diseases
- Anxiety:
oEmotional description
oA negative mood state characterised by bodily symptoms of physical
tension and by apprehension about the future
oPhysiological arousal
oApprehension about the future
Different to fear in that it might happen
- Fear:
oCaused by something that is immediate response to something
oReaction to an immediate danger
- Similarities:
oNegative affect
oAccompanied by somatic sensations
- Differences:
oNature of threat:
Fear: known, identifiable, external, immediate
Anxiety: unknown, elusive, internal, diffuse, future-oriented
oResponse to threat:
Fear: emergency, flight or fight
Anxiety: vigilance/on the lookout
oSome of the anxiety disorders exhibit inappropriate fear reaction
whereas others involved an anxiety response
- Anxiety is a normal human emotion:
oEveryone experiences anxiety from time to time
Novel situations
Public speaking
Important events
- Anxiety can be adaptive:
oSignals that threat is imminent
oCues us to attend to important stimuli in the future
oHelps us to perform
Yerkes Dodson curve
Too little stress/anxiety:
Bored, restless, tired, prone to illness
Right amount of stress/anxiety:
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Productive, energetic. Creative, healthy
Too much stress/anxiety:
Burned out
Overwhelmed
Exhausted
Prone to illness
Evolutionally stress was acute and our bodies were able to deal
with this
Now days stress is chronic and our bodies are yet to adapt and
be able to cope with this and respond effectively
- Anxiety is multifaceted: three elements operate in tandem
oCognitive: what the person is thinking
oPhysiological: what is happening to the persons body
Sympathetic nervous system
oBehavioural: what the person is doing
oThis is important in case formulation and treatment of anxiety
disorders
How we tap into different parts of anxiety to break into the
process and ways in which it is becoming unhelpful to the
person
- Fight or flight response:
oIs normal, purposeful and a survival response
oOperates very quickly
Sudden changes in sympathetic nervous system
oInbuilt system in our bodies that prepares us to fight off danger or run
away from
Or freeze
oIndividualized reaction that are sometimes uncontrollable
Introduction to anxiety disorders:
- Common themes in anxiety disorders
oOver-estimate the likelihood of something bad happened
Or consequences
oUnder estimate their ability to cope
Feel helpless and as if there is nothing they can do
oActivation of the flight or fight system
Although to different degrees
Some may be activated at low-grades which are just enough for
it to be uncomfortable
oAnxiety disorders are very common
1/3 people experience an anxiety disorder in their lifetime
oCo-occurring anxiety disorders
As well as with other disorders
oAnxiety disorders are costly to society
Treatment costs
Lost productivity
- Gender differences:
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oWomen more than twice as likely to be diagnosed with an anxiety
disorder
oBiological differences
Hormonal? Or other differences are also possible
oUnder reporting in men
Less likely to present and talk about these issues
oSocialization
In men they feel pressured to not talk about their issues
- Cultural differences
oAnxiety disorders occur across all cultures but some variation in the
presentations
Specific and unique to different cultures
Japan: concerns about offending others with inappropriate
social behaviour
Greenland: in kayak angst
Latin America: anxiety about the soul leaving the body as a
result of a severe fright
- Risk factors across the anxiety disorders:
oThe biopsychosocial perspective: biological, social, psychological
Many factors collectively come together to explain how
disorders present and occur
oHow we conceptualize anxiety disorders
oMost popular and supported by evidence
oBiological:
Genetics:
Anxiety disorders are known to be highly heritable
Separate genes for panic and anxiety tendencies
oRisk for developing
oContributing factors include genes
oHuge burst in recent into different genes that are
involved
Polygenetic effects:
oUnlikely that there is A GENE for anxiety
oGenetics are a combination: the combination is
what may make you vulnerable to anxiety
Neurotransmitters:
Corticotropn releasing factor: increased
oHas a big impact
oAlso has an impact on the other
neurotransmitters
oCertain neurotransmitters have a knock on effect
oBeginning to discover these relationships better
oGrowth in evidence for this
Serotonin: decreased
Norepinephrine: increased
GABA: decreased
Neurobiological factors:
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Document Summary
Prevalence: the number of people that have been diagnosed with a disorder in a given time: within a specific population. Etiology/aetiology: the underlying causes for a given condition. Comorbidity: the presence of two or more conditions. Anxiety: emotional description, a negative mood state characterised by bodily symptoms of physical tension and by apprehension about the future, physiological arousal, apprehension about the future. Different to fear in that it might happen. Fear: caused by something that is immediate response to something, reaction to an immediate danger. Similarities: negative affect, accompanied by somatic sensations. Anxiety: unknown, elusive, internal, diffuse, future-oriented: response to threat: Anxiety: vigilance/on the lookout: some of the anxiety disorders exhibit inappropriate fear reaction whereas others involved an anxiety response. Anxiety is a normal human emotion: everyone experiences anxiety from time to time. Anxiety can be adaptive: signals that threat is imminent, cues us to attend to important stimuli in the future, helps us to perform.
