Anxiety

• Clients suffering from anxiety disorders can demonstrate unusual behaviors such as: UPU

  panic without reason, unwarranted fear of objects or life conditions, or unexplainable or overwhelming worry.
• They experience significant distress over time, and the disorder significantly impairs: DOS

  daily routines, social lives, and occupational functioning.
• Anxiety disorders have the highest prevalence rates of all mental disorders in the United States for both children and adults.
• Nearly one in four adults in the United States is affected, and the magnitude of anxiety disorders in young people is similar.
• Prevalence of Anxiety:

  women

  <45 y/o

  divorced/separated

  LSS
• Theories explaining why anxiety occurs: BPICB

  biological

  psychodynamic

  interpersonal

  cognitive

  behavioral
• Biological theories of anxiety: genetic and neurochemical
• first-degree relatives of clients with increased anxiety - Anxiety may have an inherited component because they have higher rates of developing anxiety.
• These have moderate heritability: SPS

  social anxiety disorder

  panic disorder

  specific phobias (agoraphobia)
• Generalized anxiety disorder (GAD) - tends to be more common in families, indicating a strong genetic component
• Gamma-aminobutyric acid (GABA) is the amino acid neurotransmitter believed to be dysfunctional in anxiety disorders.
• GABA - an inhibitory neurotransmitter, functions as the body’s natural antianxiety agent by reducing cell excitability, thus decreasing the rate of neuronal firing.
• GABA is available in one-third of the nerve synapses, especially those in the limbic system and in the locus coeruleus
• limbic system and locus coeruleus - the area where the neurotransmitter norepinephrine is produced
• norepinephrine - neurotransmitterwhich excites cellular function
• Because GABA reduces anxiety and norepinephrine increases it, researchers believe that a problem with the regulation of these neurotransmitters occurs in anxiety disorders.
• 5-Hydroxytryptamine type 1a -a subtype of serotonin known to play a role in anxiety, panic disorder, GAD
• norepinephrine - excess of this neurotransmitter is suspected in panic disorder and GAD.
• Psychodynamic view of anxiety - inability of the ego to intervene when conflict occurs between occurs between the id and the superego
• reasons why ego development is delayed: CUP

  unsatisfactory parent-child relationship

  conditional love

  provisional gratification
• When developmental defects in ego functions compromise the capacity to modulate anxiety, the individual resorts to unconscious mechanisms to resolve the conflict.
• Overuse or ineffective use of ego defense mechanisms - results in maladaptive responses to anxiety.
• caregivers can communicate anxiety to infants or children through: ADI

  inadequate nurturing

  agitation when holding or handling the child

  distorted messages
• Communicated anxiety can result in dysfunction, such as the failure to achieve age- appropriate developmental tasks.
• In adults, anxiety arises from the person’s need to conform to the norms and values of his or her cultural group.
• The higher the level of anxiety, the lower the ability to communicate and to solve problems and the greater the chance for anxiety disorders to develop.
• Behavioral Learning Theory - anxiety is viewed as being learned through experiences
• cognitive theory - main thesis is that faulty, distorted, or counterproductive thinking patterns accompany or precede maladaptive behaviors and emotional disorders.
• When there is a disturbance in this central mechanism of cognition, there is a consequent disturbance in feeling and behavior.
• Because of distorted thinking, anxiety is maintained by erroneous or dysfunctional appraisal of a situation
• Loss of ability to reason regarding the problem, whether it is physical or interpersonal
• The individual feels vulnerable in a given situation, and the distorted thinking results in an irrational appraisal, fostering a negative outcome.
• types of anxiety disorders: SPAGS

  generalized anxiety disorder

  panic disorder

  agoraphobia

  specific phobia

  social anxiety disorder (social phobia).
• Generalized Anxiety Disorder (GAD) - characterized by the presence of excessive anxiety and worry about a variety of topics, events, or activities.
• GAD - Worry occurs more often than not for at least six (6) months and is clearly excessive.
• GAD - The worry is experienced as very challenging to control.
• In GAD, according to the DSM-5, the anxiety and worry is associated with at least three (3) of the following physical or cognitive symptoms: TIDE II

  1. Edginess or restlessness.

  2. Tiring easily; more fatigued than usual.

  3. Impaired concentration or feeling as though the mind goes blank.

  4. Irritability (which may or may not be observable to others).

  5. Increased muscle aches or soreness.

  6. Difficulty sleeping (due to trouble falling asleep or staying asleep,

  restlessness at night, or unsatisfying sleep).
• In children, only 1 symptom is necessary for a diagnosis of GAD.
• Panic Disorder - characterized by recurrent unexpected panic attacks.
• panic attack - discrete period of intense fear or discomfort emerging from either a calm or anxious state