Mood depressive disorder (MDD)
-Anhedonia- cant enjoy anything even there is something fun happening
-4 additional symptoms change in sleeping change in appetite fatigue psychomotor retardation – move or think slowly sense of guilt or worthlessness difficulty concentrating thought of suicide or death
3 times as common among population in poverty
Dysthymic Disorder (Dysthymia)
-chronic (at least 2 years without major depression
-with 2 other symptoms
Double depression
-dysthymia PLUS major depressive episode (after 2 yrs of dysthymia)
1. specific phobias – fear of objects or situation that is out of proportion
2. Social anxiety disorder – fear of unfamiliar people or public speaking
3. Panic disorder – anxiety about recurrent panic attacks
4. Agoraphobia – scare of being trapped in where escaping or getting help would be difficult if anxiety symptoms occur
5. Generalized anxiety disorder
Social Anxiety Disorder
Causes more life disruption than other phobias
• More intense and extensive than shyness
– Persistent, intense fear and avoidance of social situations
– Fear of negative evaluation or scrutiny
– Exposure to trigger leads to anxiety about being humiliated or embarrassed socially
– Onset often adolescence
• 33% also diagnosed with Avoidant Personality Disorder
– Overlap in genetic vulnerability for both disorders
DSM‐5 Criteria for Social Anxiety Disorder
• Marked and disproportionate fear consistently triggered by exposure to potential social scrutiny
• Exposure to the trigger leads to intense anxiety about being evaluated negativelyPanic Disorder
• Frequent panic attacks unrelated to specific situations
• Panic attack sudden, intense episode of apprehension, terror, feelings of impending doom
Intense urge to flee
Symptoms reach peak intensity within 10 minutes
Physical symptoms can include:
Labored breathing, heart palpitations, nausea, upset stomach, chest pain, feelings of choking and smothering, dizziness, sweating, lightheadedness, chills, heat sensations, and trembling
– Other symptoms may include:
Depersonalization
DerealizationFears of going crazy, losing control, or dying
• Uncued attacks
Occur unexpectedly without warning
Panic disorder diagnosis requires recurrent uncued attacks
Causes worry about future attacks
• Cued attacks
Triggered by specific situations (e.g., seeing a snake)
• More likely a phobia
DSM‐5 Criteria for Panic Disorder
• Recurrent uncued panic attacks
• At least 1 month of concern about the possibility of more attacks, worry about the consequences of an attack, or behavioral changes because of the attacks
Agoraphobia
• From the Greek word “agora” or marketplace
• Anxiety about inability to flee anxiety‐ provoking situations– E.g., crowds, stores, malls, churches, trains, bridges, tunnels, etc. DSM‐5 Criteria for Agoraphobia
• Disproportionate and marked fear or anxiety about at least 2 situations where it would be difficult to escape or receive help in the event of incapacitation or panic‐like symptoms, such as:
– being outside of the home alone; traveling on public transportation; open spaces such as parking lots and marketplaces; being in shops, theaters, or cinemas; standing in line or being in a crowd
GAD: Symptoms
• Worry plus 3 or more:
• 1. Restless or keyed up
• 2. Easily fatigued
• 3. Hard to concentrate
• 4. Irritable
• 5. Muscles are tense
• 6. Sleep problems
Comorbidity
• 80% of those with anxiety disorder meet criteria for another anxiety disorder
– Subthreshold symptoms (do not meet full DSM) very common
– Causes of comorbidity
Symptoms used to diagnose the various anxiety disorders overlap:
Social anxiety and agoraphobia might both involve a fear of crowds
Etiological factors may increase risk for more than one anxiety disorder
• 75% of those with anxiety disorder meet criteria for another psychological disorder
– Disorders commonly comorbid with anxiety:
60% with anxiety also have