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Mind Map by DaniTemeng, updated more than 1 year ago
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Created by DaniTemeng
over 9 years ago
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Developmental Psychology - Anxiety
(When Does Adaptive Anxiety Become
Pathological?)
- What is Anxiety?
- Subjective state of being,
that has a diverse set of
symptoms. Causes the
sufferer to 'worry'. It is a
normal part of
experience and it varies
in intensity.
- Subjective state of being,
that has a diverse set of
symptoms. Causes the
sufferer to 'worry'. It is a
normal part of
experience and it varies
in intensity.
- Anxiety Vs. Fear
- Physiological
manifestations are
similar
- Fear is a
primary
emotion, anxiety
is a secondary
emotion
- Fear is a response to
danger in the present.
Anxiety is anticipation of
potential threat in the
future.
- Physiological
manifestations are
similar
- What is Good About Anxiety?
- Survival: - protective mechanism, -
escaping dangerous situations,.
Achievement: Anxiety increases
performance due to the fear of
failure.
- Survival: - protective mechanism, -
escaping dangerous situations,.
Achievement: Anxiety increases
performance due to the fear of
failure.
- Anxiety as a Marker of
Complex Cognition
- Evolution from transient fears of
animals to elaborate fears of
supernatural phenomenon signals
progression in the capability for
abstract thought.
- Evolution from transient fears of
animals to elaborate fears of
supernatural phenomenon signals
progression in the capability for
abstract thought.
- Anxiety as a Problem
- - Duration - Intensity -
Frequency - Causes Distress
- Interferes with Functioning
- - Duration - Intensity -
Frequency - Causes Distress
- Interferes with Functioning
- Physiological Symptoms
- - Restlessness - Shortness of
breath - Sweaty palms -
Increased heart rate - Chest
pain - Muscle tension -
Trembling - Nausea -
‘Butterflies’ - Exaggerated
startle response
- - Chills - Numbness - Sleep
disturbance - Fatigue -
Lethargy - Poor appetite -
Hot Flush - Dizziness - Dry
throat - Lump in the throat
- - Restlessness - Shortness of
breath - Sweaty palms -
Increased heart rate - Chest
pain - Muscle tension -
Trembling - Nausea -
‘Butterflies’ - Exaggerated
startle response
- Behavioral Symptoms
- - Avoidance - Escape -
Withdrawal - Apprehension -
Self-destructive behaviors -
Becoming over attached -
Distress - Depressive behaviors
- - Avoidance - Escape -
Withdrawal - Apprehension -
Self-destructive behaviors -
Becoming over attached -
Distress - Depressive behaviors
- Cognitive Symptoms
- - Negative self-appraisals
- Negative automatic
thoughts - Negative
interpretations - Negatives
biases - Inability
concentrating - Problems
with memory - Low
self-esteem
- - Negative self-appraisals
- Negative automatic
thoughts - Negative
interpretations - Negatives
biases - Inability
concentrating - Problems
with memory - Low
self-esteem
- Anxiety Disorders in DSM-5
- Generaliszed Anxiety Disorder,
Panic Attacks, Social Phobia,
Separation Anxiety Disorder,
Panic Disorder, Selective Mutism,
Specific Phobia, Agrophobia
- - Both in Children & Adults:
some more common in children,
dissimilarities described,
symptoms differ, duration
differs. - Many develop during
childhood. - Culture differences
play major role.
- Generaliszed Anxiety Disorder,
Panic Attacks, Social Phobia,
Separation Anxiety Disorder,
Panic Disorder, Selective Mutism,
Specific Phobia, Agrophobia
- Prevalence : Most common
problem during childhood and
adolescence, approx. 13/100
children aged between 9-17
suffer. Girls affected more
than boys. Often overlaps
with other anxiety disorders
eg. depression. * one of the
earliest forms = separation
anxiety
- Co-Morbidities
- - Anxiety is symptomatic
of many psychiatric
disorders: - The presence
of anxiety does not
automatically indicate an
anxiety disorder. - Most of
the addictive disorders
have some anxious
features. - Extreme fear
of fatness is an eating
disorder, not a phobia.
- - Co-occurring disorders:
- Two separate disorders
can and may be present
at the same time.
- Anxiety and
Depression
commonly
occur together
and have a
50%
comorbidity
rate.
- - Anxiety is symptomatic
of many psychiatric
disorders: - The presence
of anxiety does not
automatically indicate an
anxiety disorder. - Most of
the addictive disorders
have some anxious
features. - Extreme fear
of fatness is an eating
disorder, not a phobia.
- ANXIETY DISORDER: Separation -
Developmentally inappropriate and
excessive fear of being separated
from an attachment figure
- Characterized by: - excessive distress
when separation is anticipated or
occurs, - worry about well-being or
death of attachment figure, -
reluctance to go out for fear of
separation, - refusal to be alone at
home, - refusal to sleep alone, -
repeated nightmares involving theme
of separation.
- Lasts at least 4 wks in
children & 6 mnts. in adults.
Causes clinically significant
distress. Not better explained bt
another mental disorder.
- Differentiating from the norm: normal
stranger anxiety = 8-10mnts, SAD is more
intense, persistent and unrealistic concern -
unrealistic worried about the harm that might
occur to the attachment figure. *cultural
context to be considered *varying development
course
- School refusal = most common symptom of
SAD (75%), only 1/3 of kids who refuse to attend
school do so because of SAD, often occurs after
a period of legitimate absence.
