Diploma in Psychology & Counselling

Abnormal Psychology

A.G.Gayathri Chamika
BA.Hon.Psychology ( Peradeniya)
Mphil. Counseling psychology. Reading. (Peradeniya)
Dip. In. Counseling ( Pera)
Dip. In Counseling psychology (IBSC)
Motivational speaker
Aspiring Counselor
Social worker
Anxiety Disorder
The American Psychological Association (APA) defines
anxiety as "an emotion characterized by physical changes
such as tension, anxious thoughts, and increased blood
pressure."

Anxiety can be considered a normal psychological

emotion that we all experience in our daily lives.

Anxiety helps man in many everyday situations like

avoiding accidents, solving problems, overcoming
challenges etc.
• As well as the positive
aspects of anxiety, in
many cases it affects the
individual negatively as
an anxiety disorder.

• An anxiety disorder can

be defined as an
uncontrollable and
uncontrollable state of
anxiety that persists for
no reason and interferes
with a person's daily life.
Generalized anxiety symptoms
• Problems concentrating or making decisions

• Feeling angry, stressed or nervous

• Experiencing nausea or abdominal pain

• Increased heart rate

• Sweating, trembling or shaking

• Difficulty sleeping

• Having a sense of impending danger, fear, or

doom.
 Types of Anxiety Disorders

 Generalized Anxiety Disorder

 Specific Phobia
 Social Anxiety Disorder
 Separation Anxiety Disorder
 Panic Disorder
 Agoraphobia
 OCD
 Body Dysmorphic Disorder
 Hoarding Disorder
 Trichotillomania
What we are talking about today,

Generalized Anxiety Disorder

 Specific Phobia
Social Anxiety Disorder
Separation Anxiety Disorder
Panic Disorder
Generalized Anxiety Disorder
(GAD)
 Criteria for diagnosing Generalized Anxiety Disorder

A. Excessive Anxiety and worry occurring more days than

not for at least 6 months.

B. The individual find it difficult to control the worry.

C. The Anxiety and worry are associated with three (or

more) of the following symptoms.

1. Restlessness or feeling keyed up or edge.

2. Being easily fatigued.
3. Difficulty concentration or mind going blank.
4. Irratability.
5. Muscle tension.
6. Sleep disturbance
D. The anxiety, worry or physical symptoms cause clinically
significant distress or impairments in social, occupational or other
important areas of functioning.

E. The disturbance is not attribute to the physiological effects on

substance.

F. The disturbance is not better explained by another mental disorder

Symptoms of Generalized Anxiety Disorder
(GAD). Who is affected?
GAD can cause both mental and physical symptoms.
• GAD is a common condition.
These vary from person to person, but can include:

• Feeling nervous or anxious • More women are affected than

men and the condition is more
• Difficulty concentrating or sleeping common in people aged 35 to
55 years.
• Dizziness

• Increased heart rate

What causes generalized anxiety disorder How to treat generalized
(GAD)? anxiety disorder (GAD).
• The exact cause of GAD is not fully understood, but a There are several different treatments that
combination of factors may play a role. Research has can ease symptoms. These include:
suggested that these may include:
• Talking Therapy – Cognitive
• Having a history of stressful or traumatic experiences Behavioral Therapy (CBT)
such as domestic violence, child abuse or bullying
from your parents, having a painful long-term health • Medications - Many people can
condition such as arthritis, or having a history of drug manage their anxiety with treatments
or alcohol abuse such as antidepressants called selective
serotonin reuptake inhibitors (SSRIs).
• But many people develop GAD for no apparent
reason.
Specific Phobia
• It can be described as a irrational long-term and
extreme fear of a specific object, occasion, or activity.

• Fear that actually arises rationally does not fall into the
category of phobias.

• The person with phobia fails to present a definite cause

for the phobia.

• And people with phobias know their phobia is

imaginary and unnecessary, but fail to get rid of it.

• It has been found that on average, women are ten times

more likely than men to develop phobias.
 There are four levels of phobia.

