Online Education And Degree. Part 23. Common Features of Anxiety Disorders

Although different types of anxiety disorders exist, according to Michael Telch, Jasper Smits, Matt Brown, and Victoria Beckner, there are some common features across these different disorders. Common features include escape and avoidance behaviors, chronic worry, attentional hypervigilance, faulty threat perception, and sympathetic activation. Individuals with an anxiety disorder try to avoid or escape from stimuli or situations that make them anxious, and they constantly worry about current and future events. These individuals attend excessively to cues that they perceive as threatening. The excessive attention given to these cues is referred to as attentional hypervigilance. Faulty threat perception is another common feature found among individuals with an anxiety disorder. These individuals erroneously perceive situations as threatening. Sympathetic activation is also a core feature found among individuals with an anxiety disorder. Activation of the sympathetic nervous system producing physiological changes in the body occurs in individuals with an anxiety disorder when there is no real or potential threat. Physiological changes experienced by these individuals in the absence of a real or potential threat may include accelerated heart rate, muscle tension, and increased perspiration and respiration.
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Types of Anxiety Disorders
The Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) (DSM-IV-TR) has identified 15 types of anxiety disorders, including generalized anxiety disorder, separation anxiety disorder, specific phobia, social anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, acute stress disorder, panic attack, panic disorder with and without agoraphobia, agoraphobia without a history of panic disorder, anxiety disorder not otherwise specified, anxiety disorder due to a general medical condition, and substance-induced anxiety disorder. Generalized anxiety disorders, phobias, obsessive-compulsive disorders, panic disorders, and posttraumatic stress disorders are the most common types of anxiety disorders.
Although there are several types of anxiety disorders, each involves an excessive degree of worry or fear about certain stimuli, situations, or events, which significantly interferes with an individual's normal state of functioning. Generalized anxiety disorder is characterized by a chronic, excessive, and uncontrollable degree of worry about a variety of events or situations, such as friends, family, school, work, or the future. Symptoms of generalized anxiety disorder include fatigue, irritability, restlessness, muscle tension, and difficulties with concentration and sleep. Another common anxiety disorder, specific phobia, is characterized by an extreme and irrational fear in response to a specific stimulus, such as animals or insects (e.g., dogs), aspects of the natural environment (e.g., storms), blood (e.g., viewing blood or receiving an injection), situations (e.g., being in small spaces), or other stimuli (e.g., loud sounds or costumed characters). This worry must be present for at least 6 months and may lead to symptoms in children such as crying, clinging, tantrumming, dizziness, shortness of breath, and fainting.
Like a specific phobia, social phobia is associated with particular circumstances and must involve symptoms present for at least 6 months. An individual with a social phobia experiences extreme worry regarding social situations. The individual may worry over or fear the possibility of ridicule, humiliation, or embarrassment in social situations, such as speaking in class or conversing with peers. Individuals with a social anxiety disorder may attempt to avoid or escape social behaviors, and they often have poor social skills. These individuals may also experience symptoms such as trembling hands or voice, perspiration, muscle tension, and blushing.
Obsessive-compulsive disorder involves obsessions (recurrent or persistent thoughts or worries that intrude on, and interfere with, an individual's normal functioning) and compulsions (repetitive behaviors, rituals, or practices in which the individual engages to provide relief from, or comply with, the obsessive thoughts or worries). Common obsessions and compulsions in children include contamination (hand washing), safety (checking), preoccupations with orderliness and symmetry (ordering, aligning), and counting or touching rituals. Individuals with an obsessive-compulsive disorder may feel embarrassed by their compulsions and may experience difficulties related to concentration, preoccupations, and perfectionist tendencies.
Posttraumatic stress disorder refers to stress or worry experienced by an individual following a traumatic event (such as a serious injury, death, or catastrophic event). The individual reexperiences the event (via flashbacks, nightmares, or images), as well as the accompanying physiological arousal, and may attempt to avoid stimuli associated with the event. Following the event, the individual may feel helpless, fearful, agitated, or disorganized and may experience hypervigilance, irritability, and difficulties with concentration or sleep. These symptoms must be present for at least 1 month following the traumatic event. If symptoms are present for less than 1 month, then an acute stress disorder may be present. Similar to posttraumatic stress disorder, acute stress disorder also results from witnessing or experiencing a traumatic event. Symptoms include reexperiencing the event and the accompanying physiological arousal; however, these symptoms are present for no more than 1 month.
A panic disorder refers to recurrent and unexpected panic attacks that are followed for at least 1 month by concern about, or consequences of, having another attack and/or a change of behavior related to the attack. Panic attacks develop abruptly, often last for approximately 10 minutes, and involve symptoms such as heart palpitations, sweating, chest pain, dizziness, fear of dying, feelings of detaching from one's body, and feelings of losing control. If the attacks become more frequent, the individual may come to fear experiencing a panic attack in public places, and develop agoraphobia (fear of public places) as well. However, agoraphobia may also develop in the absence of, and without resulting from, a panic disorder. In these cases, individuals may avoid public situations, such as being in a crowd or traveling in a train, and may experience symptoms of panic in these situations.
Separation anxiety disorder is an anxiety disorder commonly found in children. Separation anxiety disorder refers to excessive and unrealistic worry in response to separation from home or a caregiver. Children with separation anxiety disorder may experience nightmares with separation themes, headaches, stomachaches, or nausea. These symptoms must be present for at least 4 weeks. Separation anxiety disorders tend to decrease with an increase in age. That is, this type of anxiety disorder is common during the childhood years but declines during the adolescent and adulthood years.
Anxiety disorders may also result from external factors, such as a general medical condition or substance use. Finally, for individuals who experience symptoms of anxiety, but whose symptoms, duration, or impairment do not meet the criteria for a specific disorder, a diagnosis of anxiety disorder not otherwise specified (NOS) may be appropriate.
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EDITOR Neil J. Salkind
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