Disorder SeparationAnxietyDisorder

Specificphobia

OCD* PTSD(Outline)

GAD PanicDisorder

SocialanxietyDisorder

Crux Fearofharmtoattachedwhenseparated

Activelyavoidedobjectwithout-of-proportionanxiety

Intrusivethoughts/Compulsiveacts(thoughts)

A1ExposureA2FearBRe-experienceCAvoid/*numb*Dhyperarousal

Excessiveworryabouttheeveryday

Fearisofhavingapanicattack,notwhatleadtoit

Fearofactinginawaythatwillbeembarrassingorhumiliating

Criteria -Distressonsepar.fromhomeorattachmentfig.-Worryaboutlosingpeopletodeath,etc.-Worryabouteventthatwillcauseseparation-Refusaltogoout,toschool,work,etc.-Fearofbeingalone-Wontsleepawayfromattachedfig.-Nightmaresaboutsep.-Physicalsymp.whenanticipatesseparation

-Fearofsomethingspecific(duh)-Objectalwaysprovokesfear-Objectisactivelyavoided-Anxietyoutofproportion

Obsessions-Intrusiveandunwantedthoughts-Attemptstoignoreorsuppressthoughts

Exposurethrough:-Experiencing-Witnessing-Closefamily-Repeatedfirst-handexposure-Intrusive,distressingmemories-Baddreams-Dissociation(re-experiencing)-Distressaboutcues-Physiologicalreaction-Avoidassociatedstimuli

-Anxiety-Can’tcontrolworry-Restlessness-Easilyfatigued-Prob.Concentrating-Irritability-Muscletension-Sleepproblem-Aboutminor,everydayevents

Panicattack:-Heart-Sweating-Trembling-Resp.distress-Choking-Chestpain-Nausea-Dizzy-Chills-Numbness-Derealization-Fearoflosingcontrol-FearofdyingAllin<10mins.WorryaboutmorePA’sfor1month

-Fearofsocialinteractionsinpeergroup-Fearofhumiliation,embarrassment,rejection,etc.-Socialsituationsprovokefear-Inchildren,anxietymaybecrying,tantrums,mutism,etc.-Socialsituationsavoided-Fearisoutofproportion-Ifmedicalcondition,fearisunrelated

Types:-Animal-Environment-Blood-Situational(e.g.Airplanes)-Other(e.g.vomiting)

Compulsions-Repetitivebehaviorsinresponsetoobsess.-Aimedatreducinganxiety-Timeconsuming

Time 4weekschild6monthsadult

6months 1month 6months 6months 6months

Riskfactors ParentSADFemale,young,poor

Young,female,familyhistoryofsame

Strep/virus(PANDAS)

TraumaintensityTwinstudies

FemalePoor

FemalePoorEarlylossOtheranxietydis

Ifearly,female,long,lowGAF->Bad

Treatment Physicaltorture Exposure SSRI,CBT* CBT,exposure,imaginal

Benzos,anti-D,CBT,meditate

Exposure,CBT,breathing,IPT

CPT,IPT,meds

Specifiers/(Notes)

(Developmentallyinappropriate)

(MultiplephobiasPredictsdepression,substanceuse)

-Goodinsight-Poorinsight-Noinsight/delusional-Tic-related

DepersonalizationDerealizationDelayedexpression

(60%Comorbidw/depression58%w/otheranxiety)

Performanceonly?(Seektreatment:18%adol.24%adult)

ChangesfromDSM4

NotAnxiety.NowinOCandrelateddisorder

Fromanxietydisto“traumaandstressorrelated”

DSM5–Expectedvs.unexpected

Prevalence

4%Meanage7

12%last12months-Mostcommonanx.disorder-Earliestonset

-1.6%life-1%/yr.-Female>male-Childhoodreversed

-7%life-3.5%/yr.(Assault,accident,combat-common)

~6%life~3%/year

1-3%life1-2%/year

1-13%Publicspeakingcommon

Courseandoutcomes

Followedbynearlyallotheranxietydisorders

Verystable(10yrs.)40%persist

Male14Female22

EarlyadulthoodPersistent

Adolescentand30’sêw/ageéRiskfordepress.

Lasts~16yrs.Rareafter3040%5yr.recover