1. Mild Level
2. Moderate Level
3. Severe Level
4. Chronic Level

Specific types of phobias

• Fear of heights – Acrophobia • Fear of genitals – Gentophobia

• Fear of flying – Aerophobia • Fear of Naked bodies – Gymnophobia
• Fear of cats – Aliurophobia • Fear of blood – Hemophobia
• Fear of dogs – Cynophobia • Fear of reptiles- Herpetophobia
• Fear of pain – Algophobia • Fear of the dark- Nyctophobia
• Fear of Vehicles – Amaxophobia • Fear of STD - Syphilophobia
• Fear of flowers – Anthophobia • Fear of vaccines - Trypanophobia
• Fear of people – Anthrophobia • Fear of germs - Microphobia
• Fear of water – Aquaphobia • Fear of numbers - Numrophobia
• Fear of Spiders – Arachnophobia • Fear of marriage- Gamophobia
 Criteria for diagnosing Specific Phobia

A. Marked fear or anxiety about a specific object or

E. The fear, anxiety or avoidance is persistent
situation.
typically lasting for 6 months or more.
B. The phobic object or situation almost always provokes
F. The fear, anxiety or avoidance causes
immediate fear or anxiety.
clinically significant distress or impairment
in social, occupational or other important
C. The phobic object or situation is actively avoided or
areas of functioning.
endured with intense fear or anxiety.
G. The disturbance is not better explained by
D. The fear or anxiety is out of proportion to the actual
the symptoms of another mental disorder.
danger posed by the specific object or situation and to the
sociocultural context.
 How to treat people with specific
anxiety disorders

Reasons for specific phobias- • Psychoeducation

• Genetics- If you have family • Pharmaceuticals

members with an anxiety disorder
or phobia. • Psychotherapy - talking therapy
(cognitive behavior therapy)
• Experiences – stressful or
traumatic experiences. • Exposure therapy

• Relaxation techniques

• Self-help techniques
Social Anxiety Disorder / Social Phobia
This means suffering from the anxious nature,
discomfort, or fear of facing such situations when
presenting or acting socially.
Social anxiety disorder is of two types.

1. Specific Social Phobia

2. 2. Generalized Social Phobia

 Generalized social phobia
Specific social phobia
• It is a generalized social phobia when almost
• If the phobia of some people suffering every social activity becomes anxious and tries
from social phobia affects a particular to avoid those situations.
social situation or activity, it is called • This condition is the extreme social isolation
specific social phobia. of the individual.

Eg: Selective Mutism • The social abilities of such people are very
low.
• The vast majority of people who suffer • Building and maintaining interpersonal
from social phobia are those who suffer relationships, engaging in jobs that conflict with
from this specific social phobia. society, and expressing warm feelings or
emotions are all at a very low level.
 Criteria for diagnosing Social Phobia

A. Marked fear or anxiety about one or more E. The Fear or anxiety is out o proportion to
social situations in which the individual is the actual threat posed by the social situation
and to the sociocultural context.
exposed to possible scrutiny by others.
F. The fear, anxiety or avoidance is persistent,
B. The individual fears that he or she will act in typically lasting for 6 months or more.
a way or show anxiety symptoms that will be
negatively evaluated. G. The fear, anxiety or avoidance causes
clinically significant distress or impairment in
social, occupational or other areas of
C. The social situations almost always provoke functioning.
fear of anxiety.
H. The fear, anxiety or avoidance is not
D. The social situations are avoided or endured attributable to the physiological effects of a
substance.
with intense fear of anxiety.
I. The fear, anxiety or avoidance is not
better explained by the symptoms of
another mental disorder.

J. If another medical condition is

present, the fear, anxiety or avoidance
is clearly unrelated or excessive.
what are the causes of social phobia?
Like many other mental health conditions, social anxiety disorder results
from a complex interaction of biological and environmental factors.

Inherited traits. Anxiety disorders run in families. However, it is not entirely

clear how much of this is due to genetics and how much is due to learned
behavior.

Brain structure. A structure in the brain called the amygdala plays a role in
controlling the fear response. People with overactive amygdalas may have
high levels of fear and increased anxiety in social situations.

Environment. Social anxiety disorder can be a learned behavior. Some

people may develop significant anxiety after an unpleasant or embarrassing
social situation. Also, there may be a link between social anxiety disorder
and parents who model anxious behavior in social situations or who are
more controlling or overprotective of their children.
How to treat people with social
phobia
• Psychoeducation

• Pharmaceuticals

• Psychotherapy - talking therapy

(cognitive behavior therapy)

• Exposure therapy

• Relaxation techniques

• Self-help techniques
Separation Anxiety Disorder
 Criteria for diagnosing separation Anxiety disorder
4. Persistent reluctance or refusal to go out, away
A. Developmentally inappropriate and excessive fear from home, to school, to work, or elsewhere
or anxiety concerning separation from those to because of fear of separation.
whom the individual is attached, as evidenced by at
least three of the following: 5. Persistent and excessive fear of or reluctance
about being alone or without major attachment
1. Recurrent excessive distress when anticipating or figures at home or in other settings.
experiencing separation from home or from major
attachment figures. 6. Persistent reluctance or refusal to sleep away
from home or to go to sleep without being near a
2. Persistent and excessive worry about losing major major attachment figure.
attachment figures or about possible harm to them, such
as illness, injury, disasters, or death. 7. Repeated nightmares involving the theme of
separation.
3. Persistent and excessive worry about experiencing an
untoward event that causes separation from a major 8. Repeated complaints of physical symptoms
attachment figure. when separation from major attachment figures
occurs or is anticipated
B. The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in
children and adolescents and typically 6 months or more in adults.

