Samenvatting Fear and Anxiety
HC1 Anxiety and fear
Fears are really common - being afraid of
snakes - mostly 63%
anxiety is normal
fear - is a state of immediate alarm in response to a serious, known threat to one’s
well-being
anxiety - is a state of alarm in response to a vague sense of threat or danger (knowing that is
not gonna be a good day)
both have the same physiological features:
- increase in respiration
- perspiration
- muscle tension
- etc
FEar
● an emotional response to perceived threat
● adaptive and has evolutionary value
● humans are predisposed biologically
● involves activation of the sympathetic nervous system
● fight or flight
there are a lot of things we are afraid of
you need to be able to get a quick response
hyperventilation
not fun
build in reaction is for action
specific phobias
- like being afraid of spider
- most people who are afraid have someone to take care of the spiders
- or to avoid them
- they can impact life a lot
with a panic attack the heart rate might go up, but it might also not go up
for a specific phobia it will definitely go up
When does anxiety develop into a disorder
● Normal anxiety is adaptive. it is an inborn response to threat or to the absence of
people or objects that signify safety can result in cognitive (worry) and somatic
(racing heart, sweating, shaking, freezing, etc. (symptoms)
● pathologic anxiety is anxiety that is excessive, impairs function
someone that is afraid of spiders, you can ask them many questions
, - can you get rid of the spider yourself
- do you have to have soemone to do it for you
- can you remove it with a stofzuiger yourself?
- can you just put the stofzuiger back in the closet?
you can go on and on with different questions and people might be able to do certain things,
but not others.
that i can still do.
DSM definition
● unreasonably strong or permanent
● arises without sufficient reasons
● cannot be controlled or endured
● causes suffering and constraints in life
> spider phobia is not that easy to get. you need to suffer from it
if you take a lot of cortisol they can trigger a lot of somatic symptoms
mental underlying disease - mostly schizophrenic
this looks quite easy to categorize - and it is, but is also is not
social phobia > social anxiety
they moved it from fear to anxiety
they worry a lot beforehand and afterhand: postmortem or post event processing
> there's a lot of cognitive worrying - anxiety
it has both the fear and the anxiety
all have in common: Avoidance
they all have some kind of avoidance behavior
● try to avoid the trigger (maybe a spider, so avoiding woods)
● developing a safety behavior
○ for example you're worried about your blushing, so you would wear a lot of
makeup. or a jacket that covers the redness in your neck
○ > some of them can be really hidden
, ○ reassurance seeking (control and check on people for example)
○ especially in generalized anxiety and also in OCD
● using a substance or medication
○ also alcohol e.g.
○ especially males do this as a part of self medication
○ most of the people who really use this, might have a social anxiety
clinical characteristics of adult anxiety disorders
agoraphobia - they feellike they could loose the contorl at any moment
a lot of avoidance behavior
they won't drive anymore because they can faint at any moment. they will look at where the
exit is and will keep that in mind
rarely some spontaneous panic attacks - social phobia > they worry much more
specific phobia - afraid of giving a talk for example
PTSD
- specific - the triggers that remind them of the event
- avoidance behavior is hard to track
- maybe less going into the dark by yourself, but hard to measure
- rare sponatenous attacks
, Lifetime prevalence for any anxiety disorder ranges from 10% to 29%
12 month prevalence 18% - how many disorders there are in that time frame
Depression has a very high prevalence
a lot of psychologists have had a patiënt with a panic disorder and almost no one GAD
anxiety disorders can be culturally linked, there might be disorders that are more prevalent in
certain countries than in others (depression more northern and GAD more southern)
if you only look at the people that have help seeking behaviors, then it will seem that their
prevalence is higher because they're easier to count in the clinical practice.
