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Symptoms and syndromes of anxiety

Jeffrey A. Gray and Neil McNaughton

in The Neuropsychology of Anxiety: An enquiry into the function of the septo-hippocampal system

This chapter provides a typology of disorders of fear and anxiety — such as anxiety disorder, phobias including agoraphobia, panic, and social anxiety, post-traumatic stress disorder, and ... More

This chapter provides a typology of disorders of fear and anxiety — such as anxiety disorder, phobias including agoraphobia, panic, and social anxiety, post-traumatic stress disorder, and obsessive-compulsive disorder — mapping them to the two-dimensional framework provided by Chapters 2 and 6. It treats syndromes as resulting from unusual reactivity of structures and symptoms as resulting from unusual activity, with symptoms not providing a good guide to syndromes. Specific tests for some syndromes are derived from the theory.Less

Emotional regulation and affective disorders in children and adolescents with obsessive compulsive disorder

Martine Flament and David Cohen

in Emotional Development:: Recent Research Advances

This chapter examines the psychological, biochemical, and neurological models of obsessive-compulsive disorder (OCD) in children. Typically, children and adolescents with OCD experience multiple ... More

This chapter examines the psychological, biochemical, and neurological models of obsessive-compulsive disorder (OCD) in children. Typically, children and adolescents with OCD experience multiple obsessions and compulsions, whose content may change over time. Generally, compulsions are carried out to dispel anxiety and/or in response to an obsession. This chapter proposes that OCD should be examined using modern neuropsychological and neurophysiological tools to bring better understanding of both normal and abnormal cognitive schemes in OCD subjects, as well as to lead better strategies for more effective psychological treatment.Less

Serotonin in obsessive-compulsive disorder: a causal connection or more monomania about a major monoamine?

Thomas R. Insel

in 5-Hydroxytryptamine in Psychiatry: A Spectrum of Ideas

Serotonin (5-hydroxytryptamine, 5-HT) has been implicated in a number of psychiatric syndromes, but it is obsessive-compulsive disorder (OCD) that currently provides the most compelling evidence of a ... More

Serotonin (5-hydroxytryptamine, 5-HT) has been implicated in a number of psychiatric syndromes, but it is obsessive-compulsive disorder (OCD) that currently provides the most compelling evidence of a connection between serotonin and psychopathology. The precise nature of this connection remains unclear — in spite of strong evidence implicating serotonin in the treatment of OCD, there is a lack of a clear model of serotonergic dysfunction to explain the pathophysiology of this syndrome. This chapter reviews the current literature about serotonin and OCD to examine two questions: do OCD patients have an abnormality in serotonergic neurotransmission and, if so, what is the nature of this abnormality?Less

Mental Illness and Its Limits

Jennifer Radden (ed.)

in The Philosophy of Psychiatry: A Companion

Studies indicate an ongoing “epidemic of psychopathology.” These newly popular pathologies range widely, not just in their incidence but in their presentation: social anxiety disorder, panic ... More

Studies indicate an ongoing “epidemic of psychopathology.” These newly popular pathologies range widely, not just in their incidence but in their presentation: social anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, generalized anxiety disorder, anorexia nervosa, bulimia, and attention deficit hyperactivity, to name a few. A number of new conditions have also emerged alongside these commonly accepted disorders—such as fibromyalgia, chronic fatigue syndrome, and repetitive stress injury—whose very status as mental disorders is hotly disputed. This chapter examines this recent upsurge in mental disorder. It identifies four factors at work: the ascendancy of biomedicine as the dominant way of understanding and explaining psychological distress; the success of biomedicine in treating mental illness; the growth of support and advocacy groups; and the commercial availability of medications.Less

Psychiatric Models

Henry Szechtman and David Eilam

in The Behavior of the Laboratory Rat: A Handbook with Tests

This chapter begins with a discussion of the conflicts associated with a rise of a biological psychiatry perspective on mental illness, suggesting that the current preeminence of this viewpoint has ... More

This chapter begins with a discussion of the conflicts associated with a rise of a biological psychiatry perspective on mental illness, suggesting that the current preeminence of this viewpoint has aligned clinical psychiatry with behavioral neuroscience for the source of much of its basic science knowledge. It then elaborates on the methods of behavioral neuroscience and shows how this methodology is in fact just what is needed to investigate mechanisms of mental disorders of interest to psychiatry. The chapter attempts to clear up some confusion revolving around the distinction between tests, models, and theories. Finally, it illustrates some of the discussed principles by examining a rat model of a psychiatric illness—obsessive-compulsive disorder.Less

