Anxiety Workshop 03.11.15

7/24/2019 Anxiety Workshop 03.11.15

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Anxiety Disorders

Dr Jo Billings

UCL Division of Psychiatry

Clinical Mental Health Module

MSc Clinical Mental Health Sciences / Mental Health Sciences Research


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What is anxiety?


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What does it feel like to feel anxious?


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What does it feel like to feel anxious?


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Anxiety

Is a noral and natural reaction! essential to "ee# us safe

Is an eotional #rediction of danger

Physical! eotional and cognitive e$#erience %lthough there is soe evidence for innate fear in

huans &e'g' (an Strien et al'! )*+,- ost an$iety is

learnt

%n$iety disorders are .here this an$iety is out of#ro#ortion to the actual ris" and is constant or intrusive

enough to cause significant disaility


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6Fs of Anxiety es!onse ("#hauer & $lbert% '')

BABCP 2015 Andy Pike & Kerry Young 7


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he anxiety disorders

Panic disorder

%gora#hoia S#ecific Phoia

0eneralised %n$iety Disorder

Social an$iety

Health an$iety 1sessive co#ulsive disorder &1CD-


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Pani# Disorder

Recurrent une$#ected #anic attac"s! at least one of

.hich has een follo.ed y at least a onth of one of

the follo.ing2 #ersistent concern aout having additional attac"s

.orry aout the i#lications of the attac" or its

conse3uences &eg losing control! having a heart

attac"! 4going cra5y6

a significant change in ehaviour related to the

attac"s'


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Pani# Disorder

Refers to a discrete #eriod of intense fear of discofort! in .hich at least

four of the follo.ing sy#tos develo#ed aru#tly and reached a #ea"

.ithin +* inutes'

Heart racing! #ounding! fluttering or s"i##ing eats S.eating! treling! sha"ing

7roule catching reath / feeling li"e eing sothered

8eel li"e cho"ing

Chest #ain! #ressure! tightness or discofort

9ausea! sic"ness! gastrointestinal difficulty

Di55y! light:headed! unsteady or faint 8eelings of unreality or in a drea:li"e state

8eeling as if going cra5y or ight lose control

% fear they ight die

8eeling of nuness or tingling in fingers or feet

Have hot flashes or chills


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Pani# Disorder

Lifetie #revalence ,';*


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Agora!hobia

%n$iety aout eing in &or antici#ating- situations fro .hich esca#e

ight e difficult

) i#ortant features2 Panic attac"s

%n$ious cognitions aout fainting and loss of control

DSM:= re3uires at least ) of the = situations #resent for a diagnosis2

+- Using #ulic trans#ort e'g' uses

)- Being in o#en s#aces e'g' ridges

?- Being in enclosed s#aces e'g' sho#s

,- Standing in line or eing in a cro.d

=- Being outside the hoe alone


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Agora!hobia

Prevalence rates difficult to inter#ret

Lifetie #revalence of %gora#hoia .ithout Panic

Disorder *';< &essler et al'! )**>-

rates in .oen onset later &id:late )*s-

Etiological theories of onset siilar to Panic Etiological theories of aintenance include

#ersonality and faily influences


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"!e#ifi# Phobia

E$cessive fear or an$iety of a #articular oFect or

situation

%voided or endured

E$#osure gives acute severe an$iety

Interferes .ith functioning DSM:= identifies = suty#es2

anials lood/inFection/inFury nature/environent situational other


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"!e#ifi# Phobia

Lifetie #revalence rates a##ro$ ,< en and

+?< .oen

%ge of onset G ty#ically in childhood or early

adolescence

High cooridity of s#ecific #hoias


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Generalised Anxiety Disorder

E$cessive an$iety and .orry occurring ore days than not for at least >

onths! aout a nuer of events or activities

orry feels difficult to control &.orry aout .orry-

%n$iety and .orry are associated .ith at least ?/> follo.ing sy#tos &.ith atleast soe sy#tos #resent for ore days than not for the #ast > onths- feeling restless! fidgety! Fittery! "eyed u#! on edge tiring easily difficulty concentrating feeling irritale tense! aching or soreness in

uscles have #roles falling or staying aslee#'

7he an$iety! .orry or #hysical sy#tos cause clinically significant distress or

i#airent in social! occu#ational or other i#ortant areas of functioning'

Excludeif focus of an$iety confined to #articular sy#tos or situation or ifsy#tos are a direct #hysiological effects of a sustance or a general

edical condition or are etter accounted for y one of the other an$iety

diagnosis


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GAD

Lifetie #revalence rates ,'?:='A onths or longer'

7he avoidance! an$ious antici#ation! or distress in the feared social#erforance situation interferes significantly .ith the #ersons noral

routine! occu#ational functioning! or social activities or relationshi#s!

or there is ar"ed distress aout having the #hoia'

Excludediagnosis if sy#tos are a direct #hysiological effects of a

sustance &e'g' drugs! alcohol! edication- or a general edicalcondition or are etter accounted for y one of the other an$iety

diagnosis

Excludethe diagnosis if the fear is related to another #sychiatric or

#hysical disorder &eg fear of #anic attac"! stuttering etc-


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"o#ial Anxiety

Lifetie #revalence +?'?

Anxiety Workshop 03.11.15

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