Anxiety Disorders

A Closer Look at Anxiety Disorders Can you imagine how it would feel to have constant feelings of fear and dread? These feelings are a reality for the twenty-nine percent of people who suffer from some kind of anxiety disorder in their lifetime (Comer 96). There are many different types of anxiety disorders. They include generalized anxiety disorder, phobia, panic disorder, and obsessive compulsive disorder. The symptoms of these disorders vary, but they all have an underlying similarity; fear. The fear in these patients is unbearable. An anxiety disorder is able to be classified when their discomfort is considered too severe or too frequent, is triggered too easily, or lasts too long (Comer 96). Although anxiety is the most common mental disorder in the United States, only about one-fifth of sufferers seek treatment (Comer 96). Of these four types of anxiety disorders, I will be focusing on generalized anxiety, phobia, and obsessive compulsive disorder. Two perspectives that I feel help anxiety sufferers the most are the behavioral and cognitive perspectives. Generalized anxiety disorder is a state of tireless and extreme feelings of anxiety and worry about practically anything (Comer 97). The DSM IV TR would classify symptoms of generalized anxiety as excessive or ongoing anxiety and worry, for at least six months, about numerous events or activities, difficulty controlling the worry, also at least three of the following symptoms: restlessness, easy fatigue, irritability, muscle tension, sleep disturbances, and also significant distress or impairment (Comer 96). Philip C. Kendall et al. has found that anxiety disorders of youth is able to lead to mood, anxiety, and substance disorders in parents (Kendall, et al. 415). Kendall’s research is to show the correlation between children and their parents, but it is also mentioned that the significant stress of an anxious child causes anxiety, mood, and substance disorders as well in the parent (Kendall, et al. 415). Kendall claims that, “By assessing for parental anxiety prior to child anxiety treatment and providing services to anxious parents, a positive treatment response among anxious youth may be improved” (Kendall et al. 415).
The cognitive perspective believes that generalized anxiety results from faulty thinking (Comer 100). Cognitive theorists believe that people who suffer from generalized anxiety disorder have basic irrational assumptions; meaning that they have inaccurate and inappropriate beliefs. According to Albert Ellis, a cognitive theorist, one of these assumptions would be, “It awful and catastrophic when things are not the way one would very much like them to be” (Comer 100). Research has proved that people with generalized anxiety disorder do actually hold maladaptive assumptions, particularly about dangerousness (Comer 100). Cognitive therapies include rational-emotive therapy to change maladaptive assumptions, and also acceptance and commitment therapy, which allows sufferers of generalized anxiety to accept their thoughts as just mere events of their mind (Comer 102, 103). Phobias are classified as a specific fear of an object or of a situation. Phobias can be specific or social, but both interfere greatly with one’s life. The DSM IV TR states that specific phobias are, “a marked and persistent fear of a specific object or situation that is excessive or unreasonable, lasting at least six months” (Comer 107). For a diagnosis to be in order one must also have immediate anxiety produced by exposure to the object, recognition that fear is unreasonable and also significant distress or impairment (Comer 107). In contrast, social phobias are marked by severe, persistent, and irrational fears of social or performance situations in which humiliation may occur (Comer 108). The physical symptoms of a social phobia include sweating, nausea, and difficulty breathing, which may lead to behavioral avoidance to attempt to prevent these symptoms (McGrandles, Duffy 50).
The behavioral perspective claims that phobias are caused by classical conditioning. Classical conditioning is a learning process in which two events occur closely in time. They then become tied together in the person’s mind and produce the same reaction (Comer 108). Two other behavioral explanations include modeling and stimulus generalization. Modeling is a learning process in which a person observes someone else, and them imitates their actions (Comer 109). Also stimulus generalization is when responses to one stimulus are also produced by similar stimuli (Comer 109). Behavioral therapy techniques, including exposure treatments, are in fact the most widely used techniques for specific phobias. These techniques are highly effective, and proven to be better than the other methods (Comer 112). Exposure treatments are behavioral treatments that expose the person to the objects or situations that they dread (Comer 112). The exposure treatments consist of desensitization, flooding, and modeling. Together these work as a team to help to client overcome their specific phobia. During desensitization, therapist usually will first offer patients relaxation training to help calm them down independently (Comer 112). This is very important so that the client will be able to relax themselves while they are