- Prevalence of SAD: - affects children, adults and
elderly (difference based on duration).
Occurrence prior to age 6 = early onset. - 1/25
children suffer. - Higher in girls (community),
equal in clinical samples. CO-MORBIDITIES:
Children - GAD and specific phobias. Adults -
GAD, social phobias, OCD, depression,
agoraphobia, personality disorders.
- Prevalence of SAD: - affects children, adults and
elderly (difference based on duration).
Occurrence prior to age 6 = early onset. - 1/25
children suffer. - Higher in girls (community),
equal in clinical samples. CO-MORBIDITIES:
Children - GAD and specific phobias. Adults -
GAD, social phobias, OCD, depression,
agoraphobia, personality disorders.
- School refusal = most common symptom of
SAD (75%), only 1/3 of kids who refuse to attend
school do so because of SAD, often occurs after
a period of legitimate absence.
- Characterized by: - excessive distress
when separation is anticipated or
occurs, - worry about well-being or
death of attachment figure, -
reluctance to go out for fear of
separation, - refusal to be alone at
home, - refusal to sleep alone, -
repeated nightmares involving theme
of separation.
- Etiological Perspectives:
exact cause unknown,
genetics & biology,
learning (behavior),
attachment/parental
practices, cognition.
- Genetics: environmental
influences add to genetic
influences. 80% of mothers
who have children with SAD
have a history of anxiety
disorders. Shared genetic
diathesis between SAD and
adult onset panic attacks
(Roberson-Nay et al., 2012)
- 'Separation Anxiety Hypothesis'
- link with panic disorder
(Kossowsky et al, 2013). - SAD
reflects general susceptibility to
future psychopathology. -
Maybe genuine co-morbidity. -
SAD & panic disorder =
elements of non-specific
vulnerability. - Shared genetic
diathesis.
- Attachment: Bowlby’s
“Anxious Attachment” -
Arises from disturbances
in primary bonds. -
Typical separation anxiety
symptoms are
characteristic of early
development. - Older
children show symptoms
as a form of ‘regression’.
- Adults manifest in
theform of panic disorder
/ agoraphobia (see
‘Separation Anxiety
Hypothesis’)
- Parental Practices & Pathology: - Parent
overprotectiveness, overcontrolling,
reinforcement of avoidance, authoritarian /
critical parenting practices, parental
intrusiveness. - Parental stress or
psychopathology: Parental anxiety influences
child’s genetic tendencies and parental
reactions / style. - Maternal depression and
family dysfunction leads to over
parentification
- RESEARCH: Perez-Olivas, Stevenson, & Hadwin
(2008); Wood (2007); UC Berkeley, 2008: Low
Cortisol Levels Found in Kids Whose Mothers
Show Signs of Depression (Genetics)
- RESEARCH: Perez-Olivas, Stevenson, & Hadwin
(2008); Wood (2007); UC Berkeley, 2008: Low
Cortisol Levels Found in Kids Whose Mothers
Show Signs of Depression (Genetics)
- Cognitive: Beck (1976) -
Information Processing Biases.
- Attention to threat-relevant
material. - Bias towards
recalling negative memories. -
Misinterpretation of
information. - Over-estimating
the likelihood of negative
events
- Genetics: environmental
influences add to genetic
influences. 80% of mothers
who have children with SAD
have a history of anxiety
disorders. Shared genetic
diathesis between SAD and
adult onset panic attacks
(Roberson-Nay et al., 2012)
- Interpretation Bias
- Children with SAD
interpreted ambiguous
situations negatively and had
lower estimations of
competency to cope (Bogels &
Zigterman, 2000)
- Content-specificity:
children with SAD
report more negative
thoughts on
separation themes
compared to GAD
- Children with SAD
gaze significantly
more at separating
pictures than
non-anxious controls
after a period of 1s
(In-Albon, Kossowsky
& Schneider, 2010)
- Children with SAD
interpreted ambiguous
situations negatively and had
lower estimations of
competency to cope (Bogels &
Zigterman, 2000)
- Treatment
- - Anxiety disorders are one
of the most treatable
psychiatric conditions. - Early
intervention is vital. -
Research has identified what
works and what doesn’t . -
Therapy is unique to the
patient and symptoms, and
also the therapist
- Other Forms of Therapy:
Family therapy, Art therapy,
Mindfulness, Interpersonal
Psychotherapy,
Pharmacological, Systematic
Desensitisation, Relaxation
- Other Forms of Therapy:
Family therapy, Art therapy,
Mindfulness, Interpersonal
Psychotherapy,
Pharmacological, Systematic
Desensitisation, Relaxation
- Cognitive Behavioual Therapy (CBT):
Participant modelling, exposure and
reinforced practice. Cognitive
restructuring (adapted based on age): -
Challenging cognitive distortions, -
Identify key fearful thoughts or beliefs
that trigger those thoughts, - Taught
techniques for generating less-anxiety
provoking thoughts, - Rehearsal, -
Thought records
- Play Therapy: - Particularly useful for
younger children. - Uses toys, puppets,
games and art for expression of feelings. -
Helps child understand reasons behind
feelings. - Therapist provides alternative
ways of coping with the feelings
- - Anxiety disorders are one
of the most treatable
psychiatric conditions. - Early
intervention is vital. -
Research has identified what
works and what doesn’t . -
Therapy is unique to the
patient and symptoms, and
also the therapist
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