Anxiety Disorders

Phobias

or (b) they do not cause hardship (e.g.,fear of snakes in Hawaii where no snakes live in nature)

Examples of Phobias

Phobia Involves Fear of:

Agoraphobia Public Places

Acrophobia Heights

Pnigophobia Choking

Taphephobia Being Buried Alive

Hellenologophobia Pseudoscientific Terms

Claustrophobia Closed Places

-names derived from Greek

-Greek god Phobos frightened his enemies

Classes of Phobias

*avoidance must impair functioning to be a phobia

* fear can generalize to impair functioning

3% to 13% for social

Etiology of Phobias

Treating Phobias

 

- also social skills training for social phobias

Treating Phobias

Panic Disorder

Etiology of Panic Disorder

Etiology of Panic Disorder

ETIOLOGY OF PANIC DISORDER

 

 

 

 

-- The panic attack is a defense mechanism used when the ego fears that the id may take control

 

--As with all disorders, self-actualization is impeded and there may be some decisions or choices to make

Panic Disorder Treatments

Reduction or elimination of panic in long-term after treatment

Generalized Anxiety Disorder

Women are twice as likely to develop GAD as are men

Etiology of GAD

- sexual and aggressive impulses from any stage of psychosexual development in conflict with ego

-defenses fail to displace anxiety onto an object

Therapies for GAD

Obsessive-Compulsive

Common Compulsions

Performing a particular act (e.g. chewing slowly)

Etiology of OCD

OCD Therapy

POSTTRAUMATIC STRESS DISORDER

[In children, agitation]

POSTTRAUMATIC STRESS DISORDER

 

POSTTRAUMATIC STRESS DISORDER

 

 

 

POSTTRAUMATIC STRESS DISORDER

(3 of following continued)

- feeling detached from others

-restricted range of affect (e.g., unable to feel love)

-sense of foreshortened future (e.g., does not expect to have a career or normal life span)

POSTTRAUMATIC STRESS DISORDER

-difficulty falling or staying asleep

-irritability or outbursts of anger

-difficulty concentrating

POSTTRAUMATIC STRESS DISORDER

(2 of following continued)

-hypervigilance

-exaggerated startle response

 

ETIOLOGY OF PTSD

-sex (females more at risk)

-early separation from parents

-family or personal history of a behavioral disorder

THEORIES OF PTSD

TREATMENTS FOR PTSD

Biological: anxiety & depression meds

EMPIRICALLY VALIDATED TREATMENTS FOR ANXIETY DISORDERS

Chambless, D. L., et al. (1998).   Update on empirically validated therapies, II.  The Clinical Psychologist, 51, 3 - 16.

CRITERIA FOR EMPIRICALLY-VALIDATED TREATMENTS

Well-Established Treatments

I. At least two good between group design experiments demonstrating efficacy in one or more of the following ways:

A. Superior (statistically significantly so) to pill or psychological placebo or to another treatment.

B. Equivalent to an already established treatment in experiments with adequate sample sizes.

OR

II. A large series of single case design experiments (n >9) demonstrating efficacy. These experiments must have:

A. Used good experimental designs and

B. Compared the intervention to another treatment as in IA.

FURTHER CRITERIA FOR BOTH I AND II:

III. Experiments must be conducted with treatment manuals.

IV. Characteristics of the client samples must be clearly specified.

V. Effects must have been demonstrated by at least two different investigators or investigating teams.

Probably Efficacious Treatments

I. Two experiments showing the treatment is superior (statistically significantly so) to a waiting-list control group.

OR

II. One or more experiments meeting the Well-Established Treatment Criteria IA or IB, III, and IV, but not V.

OR

III. A small series of single case design experiments (n >3) otherwise meeting Well-Established Treatment

 

Well-Established Treatments for Anxiety Disorders

Cognitive behavior therapy for panic disorder

with and without agoraphobia

Cognitive behavior therapy for generalized anxiety disorder

Exposure treatment for agoraphobia

*Exposure/guided mastery for specific phobia

Exposure and response prevention for obsessive-compulsive disorder

Stress Inoculation Training for Coping with Stressors

 

Probably Efficacious Treatments for Anxiety Disorders

Applied relaxation for panic disorder

Applied relaxation for generalized anxiety disorder

*Cognitive behavior therapy for social phobia

Cognitive therapy for OCD

Couples communication training adjunctive to exposure for agoraphobia

*EMDR for civilian PTSD

Exposure treatment for PTSD

*Exposure treatment for social phobia

Stress Inoculation Training for PTSD

Relapse prevention program for obsessive-compulsive disorder

Systematic desensitization for animal phobia

Systematic desensitization for publicspeaking anxiety

Systematic desensitization for social anxiety