Psychology anxiety

1. .

2.  Anxiety
• Apprehension about a future threat
 Fear
• Response to an immediate threat
 Both involve physiological arousal
• Sympathetic nervous system
 Both can be adaptive
• Fear triggers “fight or flight”
 May save life
• Anxiety increases preparedness
 “U-shaped” curve (Yerkes & Dodson, 1908)
 Absence of anxiety interferes with performance
 Moderate levels of anxiety improve performance
 High levels of anxiety are detrimental to performance

3. DSM-5 Anxiety Disorders
• Specific phobias
• Social anxiety disorder
• Panic disorder
• Agoraphobia
• Generalized anxiety disorder
Most common psychiatric disorders
28% report anxiety symptoms
Most common are phobias

4. DSM-5 criteria for each disorder:
• Symptoms interfere with important areas of
functioning or cause marked distress
• Symptoms are not caused by a drug or a medical
condition
• Symptoms persist for at least 6 months or at least 1
month for panic disorder
• The fears and anxieties are distinct from the
symptoms of another anxiety disorder

5.  Involves chronic, excessive, generalized,
uncontrollable worry
• Lasts at least 6 months
• Interferes with daily life
 Often cannot decide on a solution or course of action
 Other symptoms:
• Restlessness, poor concentration, tiring easily,
restlessness, irritability, muscle tension
 Common worries:
• Relationships, health, finances, daily hassles
 Often begins in adolescence or earlier
• I’ve always been this way

6.  Excessive anxiety and worry at least 50 percent of days about at
least two life domains (e.g., family, health, finances, work, and
school)
 The person finds it hard to control the worry
 The worry is sustained for at least 3 months
 The anxiety and worry are associated with at least three (or one in
children) of the following:
• 1. restlessness or feeling keyed up or on edge
• 2. being easily fatigued
• 3. difficulty concentrating or mind going blank
• 4. irritability
• 5. muscle tension
• 6. sleep disturbance
 The anxiety and worry are associated with marked avoidance of
situations in which negative outcomes could occur, marked time and
effort preparing for situations that might have a negative outcome,
marked procrastination, difficulty making decisions due to worries,
or repeatedly seeking reassurance due to worries
.

7. 50% of those with anxiety disorder meet criteria
for another anxiety disorder
75% of those with anxiety disorder meet criteria
for another psychological disorder
• Disorders commonly comorbid with anxiety:
 60% with anxiety also have depression
 Substance abuse
 Personality disorders
 Medical disorders, e.g. coronary heart disease

8.  Women are twice as likely as men to have anxiety disorder
• Possible explanations
 Women may be more likely to report symptoms
 Men more likely to be encouraged to face fears
 Women more likely to experience childhood sexual abuse
 Women show more biological stress reactivity
 Cultural factors
• Culture can shape anxieties and fears
• Culturally specific syndromes
 Taijin kyofusho
 Japanese fear of offending or embarrassing others
 Kayak-angst
 Inuit disorder in seal hunters at sea similar to panic
• Rate of anxiety disorders varies by culture, but ratio of somatic to
psychological symptoms appears similar (Kirmayer, 2001)

10.  Behavioral conditioning (classical and operant
conditioning)
 Genetic vulnerability
 Increased activity in the fear circuit of the brain
 Decreased functioning of GABA and serotonin;
increased norepinephrine activity
 Behavioral inhibition
 Neuroticism
 Cognitive factors, including sustained negative
beliefs, perceived lack of control, and attention
to cues of threat

11.  Relaxation training
 Cognitive behavioral methods
• Challenge and modify negative thoughts
• Increase ability to tolerate uncertainty
• Worry only during “scheduled” times
• Focus on present moment

12.  Anxiolytics: drugs that reduce anxiety
• Benzodiazepenes
 Valium
 Xanax
• Antidepressants
 Tricyclics
 Selective Serotonin Reuptake Inhibitors (SSRIs)
 Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
• Side effects can be problematic with continuing
medication
 D-cycloserine (DCS)
 Enhances learning and can bolstered treatment effectiveness