exposed to their phobias. It is also important to the behaviorists for the clients to create a fear hierarchy so that they can understand what truly upsets them. Throughout several sessions the client will be able to move up their fear hierarchy and become comfortable with what upsets them the most (Comer 113). These treatments are generally successful and after several sessions the clients are usually able to approach the objects or situations calmly. Obsessive compulsive disorder (OCD) was once among the most misunderstood of all the psychological disorders (Comer 123). There have been great strides in research to understand this disorder, and the cognitive and behavioral explanations are remarkable. Obsessive compulsive disorder is marked by obsessions by the individual, which can vary from wishes, images, impulses, ideas, or doubts (Comer 122). These obsessions are then followed by compulsions, most commonly seen as cleaning compulsions (Comer 123). The DSM IV TR classifies obsessive compulsive disorder with, “Recurrent obsessions and compulsions, past or present recognition that the obsessions or compulsions are excessive or unreasonable, and significant distress or impairment, or disruption by symptoms for more than one hour per day” (Comer 121).
The behavioral perspective holds that OCD sufferers come upon their compulsions coincidentally. They believe that a threat lifting is linked to a previous action, which triggers obsessive compulsions (Comer 125). Exposure and response prevention is a treatment used by behaviorists. This treatment exposes the client to anxiety arousing situations or thoughts, and then prevents the client from performing the calming ritual (Comer 126). This treatment is highly effective, as fifty-five to eighty-five percent of clients with obsessive compulsive disorder improve significantly (Comer 126). Thankfully, behavioral therapy has been able to do wonders for those who suffer from obsessive compulsive disorder. This topic is newsworthy because it not only affects the individual, but it affects society as well. Philip C. Kendall et al. found that about fifty-one percent of youth from his study of anxiety disorders met the DSM IV criteria for generalized anxiety (Kendall et al. 408). Anxiety effects the individuals physical functioning because it causes sufferers to have muscle tension, sleep disturbances, and fatigue (Comer 96). Clients are emotionally impaired because they are in a constant state of worry and freight. This causes sufferers to become emotionally distressed (Comer 96). Clients are affected cognitively when they are no longer able to control the worry; it then affects their cognitive function (Comer 96). Social function is highly impaired by anxiety disorders, most commonly phobias. Phobias affect social functioning because the client is constantly in fear that they will come into contact with their phobia. This prevents them from living life freely, and being socially active (Comer 106). Anxiety has an impact on society because six percent of all people will develop generalized anxiety within their lifetime (Comer 96). This is significant because this is a debilitating disorder that needs to be accounted for. Society needs to know about it because they need to be able to recognize the symptoms to help themselves and their loved ones. This topic is relevant to me because I plan to go to UMSL for nursing. Understanding anxiety disorders and how to deal with anxiety will help me understand what some of the patients and their family members will be going through. This is also relevant because I have learned about anxiety disorders previously in general psychology classes, but am glad I was able to learn about them more in depth with this research paper. What I could do now based on my reading is have a better understanding of not only others, but myself as well. I have learned the very important symptoms of anxiety disorders and it will help me to be able to recognize those in myself and others. This will allow me to have more patients in dealing with people that, for instance have a phobia or serious fear of needles or blood. While I am not personally a squeamish person, knowing that close to nine percent of all people are diagnosed with a specific phobia each year, will allow me to be more understanding (Comer 107).

Works Cited
Comer, Ronald J. Fundamentals of Abnormal Psychology. Sixth ed. New York: Worth, 2011. Print.
McGrandles, Amanda, and Tim Duffy. "Assessment And Treatment Of Patients With Anxiety." Nursing Standard 26.35 (2012): 48-56. Academic Search Premier. Web. 16 Nov. 2012.
Philip C. Kendall, et al. "Anxiety, Mood, And Substance Use Disorders In Parents Of Children With Anxiety Disorders." Child Psychiatry & Human Development 40.3 (2009): 405-419. Academic Search Premier. Web. 15 Nov. 2012.

Cited: Comer, Ronald J. Fundamentals of Abnormal Psychology. Sixth ed. New York: Worth, 2011. Print. McGrandles, Amanda, and Tim Duffy. "Assessment And Treatment Of Patients With Anxiety." Nursing Standard 26.35 (2012): 48-56. Academic Search Premier. Web. 16 Nov. 2012. Philip C. Kendall, et al. "Anxiety, Mood, And Substance Use Disorders In Parents Of Children With Anxiety Disorders." Child Psychiatry & Human Development 40.3 (2009): 405-419. Academic Search Premier. Web. 15 Nov. 2012.