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Anxiety Disorders

Anxiety Disorders. Anxiety Disorders - Terms. Fear = emotional rxn to danger Anxiety Future orientation Feelings of apprehension No danger may be present Panic – physiological rxn; fight or flight Phobias = pathological fears. Fears vs. Phobias. Out of proportion

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Anxiety Disorders

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  1. Anxiety Disorders

  2. Anxiety Disorders - Terms • Fear = emotional rxn to danger • Anxiety • Future orientation • Feelings of apprehension • No danger may be present • Panic – physiological rxn; fight or flight • Phobias = pathological fears

  3. Fears vs. Phobias • Out of proportion • Cannot be explained away • Leads to avoidance • Not adaptive • Persists over time • Not age or stage specific

  4. Fears • Common and normal • 90% of children have at least one specific fear • 50% have numerous fears • Generally decline with age; peak around 11 • Phobias only 1%

  5. Common fears • Fears of physical injury or personal loss • Fears of natural or supernatural danger • Fears reflecting psychic distress • animals

  6. Developmental changes in fears • 1st year: loud noises, separation from parent • Preschoolers – animals, the dark, imaginary creatures • school age – school, injury, social fears • Adolescence – interpersonal fears, appearance, school, safety

  7. Difficulties in assessment of anxiety disorders in children • Differentiate normal fears from pathological anxiety • impairment • domains may not correspond • Verbal • Behavioral • Physiological • Problems operationalizing behavioral manifestations of anxiety • Physiological measures limited • Verbal report - ?? • Rating scales good but don’t distinguish

  8. DSM-IV Anxiety Disorders • 9 disorders • Same as adult except for separation anxiety disorder • OCD, PTSD, GAD, Panic Disorder, phobia, social phobia, agoraphobia, acute stress disorder

  9. Separation Anxiety Disorder • Excessive anxiety concerning separation from home or caregivers beyond that expected for developmental level • Lasts 4 weeks or more • Often early age of onset • Often precipitated by major stressor

  10. Social Phobia • Extreme shyness • Children may not recognize why they feel anxious • Must have capacity for social relationships with familiar people • Must occur in peer setting, not just with adults

  11. Components of Treatment • Avoidance/escape – exposure • Physiological reactions – relaxation training and/or meds • Cognitive – alter distorted thinking • Cognitive – sense of control, self-efficacy

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