Anxiety and obsessive compulsive disorders
Wednesday, September 29, 2021 9:30 PM
• Stress and Anxiety
○ Stress and anxiety: Universal experiences
○ Anxiety: An emotional and physiological response to a stressor or perceived threat
that involves both physiological and emotional arousal, and can result in an
uncomfortable feeling of apprehension or dread
○ Anxiety results in physical, emotional, cognitive, and behavioral changes and
symptoms
○ It is adaptive to a point but if chronic or in excess, it can be damaging or disruptiv
○ Overwhelming stress can significantly affect our physical health as well (e.g.
decreased immunological function, altered cardiac function)
○ Medical illnesses can cause anxiety: e.g. COPD, CHF, TBI
○ Learned response and biology also play role
○ Long and short term effects - increased HR and shift in blood flow to chrinic cortico
levels
• Responses to Stress
○ Many factors affecting how we respond to stress:
§ Culture, values, beliefs
§ Perceptions of the stressor—what it means to us, what we tell ourselves
about it
§ Pre-existing stress load
§ Existing coping resources—energy, coping skills, resilience, supports
○ Some expected/desirable responses to stress:
§ Avoid or minimize excessive stress exposure where possible
§ When it can’t be avoided, respond with constructive/adaptive relief and
coping actions
§ One’s response is proportional to the stressor
§ New stress can also happen when stressed
○ Unexpected/undesirable responses to stress:
§ 1.Fails to avoid or minimize stressors where possible
§ 2.While physiological and emotion arousal occurs, it does not lead to effectiv
relief/coping actions
§ 3.Response is disproportional to the stressor
, § 4.Response is maladaptive (counterproductive or destructive)
• Theories about anxiety - know NT responsible for anxiety is GABA
○ Psychoanalytic View—unmet and conflicting drives cause anxiety
○ Cognitive—irrational thoughts, unrealistic expectations of oneself, and/or
misinterpretation or distortion of events create anxiety
○ Interpersonal View—experiences as infant/child cause anxiety; lowers self-esteem
decreases resilience
○ Behavioral View—anxiety results from inability to attain one’s goals, and/or is a
learned behavior wherein a person learns to worry from anxious role models (whic
in turn is later reinforced during social interaction). Maladaptive coping can be
learned as well.
○ Biological Basis—genetic factors play a role; implicated neurotransmitters include
gamma aminobutyric acid (GABA). The HPA axis is involved (esp. for PTSD); there
may be neuroanatomical changes as well.
• Ego Defense Mechanisms**
○ Denial
○ Displacement
○ Compensation - balancing out perceived deficiencies (short person working hard a
athletics)
○ Projection
○ Rationalization
○ Intellectualization
○ Minimizing
○ Reaction formation - adopting opposite behavior or emotion
○ Repression
○ Suppression - blocking source of anxiety
○ Disassociation - disruption of consciousness or awareness to compartmentalize
distressing experiences or aspects of oneself
○ Sublimation*
§ See p 283 in Halter
• Continuum of Anxiety: From Functional to Disruptive
○ Anticipation
○ Mild
○ Moderate
○ Severe
○ Panic
• Mild Anxiety
○ Perceptual Field - ability to see or sense what is going on around you
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