Comprehensive Overview: Panic, Anxiety, Ob-
sessions, and Their Disorders
Understanding panic, anxiety, and obsessive-compulsive disorders is essential for both mental
health professionals and those seeking to comprehend these experiences. The following
expanded notes provide detailed insights across various learning objectives, highlighting the
distinctions, features, clinical aspects, and treatments of different anxiety disorders.
Fear vs. Anxiety (6.1)
Fear and anxiety are often intermingled emotions, yet they represent distinct psychological
states.
• Fear: A basic, primal emotion often triggered by an immediate threat. For example,
seeing a snake may induce fear, activating the "fight-or-flight" response managed by the
autonomic nervous system. Fear reactions are almost instantaneous, preparing individuals
for immediate action, whether to confront or escape danger.
• Anxiety: Unlike fear, anxiety is a more diffuse and anticipatory emotion concerning potenti-
al future threats. For instance, worrying about a loved one's health involves anxiety because
no specific threat is present. Anxiety may primely elevate apprehension in individuals
and can manifest physically through symptoms like muscle tension and state of general
nervousness.
Despite slight overlaps, anxiety disorders are identified by unrealistic and irrational fears
causing distress and impaired functioning, affecting nearly 29% of the U.S. population at some
point in their lives.
Overview of Anxiety Disorders (6.2)
Anxiety disorders include:
1. Specific Phobia: Intense, irrational fear of specific objects or situations (e.g., heights,
spiders). Individuals avoid the feared object and often experience distress when confronted
with it.
2. Social Anxiety Disorder: Persistent fear of social or performance situations due to
concerns over negative evaluation by others. Commonly involves fear of public speaking
or eating in public spaces.
3. Panic Disorder: Recurrent and unexpected panic attacks characterized by physical
symptoms (e.g., heart palpitations, sweating) and intense fear.
4. Agoraphobia: Fear and avoidance of situations where escaping might be difficult; often
occurs alongside panic disorder.
5. Generalized Anxiety Disorder (GAD): Chronic, excessive worry about various life topics,
causing distress and physical symptoms like fatigue and muscle tension.
Commonalities Among Disorders
• All anxiety disorders share symptoms involving excessive worry, panic attacks, or the fear
of encountering anxiety-inducing situations.
• Many people with one anxiety disorder may experience additional anxiety disorders or
depressive disorders.
Biological and Psychological Causes
• Genetic Factors: Across most anxiety disorders, genetic vulnerability is often noted, with
various personality traits (such as neuroticism) increasing susceptibility.
• Learning Theory: Classical conditioning plays a significant role in developing these disor-
ders; fear responses can become conditioned to specific stimuli associated with threats.
Specific Phobia (6.3)
Specific phobias entail excessive, irrational fears towards specific objects/situations, triggering
an immediate fear response that may resemble a panic attack.
DSM-5 Diagnosis Criteria
1. Marked fear or anxiety about a specific object or situation.
2. Immediate fear response upon exposure to the phobia.
3. Active avoidance of the phobic situation or enduring it with intense distress.
4. Fear is out of proportion to the actual danger posed.
Key Features
• Individuals recognize their fear is excessive but feel incapable of overcoming it.
• Avoidance behavior tends to reinforce the phobia, further entrenching the fear response.
Social Phobia (6.4)
Social phobia, or social anxiety disorder, features disabling fear associated with social situa-
tions.
DSM-5 Criteria
1. Intense fear of being scrutinized or negatively evaluated in social contexts.
2. Anxiety in social situations leading to avoidance or endurance with distress.
Clinical Manifestations
• Individuals may experience panic attacks in social situations, exacerbating fear of engage-
ment and creating a cycle of avoidance behavior fueled by anticipatory anxiety.
Panic Disorder (6.5)
Panic disorder is defined by the presence of recurrent, unexpected panic attacks marked by
abrupt surges of intense fear.
DSM-5 Criteria
1. Recurrent and unexpected panic attacks.
2. Persistent concern about additional attacks or their consequences.
3. Significant behavioral changes related to the attacks.
Key Features
• Often involves physiological symptoms: heart palpitations, choking sensations, derealiza-
tion, fear of dying.
• Biological factors: Increased activity in the amygdala, norepinephrine, and serotonin
dysregulation.
Generalized Anxiety Disorder (GAD) (6.6)
GAD presents as pervasive, excessive worry across multiple domains, often intensified in
individuals who perceive their environments as unpredictable.
DSM-5 Criteria
1. Chronic worry regarding events, existing on more days than not for 6 months.
2. Difficulty controlling these worries.
3. Accompanied by physical symptoms such as restlessness, fatigue, irritability.
Features
• Individuals exhibit marked vigilance towards potential threats and focus excessively on
possible future calamities.
• Bio-psycho-social perspective is crucial in understanding the development and mainte-
nance of GAD.
Obsessive-Compulsive Disorder (OCD) (6.7)
Recognized as a distinct disorder in DSM-5, OCD involves obsessions (intrusive thoughts) and
compulsions (repetitive behaviors).
DSM-5 Criteria
1. Presence of obsessions, compulsions, or both.
2. Compulsive behaviors aim to reduce anxiety stemming from the obsessions.
3. Time-consuming and significantly impairing in functioning.
Treatment Approaches
• Exposure and Response Prevention: Effective behavioral strategy to confront fears without
performing compulsive actions.
• Medications: SSRIs have shown efficacy in reducing symptoms significantly.
Body Dysmorphic Disorder (BDD) and Hoarding Disorder
Body Dysmorphic Disorder (BDD)
• Preoccupation with perceived flaws in appearance that are often unnoticeable to others,
leading to significant distress and impairment.
• Treatment similar to OCD, including exposure therapy.
Hoarding Disorder
• Characterized by the accumulation of possessions leading to clutter and impairment in
functioning.
• Recent research suggests neurological differences in those with compulsive hoarding
compared to individuals with OCD without hoarding.
Cultural Perspectives on Anxiety Disorders (6.8)
Cultural factors influence both the prevalence and expression of anxiety disorders.
Examples Include:
• Yoruba Culture (Nigeria): Concerns revolve around family welfare, witchcraft, and psycho-
logical perceptions of the brain.
• Taijin Kyofusho (Japan): Fear of offending others through physical appearance or behavior
rather than the individual’s fear of scrutiny.
In conclusion, understanding the distinctions, features, and treatments of anxiety-related dis-
orders provides critical insights into the therapeutic approaches, the importance of cultural
contexts, and the complexities surrounding mental health issues.