C. The disturbance causes clinically significant distress or impairment in

social, academic (occupational), or other important areas of functioning.

D. The disturbance is not better explained by another mental disorder,

such as refusing to leave home because of excessive resistance to change
in autism spectrum disorder; delusions or hallucinations concerning
separation in psychotic disorders; refusal to go outside without a trusted
companion in agoraphobia; worries about ill health or other harm
befalling significant others in generalized anxiety disorder; or concerns
about having an illness in illness anxiety disorder.
Causes of separation anxiety disorder
Genetic Factors – The majority of patients diagnosed with separation
anxiety disorder have a history of other psychiatric conditions or run in
their family. Therefore, researchers believe that separation anxiety
disorder is a hereditary disorder and has a genetic origin.

Biological Factors – Similar to other psychiatric disorders, separation

anxiety disorder involves imbalances in neurotransmitter levels. In
patients with separation anxiety disorder, the regulatory mechanism that
controls optimal levels of such brain chemicals is impaired. Serotonin
and norepinephrine levels are believed to be mainly affected in such
patients.

Environmental factors - Environmental factors can be identified

relatively easily by closely observing the surroundings and events in the
patient's life. ( the death , )
How to treat separation anxiety?
Drug treatment

Psychotherapy (CBT) Cognitive behavioral therapy (CBT) is an effective

form of psychotherapy for separation anxiety disorder. During therapy the
child can learn to face and manage fears of separation and uncertainty. In
addition, parents can learn how to effectively provide emotional support
and encourage age-appropriate independence. Sometimes, if symptoms are
severe, combining medication with CBT can be helpful. Antidepressants
called serotonin reuptake inhibitors (SSRIs) may be an option for children
and adults.

Family counseling

Relaxing exercises
Panic Disorder
 Criteria for diagnosing Panic disorder
5. Feelings of choking.
A. Recurrent unexpected panic attacks. A panic
attack is an abrupt surge of intense fear or intense 6. Chest pain or discomfort.
discomfort that reaches a peak within minutes,
and during which time four (or more) of the 7. Nausea or abdominal distress.
following symptoms occur:
8. Feeling dizzy, unsteady, light-headed, or faint.
Note: The abrupt surge can occur from a calm state
or an anxious state. 9. Chills or heat sensations.

1. Palpitations, pounding heart, or accelerated heart 10. Paresthesia (numbness or tingling sensations).
rate.
11. Derealization (feelings of unreality) or
2. Sweating. depersonalization (being detached from oneself).

3. Trembling or shaking. 12. Fear of losing control or “going crazy.”

4. Sensations of shortness of breath or smothering. 13. Fear of dying.

Note: Culture-specific symptoms (e.g., tinnitus, neck C. The disturbance is not attributable to the
soreness, headache, uncontrollable screaming or crying) physiological effects of a substance (e.g., a drug
may be seen. Such symptoms should not count as one of of abuse, a medication) or another medical
the four required symptoms. condition.

B. At least one of the attacks has been followed by 1 D. The disturbance is not better explained by
month (or more) of one or both of the following: another mental disorder (e.g., the panic attacks
do not occur only in response to feared social
1. Persistent concern or worry about additional panic situations, as in social anxiety disorder; in
attacks or their consequences (e.g., losing control, response to circumscribed phobic objects or
having a heart attack, “going crazy”). situations, as in specific phobia; in response to
obsessions, as in obsessive-compulsive disorder;
2. A significant maladaptive change in behavior related to in response to reminders of traumatic events, as
the attacks (e.g., behaviors designed to avoid having in posttraumatic stress disorder; or in response
panic attacks, such as avoidance of exercise or unfamiliar to separation from attachment figures, as in
situations). separation anxiety disorder).
 How to treat people with panic
disorder
Causes of panic disorder
• Psychoeducation
As with many mental health conditions, the exact cause
of panic disorder is not fully understood, but is thought to • Pharmaceuticals
be linked to a combination of factors, including:
• Psychotherapy - talking therapy
• A traumatic or very stressful life experience, such as a
bereavement
(cognitive behavior therapy)

• Having a close family member with panic disorder • Relaxation techniques

• An imbalance of neurotransmitters (chemical

messengers) in the brain
• Self-help techniques
THANK YOU