Disorder
Separation
Anxiety
Disorder
Specific
phobia
OCD*
PTSD
(Outline)
GAD
Panic
Disorder
A1 Exposure
A2 Fear
B Re-experience
C Avoid/*numb*
D hyper arousal
Exposure
through:
-Experiencing
-Witnessing
-Close family
-Repeated firsthand exposure
-Intrusive,
distressing
memories
-Bad dreams
-Dissociation (reexperiencing)
-Distress about
cues
-Physiological
reaction
-Avoid associated
stimuli
Excessive worry
about the every
day
Fear is of having
a panic attack,
not what lead to
it
Fear of acting in a
way that will be
embarrassing or
humiliating
-Anxiety
-Cant control
worry
-Restlessness
-Easily fatigued
-Prob.
Concentrating
-Irritability
-Muscle tension
-Sleep problem
-About minor,
everyday events
Panic attack:
- Heart
-Sweating
-Trembling
-Resp. distress
- Choking
-Chest pain
-Nausea
-Dizzy
-Chills
-Numbness
-Derealization
-Fear of losing
control
-Fear of dying
All in <10 mins.
Worry about
more PAs for 1
month
-Fear of social
interactions in
peer group
-Fear of
humiliation,
embarrassment,
rejection, etc.
-Social situations
provoke fear
- In children,
anxiety may be
crying, tantrums,
mutism, etc.
- Social situations
avoided
- Fear is out of
proportion
-If medical
condition, fear is
unrelated
1 month
6 months
6 months
6 months
Female
Poor
Early loss
Other anxiety dis
Exposure, CBT,
breathing, IPT
If early, female,
long, low GAF
->Bad
DSM 5
Expected vs.
unexpected
1-3% life
1-2% / year
Adolescent and
30s
w/ age
Risk for
depress.
Lasts ~16 yrs.
Rare after 30
40% 5 yr. recover
Crux
Fear of harm to
attached when
separated
Actively avoided
object with outof-proportion
anxiety
Intrusive
thoughts/
Compulsive acts
(thoughts)
Criteria
-Distress on
separ. from home
or attachment fig.
-Worry about
losing people to
death, etc.
- Worry about
event that will
cause separation
- Refusal to go
out, to school,
work, etc.
- Fear of being
alone
- Wont sleep
away from
attached fig.
- Nightmares
about sep.
- Physical symp.
when anticipates
separation
4 weeks child
6 months adult
Parent SAD
Female, young,
poor
-Fear of
something
specific (duh)
- Object always
provokes fear
-Object is
actively avoided
- Anxiety out of
proportion
Types:
-Animal
-Environment
-Blood
-Situational (e.g.
Airplanes)
-Other (e.g.
vomiting)
Obsessions
- Intrusive and
unwanted
thoughts
-Attempts to
ignore or
suppress
thoughts
Young, female,
family history of
same
Strep/virus
(PANDAS)
Trauma intensity
Twin studies
Female
Poor
Treatment
Physical torture
Exposure
SSRI, CBT*
Specifiers/
(Notes)
(Developmentally
inappropriate)
4%
Mean age 7
Course and
outcomes
Followed by
nearly all other
anxiety disorders
From anxiety dis
to trauma and
stressor related
-7% life
-3.5%/yr.
(Assault, accident,
combat -
common)
Prevalence
-Good insight
-Poor insight
-No insight/
delusional
-Tic-related
Not Anxiety.
Now in OC and
related disorder
-1.6% life
-1%/yr.
-Female>male
-Childhood
reversed
Male 14
Female 22
Benzos, anti-D,
CBT, meditate
(60% Comorbid
w/depression
58% w/ other
anxiety)
Changes
from DSM 4
(Multiple
phobias
Predicts
depression,
substance use)
CBT, exposure,
imaginal
Depersonalization
Derealization
Delayed
expression
Time
Risk factors
6 months
12% last 12
months
-Most common
anx. disorder
-Earliest onset
Very stable (10
yrs.)
40% persist
Compulsions
-Repetitive
behaviors in
response to
obsess.
-Aimed at
reducing anxiety
-Time
consuming
~6% life
~3%/year
Early adulthood
Persistent
Social anxiety
Disorder
CPT, IPT, meds
Performance only?
(Seek treatment:
18% adol.
24% adult)
1-13%
Public speaking
common
