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Anxiety, Trauma & Stressor, and Obsessive-Compulsive Disorders

Mr. Koch

Psychology

Andover High School

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Anxiety Disorders

  • Separation Anxiety Disorder
  • Selective Mutism
  • Specific Phobia
  • Social Anxiety Disorder (Social Phobia)
  • Panic Disorder
  • Panic Attack (Specifier)
  • Agoraphobia
  • Generalized Anxiety Disorder
  • Substance/Medication-Induced Anxiety Disorder
  • Anxiety Disorder Due to Another Medical Condition
  • Other Specified Anxiety Disorder
  • Unspecified Anxiety Disorder

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Anxiety Disorders

  • Anxiety
    • Characterized by ↑ heart rate, ↑ blood pressure, sweating, rapid breathing, dry mouth, sense of dread, uneasiness, trembling, nervousness
  • Some anxiety is normal – when so intense & long-lasting that it impairs functioning, becomes a disorder
  • Most common disorders in North America
      • ~32% will experience
      • ~2/3 are women

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Generalized Anxiety Disorder (GAD)

  • Excessive & long-lasting (~6 mo.) anxiety, not focused on any particular object or situation (“free-floating anxiety”)
    • Feel disaster is about to happen, jumpy, irritable, can’t sleep
      • 2.7% of pop. in any given year
      • 5.7% of pop. In lifetime
      • Onset ~30 y.o.
      • ~2x more common in women
      • Often goes untreated

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Panic Disorder

  • Recurring, terrifying panic attacks w/o warning or obvious cause
      • Intense heart palpitations, pressure or pain in chest, dizziness or unsteadiness, sweating, feeling faint (may last minutes or hours)
      • Often mistaken for heart attack
    • Can last for years w/ improvement and recurrence
        • 30% of pop. had panic attack w/in last year
        • Only ~4.7% develop full-blown panic disorder
    • Strong association w/ agoraphobia

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Phobias

  • An intense, irrational fear of an object or situation that does not objectively justify such a reaction
    • Usually realize fear is groundless, but anxiety persists
    • May greatly interfere with daily life
    • Specific DSM diagnoses:
      • Specific Phobia (~12.5% of pop.)
      • Social Anxiety Disorder (Social Phobia) (~12.1% of pop.)
      • Agoraphobia (~1.3% of pop)
    • Typical onset: early teens

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Trauma- and Stressor-Related Disorders

  • Reactive Attachment Disorder
  • Disinhibited Social Engagement Disorder
  • Posttraumatic Stress Disorder
  • Acute Stress Disorder
  • Adjustment Disorders
  • Other Specified Trauma- and Stressor-Related Disorder
  • Unspecified Trauma- and Stressor-Related Disorder

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Post-Traumatic Stress Disorder (PTSD)

  • Pattern of adverse and disruptive reactions following a traumatic and threatening event
      • i.e., war, natural disasters, assaults, abuse, accidents, etc.
    • Characteristic reactions:
      • Anxiety, depression, irritability, jumpiness, inability to concentrate, sexual dysfunction, difficulty getting along w/ others, sleep disturbances, intense startle responses, suppressed immune system, nightmares, flashbacks
    • May last months, years, decades
    • ~6.8% of population

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Obsessive-Compulsive and Related Disorders

  • Obsessive-Compulsive Disorder
  • Body Dysmorphic Disorder
  • Hoarding Disorder
  • Trichotillomania (Hair-Pulling Disorder)
  • Excoriation (Skin-Picking) Disorder
  • Substance/Medication-Induced Obsessive-Compulsive and Related Disorder
  • Obsessive-Compulsive and Related Disorder Due to Another Medical Condition
  • Other Specified Obsessive-Compulsive and Related Disorder
  • Unspecified Obsessive-Compulsive and Related Disorder

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Obsessive-Compulsive Disorder (OCD)

  • Obsessions – plagued by persistent, upsetting, unwanted thoughts
      • i.e., infection, contamination, causing harm to self/others
  • Compulsions – ritualistic, repetitive behaviors
      • i.e., washing, counting, checking, arranging, etc.
    • Interferes w/ daily life (>1 hr/day)
    • Derive no pleasure – recognize as irrational
      • Onset: adolescence
      • 2-3% of pop. during lifetime (1 in 40)

**Hoarding Disorder is a newly added, separate disorder in the DSM-5

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Body Dysmorphic Disorder

  • The preoccupation with an imagined or exaggerated “defect” in physical appearance
    • Preoccupations often difficult to control, spend hours a day thinking about “defect” – can dominate lives
    • Self-consciousness may cause to avoid work, school, or public situations
    • Engage in frequent checking of “defect” and attempts to improve
      • Usually lead to more anxiety
      • Many cannot be convinced their view of self is inaccurate
  • Typical onset: adolescence
  • Affects ~1 in 50 in US
  • May be equal in men/women