Vulnerability
biological causes
genetic influences
● tendency to have anxiety tend to have some genetic
● you don't have a gene for anxiety disorder
● there's a tendency to react more anxious
● more risk genes
● a tendency to panic also seems to run in families
● there is increasing evidence that we inherit a tendency to be tense or uptight
BUT
HC1 Anxiety and fear
Fears are really common - being afraid of
snakes - mostly 63%
anxiety is normal
fear - is a state of immediate alarm in response to a serious, known threat to one’s
well-being
anxiety - is a state of alarm in response to a vague sense of threat or danger (knowing that is
not gonna be a good day)
both have the same physiological features:
- increase in respiration
- perspiration
- muscle tension
- etc
FEar
● an emotional response to perceived threat
● adaptive and has evolutionary value
● humans are predisposed biologically
● involves activation of the sympathetic nervous system
● fight or flight
there are a lot of things we are afraid of
you need to be able to get a quick response
hyperventilation
not fun
build in reaction is for action
specific phobias
- like being afraid of spider
- most people who are afraid have someone to take care of the spiders
- or to avoid them
- they can impact life a lot
with a panic attack the heart rate might go up, but it might also not go up
for a specific phobia it will definitely go up
When does anxiety develop into a disorder
● Normal anxiety is adaptive. it is an inborn response to threat or to the absence of
people or objects that signify safety can result in cognitive (worry) and somatic
(racing heart, sweating, shaking, freezing, etc. (symptoms)
● pathologic anxiety is anxiety that is excessive, impairs function
someone that is afraid of spiders, you can ask them many questions
, - can you get rid of the spider yourself
- do you have to have soemone to do it for you
- can you remove it with a stofzuiger yourself?
- can you just put the stofzuiger back in the closet?
you can go on and on with different questions and people might be able to do certain things,
but not others.
that i can still do.
DSM definition
● unreasonably strong or permanent
● arises without sufficient reasons
● cannot be controlled or endured
● causes suffering and constraints in life
> spider phobia is not that easy to get. you need to suffer from it
if you take a lot of cortisol they can trigger a lot of somatic symptoms
mental underlying disease - mostly schizophrenic
this looks quite easy to categorize - and it is, but is also is not
social phobia > social anxiety
they moved it from fear to anxiety
they worry a lot beforehand and afterhand: postmortem or post event processing
> there's a lot of cognitive worrying - anxiety
it has both the fear and the anxiety
all have in common: Avoidance
they all have some kind of avoidance behavior
● try to avoid the trigger (maybe a spider, so avoiding woods)
● developing a safety behavior
○ for example you're worried about your blushing, so you would wear a lot of
makeup. or a jacket that covers the redness in your neck
○ > some of them can be really hidden
, ○ reassurance seeking (control and check on people for example)
○ especially in generalized anxiety and also in OCD
● using a substance or medication
○ also alcohol e.g.
○ especially males do this as a part of self medication
○ most of the people who really use this, might have a social anxiety
clinical characteristics of adult anxiety disorders
agoraphobia - they feellike they could loose the contorl at any moment
a lot of avoidance behavior
they won't drive anymore because they can faint at any moment. they will look at where the
exit is and will keep that in mind
rarely some spontaneous panic attacks - social phobia > they worry much more
specific phobia - afraid of giving a talk for example
PTSD
- specific - the triggers that remind them of the event
- avoidance behavior is hard to track
- maybe less going into the dark by yourself, but hard to measure
- rare sponatenous attacks
, Lifetime prevalence for any anxiety disorder ranges from 10% to 29%
12 month prevalence 18% - how many disorders there are in that time frame
Depression has a very high prevalence
a lot of psychologists have had a patiënt with a panic disorder and almost no one GAD
anxiety disorders can be culturally linked, there might be disorders that are more prevalent in
certain countries than in others (depression more northern and GAD more southern)
if you only look at the people that have help seeking behaviors, then it will seem that their
prevalence is higher because they're easier to count in the clinical practice.
Vulnerability
biological causes
genetic influences
● tendency to have anxiety tend to have some genetic
● you don't have a gene for anxiety disorder
● there's a tendency to react more anxious
● more risk genes
● a tendency to panic also seems to run in families
● there is increasing evidence that we inherit a tendency to be tense or uptight
BUT
