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Anxiety PrevalenceMore prevalent in women (2:1) | More prevalent in people under 45 y/o | More prevalent in divorced/separated people | More prevalent in people with lower socio-economic status |
Panic DisorderOnset at ~late 20s | Recurrent unexpected panic attacks | Intense physical symptoms | May last weeks, months or years | Close morbidity rate to depression | Women affected 3x more than men | May be affiliated with stressors |
Generalized Anxiety Disorder6 months of unrealistic worry and anxiety | Affects 3% of population | Associated with Major Depressive Disorder |
Etiology for Panic and GADPsychodynamic Theory | Inability of ego to intervene
id and superego produce anxiety
unable to regulate anxiety and resorts to unconscious mechanisms
ineffective use of defence mechanisms | Cognitive Theory | Faulty thinking results in maladaptive behaviours and emotional disorders
Anxiety is maintained by dysfunctional assessment of environment | Biological Factors | Genetics
Identical twins: 30%
Close relative: 10-20%
Cholecystokinin production: induce panic attacks
Neuroanatomical
Abnormal levels of blood-lactate
Infusion of Sodium Lactate may precipitate panic attacks
Neurochemical
Norepinephrine: cause anxiety
Serotonin and GABA decrease with panic/anxiety disorders |
| | Levels of AnxietyNormal | Mild | - Something is different
- Helps person focus attention to learn, solve problems, etc.
- Perceptual field widens slightly
- Alert, more perceptive
- Able to recognize anxiety
promote motivation and growth | Moderate | - Disturbing feeling something is wrong
- nervous and aggitated
- Difficulty concentrating
- Perceptual field narrows a bit
- Diminished cognitive skills | Severe | - Perceptual field greatly reduced
- Does not notice external events
attention focused on small part of specific area
- Unaware of anxiety
- Increase Vital Signs | Panic | - Focused on defense
- Flight of ideas
- Feels dread and terror |
Specific PhobiasSigns and Symptoms
Anxiety response to object or situation
Avoidance of object/situation
Impairment of daily routine
Acknowledge reaction is unreasonable | Anxiety may be triggered | Women 2x as likely to be affected than men |
Not diagnosed as a phobia unless interferes with person's function or causes severe distress | | Separation Anxiety DisorderRecurrent distress over leaving home or attachment figure | Excessive worry about the loss of figure | Refusal to leave home | Fear of being alone | Refusal to sleep away from home or figure | Nightmares with separation theme | Physical symptoms |
Experience at least three of the above with symptoms lasting 4+ weeks in children/adolescents or 6+ months in adults AgoraphobiaPanic disorder signs and symptoms | Fears being in places where escaping is difficult or embarrassing if panic does occur | Planes, subways, buses, movie theatres, etc. | May not meet daily commitments (ie. work, grocery shopping, appointments, etc) | Knows behaviour is extreme | More common in women than men |
Social Anxiety DisorderFear that person might do something embarrassing, or be evaluated negatively by others | fear of public speaking, public eating, using public washrooms | Self-medication with alcohol or street drugs to cope |
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