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Samenvatting - Anxiety and Related Disorders (GGZ2024)
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Anxiety and Related Disorders (2324-GGZ2024)
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,Task 1: Anxiety and hyperventilation
Anxiety
Which anxiety disorders are there? (DSM criteria)
Type 1 worry = specific internal and external events
● For example, worrying about a partner involved in an accident, about one's own
competence at work, about one's own physical health
● "If I don't perform well enough, I'll probably get fired from work."
Type 2 worry / meta-worry = worrying about worries
● Concerned with the thoughts themselves and revolves around themes of the
uncontrollability of worries and their psychological and physical consequences.
● For example, worrying leads to mental breakdown, will cause physical harm.
● "If I don't stop worrying now, I'll go crazy."
● Type 2 worry can only coexist with negative meta-beliefs and not with positive meta-
beliefs.
,General anxiety disorder
Criteria DSM
A. Excessive anxiety and worry (apprehensive expectation), present more often than not for at
least six months, and concerning a number of events or activities (such as work or school
performance).
B. The individual finds it difficult to control the worry.
C. The anxiety and worry are accompanied by three (or more) of the following six symptoms:
● Restlessness; feeling keyed up or on edge
● Being easily fatigued
● Difficulty concentrating or mind going blank
● Irritability
● Muscle tension
● Sleep disturbance (difficulty falling or staying asleep, or restless sleep with feeling
unrested)
NB. In children, only one of these is required.
D. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in
social, occupational, or other important areas of functioning.
E. The disturbance is not attributable to the physiological effects of a substance or another
medical condition.
F. The disturbance is not better explained by another mental disorder.
Chronic → always fight of flight, raised heartbeat and parasympathetic system is working less
Autonomic inflexibility?
, Social anxiety
Social anxiety disorder = also known as social phobia, involves an intense fear of social
situations and scrutiny by others. Individuals with SAD may fear judgment, embarrassment, or
humiliation in social settings, leading to avoidance of social interactions or significant distress
when facing such situations.
Criteria DSM:
A. Clear fear or apprehension about one or more social situations in which the individual is
exposed to possible scrutiny by others (e.g., social interactions, being observed, performing in
front of others).
NB. In children, the fear must occur in the company of peers and not only during interactions
with adults.
B. The individual fears that they will behave or display anxiety symptoms to such an extent that
others will negatively judge them (because it will lead to rejection or offend others, because it is
humiliating).
C. The social situations almost always provoke fear or apprehension.
D. The social situations are either avoided or endured with intense fear or apprehension.
E. The fear or apprehension is disproportionate to the actual danger posed by the social
situation.
F. The fear, apprehension, or avoidance is persistent and typically lasts for six months or longer
(with some flexibility).
G. The fear, apprehension, or avoidance causes clinically significant distress or impairment in
social, occupational, or other important areas of functioning.
H. The fear, apprehension, or avoidance cannot be attributed to the physiological effects of a
substance or a medical condition.
I. The fear, apprehension, or avoidance cannot be better explained by the symptoms of another
mental disorder.
J. If there is a medical condition or somatic symptom disorder present, the fear or avoidance is
clearly not related to it or is excessive (e.g., obesity, disfigurement from burns, etc.).
Panic
There is anxiety for unexpected worry and panic. They are afraid of getting another panic attack.
Panic = a discrete period of intense fear or discomfort that reaches a peak within minutes and is
accompanied by 4 or more somatic and cognitive symptoms. It results in intense fear and
distress.
- At least 2 panic attacks to get the diagnosis PD.
- It’s often related to Agoraphobia (AG): because they are afraid of panic attacks they
often avoid places.
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