General Anxiety Disorder (GAD) Generalized anxiety disorder (GAD) is an anxiety disorder that is characterized by excessive, uncontrollable and often.

General Anxiety Disorder (GAD)

Generalized anxiety disorder (GAD) is an anxiety disorder that is characterized by excessive, uncontrollable and often irrational worry about everyday things that is disproportionate to the actual source of worry.

Definition

Causes• Hereditary• Substance induced • Caffeine• Neurology: disrupted functional connectivity of the

amygdala and its processing of fear and anxiety

DSM-IV-TR Diagnostic Criteria• Excessive anxiety and worry (apprehensive expectation), occurring

more-days-than-not for at least 6 months, about a number of events or activities (such as work or school performance).

• The person finds it difficult to control the worry.• The anxiety and worry are associated with three (or more) of the

following six symptoms (with at least some symptoms present for more-days-than-not for the past 6 months).– restlessness or feeling keyed up or on edge– being easily fatigued– difficulty concentrating or mind going blank– irritability– muscle tension– sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying

sleep)

DSM-IV-TR Diagnostic Criteria

• The focus of the anxiety and worry is not confined to features of other Axis I disorder (such as social phobia, OCD, PTSD etc.)

• The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

• The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism), and does not occur exclusively during a mood disorder, psychotic disorder, or a pervasive developmental disorder.

Panic Disorder

Panic disorder is an anxiety disorder characterized by recurring severe panic attacks

Definition

Causes• Psychological Models: no single cause for panic disorder

(exist as a co-morbid condition with many hereditary disorders such as bipolar disorder)

• Medical Model: Chemical imbalance within the limbic system

• Substance abuse• Smoking• Caffeine• Alcohol and sedatives

DSM-IV-TR Diagnostic Criteria

• Unexpected, recurrent panic attacks, followed in at least one instance by at least a month of – a significant and related behavior change, – a persistent concern of more attacks, or – a worry about the attack's consequences

• There are two types, one with and one without agoraphobia.

• Diagnosis is excluded by attacks due to a drug or medical condition, or by panic attacks that are better accounted for by other mental disorders.

Posttraumatic Stress Disorder (PTSD)

Posttraumatic stress disorder (PTSD) is a severe condition that may develop after a person is exposed to one or more traumatic events, such as sexual assault, serious injury or the threat of death.

Definition

Causes• Family violence• Evolutionary psychology • Genetics• Risk factors: Military experience• Drug misuse• Foster care

DSM-IV-TR Diagnostic Criteria

• A: Exposure to a traumatic event This must have involved both – (a) loss of "physical integrity", or risk of serious injury or death, to self or

others, and – (b) a response to the event that involved intense fear, horror, or

helplessness (or in children, the response must involve disorganized or agitated behavior).

• B: Persistent re-experiencing One or more of these must be present in the victim: flashback memories, recurring distressing dreams, subjective re-experiencing of the traumatic event(s), or intense negative psychological or physiological response to any objective or subjective reminder of the traumatic event.

DSM-IV-TR Diagnostic Criteria• C: Persistent avoidance and emotional numbing This involves a sufficient

level of:– avoidance of stimuli associated with the trauma, such as certain thoughts or

feelings, or talking about the event(s);– avoidance of behaviors, places, or people that might lead to distressing

memories as well as the disturbing memories, dreams, flashbacks, and intense psychological or physiological distress; inability to recall major parts of the trauma(s), or decreased involvement in significant life activities;

– decreased capacity (down to complete inability) to feel certain feelings;– an expectation that one's future will be somehow constrained in ways not

normal to other people.• D: Persistent symptoms of increased arousal not present before These are

all physiological response issues, such as difficulty falling or staying asleep, or problems with anger, concentration, or hypervigilance. Additional symptoms include irritability, angry outbursts, increased startle response, and concentration or sleep problems.

DSM-IV-TR Diagnostic Criteria

• E: Duration of symptoms for more than 1 month If all other criteria are present, but 30 days have not elapsed, the individual is diagnosed with Acute stress disorder.

• F: Significant impairment The symptoms reported must lead to "clinically significant distress or impairment" of major domains of life activity, such as social relations, occupational activities, or other "important areas of functioning".