| Anxiety | An apprehensive and future oriented state with a negative affect accompanied with somatic symptoms such as muscle tension, restlessness and an elevated heart rate. |
| Fear | An immediate and present oriented state with sympathetic nervous system activation. |
| Panic | A sudden and overwhelming reaction |
| Panic attack | An abrupt experience of intense fear. Physical symptoms include: heart palpitations, chest pain, sweating and heat sensations. Cognitive symptoms include: fear of losing control or "going crazy". These can either be cued or uncued |
| Psychological contribution to anxiety | Freud: a psychic reaction to danger that reactivates infantile fear to a situation.
Behaviourism: symptoms are a result of learned associations.
Modelling: linked to the beliefs about one's controlability over their environment. |
| Social contribution to anxiety | Biological vulnerabilities are triggered by stressful life events |
| Generalised anxiety disorder (GAD) - diagnostic criteria | 1)Excessive anxiety and worrying occurring more days than not over a 6 month period (or longer).
2)Difficulty controlling the worrying.
3) Three or more of the following: restlessness, difficulty concentrating, easily fatigued, irritability, muscle tension, sleep disturbances (Only one in the case of a child).
4) The worrying impairs functioning.
5) Not caused by substance abuse.
6) Symptoms not better explained by another mental disorder |
| Generalised anxiety disorder (GAD) - clinical description | Shift from possible crisis to possible crisis; worries are about minor "everyday" concerns; leads to procrastination over preparation |
| Generalised anxiety disorder (GAD) - treatment | Pharmacological: Benozodiazapines (short term); antidepressants (SSRI's)
Psychological: CBT; exposure therapy, confront anxiety provoking images; coping strategies |
| Behavioural inhibition system (BIS) | Brain circuit in the limbic system that responds to threat signals by inhibiting activity and causing anxiety (Jeffrey Gray). |
| CRF | Cotricotropin-releasing factor; activates the HPA |
| HPA | Hypothalamic-pituitary-adrenocortical axis |
| Panic disorder (PD) | Unexpected severe panic attacks and fear of another occurring and avoid situations that might provoke one; must persist for at least a month |
| Panic Disorder (PD) - diagnostic criteria | 1) Recurrent unexpected (uncued) panic attacks
2) A panic attacked followed by either or both of the following: persistent worry about additional attacks and/or a significant maladaptive change in behaviour
3) Not attributable to substance abuse or medication |
| Agoraphobia | Fear/avoidance of experiencing a panic attack. Concerned about whether or not one can get help in the event of a panic attack. Escapist tendencies. |
| Agoraphobia - diagnostic criteria | 1) A fear of two or more: public transport, open spaces, enclosed spaces, standing inline/ in a crowd, outside or home alone.
2)Fears or avoids these situations due to the thoughts that escape might be difficult or help might not be available in the event of a panic attack - the fear is not proportional to actual danger. |
| Nocturnal panic | Occurs during non-REM sleep; caused by deep relaxation, the sensation of "letting go" arouses anxiety. |
| Specific phobia | Extreme and irrational fear of a specific object/situation. Significant impairment and distress. |
| Social anxiety disorder | Extreme and irrational concern about being negatively evaluated by others. Sometimes manifests as shyness. Leads to significant impairment or distress, avoidance and fear. |
| Post-traumatic stress disorder (PTSD) - diagnostic criteria (Pt. 1) | 1)Exposure to actual or threatened death, serious injury or sexual violence
2) |
| Post-traumatic stress disorder (PTSD) - diagnostic criteria (Pt. 2) | 3)
4)
5) |
| Post-traumatic stress disorder (PTSD) - clinical description | Exposure to trauma and continued re-experiencing of said trauma (eg flashbacks, nightmares). Avoidance of things that remind of the trauma. Emotional numbing. Reckless or self destructive behaviour. INterpersonal problems. Trauma can either be experienced directly or witnessed. |
| Post-traumatic stress disorder (PTSD) - cause | Intense trauma evokes PTSD; a generalised biological predisposition/vulnerability is typically present too; Psychological vulnerabilities like the belief that one lacks control as well as poor social support. |
| Adjustment disorder | Anxious or depressive symptoms in reaction to life stressors. Milder than PTSD and only becomes clinically significant if it impairs functioning and causes distress. |
| Acute stress disorder | Assigned for patients experiencing PTSD symptoms longer than one month i.e PTSD is persistent. |
| Obsessive-compulsive disorder - clinical description | Unwanted, intrusive and persistent thoughts as well as repetitive actions to suppress these thoughts (OCD does not equate to bing neat and orderly). Debilitating and chronic. Ego dystonic. |
| Ego distonic | Behaviour goes against the conscious will of the individual. |
| Obsessions | Persistent intrusive and often nonsensical thoughts, images or urges. |
| Compulsions | Ritualistic acts that provide relief from obsessions. |
| Obsessive-compulsive disorder - diagnostic criteria | 1) Presence of obsessions or compulsions or both.
2) The obsessions are time consuming and cause clinically significant distress or impairment. |
| Body dismorphic disorder | A preoccupation with some imagined defect in appearance. If an actual defect is present it appears slight to others and is over-inflated by the sufferer. 10% coromorbid with OCD. Chronic |
