Erin Polyblank
CHAPTER 5: ANXIETY, TRUAMA-AND
STRESSOR-RELATED DISORDERS
Learning outcomes:
Identify basic biological, psychological
Use scientific reasoning to
and social components of behavioural
interpret behaviour:
explanations (e.g. inferences,
observations, operational definitions and
interpretations)
Describe problems operationally to study them
Engage in innovative and
empirically
integrative thinking and
problem solving:
Describe applications that Correctly identify antecedents and
employ discipline-based consequences of behaviour and mental
problem solving: processes
Describe examples of relevant and practical
applications of psychological principles to
everyday life
Anxiety disorders:
o Separation anxiety
o Selective mutism
o Specific phobias.
o Social phobia
o Agoraphobia
o Panic
o Generalised anxiety
o Anxiety due to medical disorder.
Trauma & Stressor-related disorders:
o Adjustment disorders
o Prolonged grief disorder.
o PTSD
o Acute stress disorder.
o Reactive Attachment
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Erin Polyblank
THE COMPLEXITY OF ANXIETY DISORDERS
OF ALARMS AND FALSE ALARMS: FEAR AND ANXIETY
Anxiety: Mood state characterised by marked negative affect and bodily
symptoms of tension in which a person apprehensively anticipates future
danger or misfortune.
o Anxiety may involve feelings, behaviours and physiological responses.
Experientially, anxiety is hardly distinguishable from fear.
o Fear is a normal, natural response to threat encountered across the animal
kingdom, including humans.
In evolution, the fear response is geared to enhance an animal’s survival
response is geared to enhance an animal's survival advantage in the face of
threat.
o The animal enters a state of physical readiness to avoid harm, avoid pain
and avert danger.
o Fear is likened to a state of alarm.
o Archetypal environmental threats provoke fear - lack of air, dangerous
places and animals, social disapproval and uncertainty.
Phenomenologically, anxiety is a negative feeling state accompanied by
apprehensive thoughts, a mix of bodily symptoms including muscular tension,
increased pulse, dry mouth and altered breathing and, often, behaviours such
as fidgeting.
Fear can be likened to an alarm, pathological fear, like panic, can be likened
to a false alarm.
Anxiety disorders impune false alarms, or a state of excessive vigilance.
o In anxiety disorders, a fearful state is experienced in excess to the threat,
or for no good reason at all.
o Pathological anxiety does not abate and, even if we know there is no
reason to be afraid, we remain anxious.
In its most intense form, fear, or anxiety, manifests as panic.
o Panic: Sudden, overwhelming fright or terror.
o Panic is non-specific and is encountered across a range of normal
situations, physical conditions and many mental disorders not limited to
panic disorder (PD).
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Fear of specific situations, or isolated threats, track with the phobias.
o As social animals, our need to belong to a group is central to our identity:
Fear of social rejection therefore tracks social phobia, or social anxiety.
Fear-anxiety rules of thumb:
Archetypal Threat Pathological response
Smothering Panic attack, panic disorder
Animals, environment Specific phobia
Social rejection Social anxiety
Dirt, disorganisation Obsessive-compulsive disorder
Future Generalised anxiety disorder
Equating fear with anxiety is somewhat of an oversimplification.
o There is much evidence that fear, and anxiety reactions differ
psychologically and physiologically.
Anxiety is a future-oriented mood state, characterised by apprehension
because we cannot predict or control upcoming events.
Fear is an immediate emotional reaction to a current threat geared
towards averting danger.
Fear is accompanied by a strong behavioural bias towards escape
and a surge in arousal.
The panic attack is a true expression of fear - immediate and over-whelming.
o Panic Attack: Abrupt experience of intense fear or discomfort
accompanied by a number of physical symptoms, such as dizziness or
heart palpitations.
DSM-5 considers panic attacks as expected (cued) and unexpected (uncued).
o If you know you are afraid of high places or of riding in a speeding taxi, you
might have a panic attack in these situations but not anywhere else; this is
an expected (cued) panic attack.
o By contrast, you might experience unexpected (uncued) panic attacks if
you are assailed by an attack for no good reason, out of the blue.
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A panic attack is not a specific disorder, rather it is included is a range of
different conditions.
CAUSES OF ANXIETY AND RELATED DISORDERS
Diagnostic criteria for panic attack:
An abrupt surge of intense fear or intense discomfort that reaches a peak
within minutes and during which time four (or more) of the following symptoms
occur:
1. Palpitations, pounding heart or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or smothering
5. Feeling of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, lightheaded or faint
9. Chills or heat sensations
10.Paraesthesias (numbness or tingling sensations)
11.Derealisation (feelings of unreality) or depersonalisation (being
detached from oneself)
12.Fear of losing control or going crazy
13.Fear of dying.
[Note: The abrupt surge can occur from a calm state or an anxious
state.]
BIOLOGICAL CONTRIBUTIONS
Evidence shows that we inherit a tendency to be tense, uptight and anxious.
The tendency to panic seems to run in ones familiy and probable holds some
genetic contributions to anxiety.
o No single gene seems to cause anxiety or panic, rather contributions from
collections of genes in several areas on chromosomes make us vulnerable
when the correct psychological and social factors are in place.
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