Stress and Anxiety Anxiety Disorders Anxiety stress and fear have slightly different uses and implications State of unrest or alarm brought on by a situation that is perceived as a threat to our sense of safety and well being Ways of Experiencing Stress Anxiety o Goal directed behavior impeded o Meeting expectations raised stakes Frustrated Pressured Conflicted Endangered o Life threatening o Resource insufficiency Sources of Stress o Incompatible goals or choices difficulty with decision making Daily hassles Note that all are part of life and not inherently pathogenic Life changes major life events Traumatic events Chronic negative conditions poverty job stress Lazarus appraisal influences whether and to what degree we experience these evens as stressful or threatening Primary Appraisal Secondary Appraisal how dangerous or life threatening is the event how well can we cope with it Problem focused coping Emotion focused coping Avoidance oriented coping direct attempts to solve the problem or respond to the challenge attempts to attend to and improve our emotional experience attempts to resist or avoid the experience altogether Appraisal of Stress Coping With Stress Anxiety Disorders Major features o Intense frequent often overwhelming feelings of anxiety out of proportion to the situation results in impairment Physiological autonomic arousal Cognitive worry apprehensive expectation o Strong desire to escape or avoid Specific Phobias o Excessive fear of a specific situation o Avoidance distress Social Anxiety Disorder o Fear of negative evaluation by others Generalized Anxiety Disorder o Persistent excessive worry over uncontrollable negative events Panic Disorder Agoraphobia o Recurrent unexpected panic attacks fear of fear o Fear of panic attack in public Separation Anxiety Disorder Selective Mutism Obsessive Compulsive and Related Disorders Obsessive Compulsive Disorder Body Dysmorphic Disorder Hoarding Disorder Trichotillomania hair pulling Excoriation Disorder skin picking Predisposing Protective Factors Autonomic Arousability Cognitive o Control orientation Stress resistant personality Behavioral and Cognitive Behavioral Treatments o Unwanted intrusive anxiety producing thought ritualistic behavior o Sympathetic nervous system arousal high reactivity slow recovery Symptoms as learned conditioned responses Replace maladaptive responses with new more adaptive response Escape avoidance behaviors must be stopped Exposure and Response Prevention Systematic desensitization Panic control therapy Key is to make contact and prevent avoidance and all new experience with the feared situation
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