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Anxiety Disorders, OCD, and PTSD

Module 41Slide2

Anxiety is a part of life for all of us.

Some of us are more prone to notice and remember information perceived as threatening, and the brain’s danger-detection system becomes hyperactive.

When this occurs, we are at greater risk for an anxiety disorder, or for two other disorders that involve anxiety:Obsessive-compulsive disorder (OCD) Posttraumatic stress disorder (PTSD)

Anxiety Disorders

, OCD

, and

PTSDSlide3

41-1: HOW DO GENERALIZED ANXIETY DISORDER, PANIC DISORDER, AND PHOBIAS DIFFER?Anxiety disorders

are marked by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety; include:Generalized anxiety disorder: Person is unexplainably and continually tense and uneasy.Panic disorder:

Person experiences

panic attacks, sudden episodes of intense dread, and fears the next episode’s unpredictable onset.Phobia: Person is intensely and irrationally afraid of a specific object, activity, or situation.Anxiety Disorders, OCD, and PTSD

Anxiety DisordersSlide4

Generalized anxiety disorder: Person is continually tense, apprehensive, and

in a state of autonomic nervous system arousal.Worry continually, often jittery, on edge, and

sleep

deprivedLack of concentration on a taskTwo-thirds womenAnxiety is free-floating (not linked to a specific stressor or threat)Often seen with depression, but usually debilitating even on its ownMay lead to physical problems (high blood pressure)

Anxiety Disorders

Generalized Anxiety DisorderSlide5

Panic disorder:

An anxiety disorder marked by unpredictable, minutes-long episodes of intense dread in which a person experiences

terror

and accompanying chest pain, choking, or other frightening sensations. Often followed by worry over a possible next attack.Panic attacks:

Sudden

episodes of intense dread

Physical symptoms accompany the attack:

Irregular heartbeat, chest pains, shortness of breath, choking, trembling, dizziness

Agoraphobia:

Fear or avoidance of public situations from which escape may be difficult (should a panic attack occur).

Anxiety Disorders

Panic DisorderSlide6

Phobia: Anxiety disorder marked by a persistent and irrational fear of

a specific object, activity, or situation.Specific phobias include a

fear

of particular animals, insects, heights, blood, or closed spaces.Social anxiety disorder (formerly called “ social phobia”) is an intense fear of other people’s negative judgments.People

with this disorder avoid

social

situations (speaking up in a group, eating out, going

to parties

),

and if unable to avoid them, may experience strong symptoms of their anxiety. Anxiety DisordersPhobiasSlide7

41-2: WHAT IS OCD?Obsessive-compulsive

disorder (OCD)Characterized by persistent and repetitive thoughts (obsessions), actions (compulsions), or bothOccurs when obsessive thoughts and compulsive behaviors persistently

interfere

with everyday life and cause distressIs more common among teens and young adults than older peopleTwin studies reveal that OCD has a strong genetic basisAnxiety Disorders, OCD, and PTSDObsessive-Compulsive

Disorder (OCD)Slide8

COMMON OBSESSIONS AND

COMPULSIONS

AMONG

CHILDREN AND ADOLESCENTS WITH OBSESSIVE-COMPULSIVE DISORDERSlide9

41-3: WHAT IS PTSD?Post traumatic stress disorder (PTSD)

Is characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, numbness of feeling, and/or insomnia lingering for four weeks or more after a traumatic experience.Often involves military veterans (7.6 percent of combatants; 1.4 of noncombatants among American military personnel in Afghanistan)

and survivors of accidents, disasters, and violent and sexual assaults (including an estimated two-thirds of prostitutes).

Women at higher risk (1 in 10) than men (1 in 20) of developing this disorder, following a traumatic event.Most men and women display impressive survivor resiliency.Anxiety Disorders, OCD, and PTSDPosttraumatic

Stress Disorder (PTSD)Slide10

41-4: HOW DO CONDITIONING, COGNITION, AND BIOLOGY CONTRIBUTE TO THE FEELINGS AND THOUGHTS THAT MARK ANXIETY DISORDERS, OCD, AND PTSD?

Conditioning research helps explain how panic-prone people associate anxiety with certain cues. Learning may magnify a single painful and frightening event into a full-blown phobia through two conditioning processes:

Stimulus generalization:

Research demonstrates how a fearful event can later become a fear of similar events.Reinforcement can help maintain a developed and generalized phobia.Understanding Anxiety Disorders, OCD, and PTSD

ConditioningSlide11

Conditioning influences our feelings of anxiety, but so does cognition—our thoughts, memories, interpretations, and expectations.Observing others can contribute to development of some fears.

Olsson and colleagues: Wild monkey research findingsOur interpretations and expectations

also

shape our reactions.Hypervigilance

Understanding Anxiety Disorders, OCD, and PTSD

CognitionSlide12

GenesGenetic predisposition to anxiety, OCD, and PTSDResearchers have identifies 17 gene variations associated with typical anxiety disorder symptoms

Genes influence levels of neurotransmitters:Serotonin: Influences

sleep

, mood, attending to threatGlutamate: Heightens activity in the brain’s alarm centersExperience affects gene expression. Epigenetic marks are often organic molecules that attach to chromosomes and turn certain genes on or off

Understanding Anxiety Disorders, OCD, and PTSD

BiologySlide13

The BrainTraumatic fear-learning experiences can leave tracks in the brain

Fear circuits created within the amygdala result in easy inroads for more fear experiences

Brain scans

show higher-than-normal activity in the amygdala of brain scans of people with PTSD when they view traumatic imagesAnterior cingulate cortex, a brain region that monitors our actions and checks for errors, is especially likely to be hyperactive in people with OCD

Understanding Anxiety Disorders, OCD, and PTSD

BiologySlide14

Natural SelectionWe seem biologically prepared to fear certain

threats—these are easily conditioned and difficult to extinguish.Some modern fears may have an evolutionary explanation

Fear of flying may be rooted in our biological predisposition to fear heights and confinement

Our phobias focus on dangers our ancestors faced. Our compulsive acts typically exaggerate behaviors that helped them survive.Understanding Anxiety Disorders, OCD, and PTSD

Biology