PSY339Anxiety - Anxiety Disorders PSY 339 Spring 2010 Dr....

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Anxiety Disorders PSY 339 Spring 2010 Dr. Bradbury
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Anxiety Disorders Anxiety is a universal human experience Anxiety disorders are among the most common mental health problems in children and adults Normal vs. abnormal anxiety Anxiety disorders are exaggerated, persistent, and interfere w functioning In most cases, children experience subjective distress from an anxiety disorder (this is in contrast to externalizing disorders like ADHD, ODD, and CD)
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Anxiety disorders Anxiety itself is the major disturbance Anxiety symptoms are: Cognitive (thoughts) Behavioral (actions) Somatic (physical body)
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All these anxiety disorders affect children as well as adults. Additionally, children are affected by Separation Anxiety
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PANIC Panic attacks: Intense fear accompanied by pounding heart, trembling, shortness of breath, fear of losing control, fear of dying Somatic symptoms often most salient: Breathlessness, dizziness, sweating, choking, nausea, heart palpitations, tingling hands and feet Most people have this experience at some point rarely does this indicate disorder For disorder: recurrent, unexpected attacks, concern about future attacks, losing control With and without agoraphobia (fear of leaving
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Panic Disorder and Generalized Anxiety Disorder Predominant characteristic: Free- floating (unfocused) anxiety Panic disorder: Characterized by intense fear accompanied by bodily sensations Generalized anxiety disorder (GAD): Characterized by intrusive anxiety- evoking thoughts; “chronic pathological worry”
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Generalized Anxiety Disorder Free-floating anxiety Chronic, intense worry over everything, small and big; daily life stress very high--at least 6 months of interference for dx Worry is experienced as difficult to control, frequently accompanied by physical symptoms Episodes of more intense anxiety may reach level of panic attacks This disorder may be over-diagnosed in children (importance of developmental sensitivity) Differential dx in children can be difficult (may resemble panic disorder, separation
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Etiology of Panic Disorder and GAD Psychodynamic Model: Etiology: internal conflicts Forbidden sexual / aggressive impulses seek expression Repression fails -> threatens ego integrity = overwhelming anxiety This entire process is unconscious Treatment: bring unconscious conflicts to awareness Low success rates, high drop-out rates
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Etiology of Panic Disorder and Generalized Anxiety Disorder Biological: Changes and dysfunction of neural structures and neurochemical responses to stressful stimuli Biological challenge tests* and genetic studies * spinning in chair, breathing through cocktail straw, cardio… Think here of the HPA axis and the stress response system – how it is “tuned” matters – the brain’s
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Biological Treatment for Panic Disorder and GAD Biochemical treatment: Benzodiazepines block induced & spontaneous
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PSY339Anxiety - Anxiety Disorders PSY 339 Spring 2010 Dr....

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