The anxiety disorders

Dianna T. Kenny

in The Psychology of Music Performance Anxiety

This chapter examines the construct of anxiety in greater detail and reviews the various diagnoses within the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) of the American ... More

This chapter examines the construct of anxiety in greater detail and reviews the various diagnoses within the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) of the American Psychiatric Association, which included anxiety as a central feature of the disorder. These include generalized anxiety disorder, social phobia/social anxiety disorder, specific phobia, panic disorder, and obsessive-compulsive disorder. It briefly examines the issues related to categorical versus dimensional conceptualizations of mental disorders, and how these disorders are classified, their defining features and their commonalities and differences. It shows that comorbidity, the co-occurrence of two or more disorders, is very common, and that high rates of comorbidity point to the possible artificiality of categorical classifications of psychological disorders. Depression and its various manifestations (e.g., dysthymia and major depression) are common comorbid conditions with the anxiety disorders. The anxiety disorders in the DSM in the context of the characteristics of music performance anxiety are reviewed.Less

Life course epidemiology of anxiety disorders

Renee D. Goodwin, Katja Beesdo-Baum, Susanne Knappe, and Dan J. Stein

in A Life Course Approach to Mental Disorders

Anxiety disorders are considered the most common and earliest occurring mental disorders. They are associated with social, academic, and occupational impairment in childhood, and increased risk of a ... More

Anxiety disorders are considered the most common and earliest occurring mental disorders. They are associated with social, academic, and occupational impairment in childhood, and increased risk of a range of mental health problems throughout development and into adulthood. This chapter examines the prevalence, correlates, risk factors, continuity/outcomes, and treatment of specific phobia, generalized anxiety disorder, panic disorder, separation anxiety disorder, social phobia, and obsessive–compulsive disorder over the life course. Also discussed are the implications of a life course approach on the epidemiology of anxiety disorders for clinical work, public health, and future research.Less

Obsessive-Compulsive Disorder

James C. Raines

in Evidence-Based Practice in School Mental Health: Addressing DSM-5 Disorders in Schools

Obsessive-compulsive disorder (OCD) and related disorders can be debilitating to children and adolescents. Childhood onset of OCD occurs in about 1–3% of all children. When childhood OCD symptoms are ... More

Obsessive-compulsive disorder (OCD) and related disorders can be debilitating to children and adolescents. Childhood onset of OCD occurs in about 1–3% of all children. When childhood OCD symptoms are particularly sudden and/or suddenly more severe, clinicians should investigate if it is precipitated by infectious or immune problems. The most common comorbid diagnoses are anxiety disorders, followed by oppositional defiant disorder. The Child Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) is the gold standard clinician-completed assessment. Intervention can be titrated using a multitiered system of supports framework. Collaborating with teachers, parents, and community providers is essential for these students. A case study is provided to illustrate chapter recommendations.Less

OCD: Now and Forever

in Obsession: A History

Obsessive-compulsive disorder (OCD) was a rare and strange disease before the 1970s. Most estimates now say that 2 to 3 percent of the population will have OCD during their lifetime; that is two or ... More

Obsessive-compulsive disorder (OCD) was a rare and strange disease before the 1970s. Most estimates now say that 2 to 3 percent of the population will have OCD during their lifetime; that is two or three out of a hundred people. Recent attempts to describe an OCD spectrum increase the incidence to one in ten. How did we go from one out of twenty thousand to three out of a hundred to one in ten in less than thirty years? This chapter shows that we must be as scrupulous and suspicious of claims made in the name of science as we are about those made in the name of the arts or the humanities. It seeks to demonstrate the virtues of biocultural criticism and discussion, so that we can consider things like brain scans and chemical analyses to be as subject to an informed discussion as we would consider Moby-Dick or the work of Van Gogh.Less

Selective Memory Effects in Anxiety Disorders: An Overview of Research Findings and their Implications

Colin Macleod and Andrew Mathews

in Memory and Emotion

This chapter examines how memory might be influenced by a variety of emotional states and conditions experienced by people with anxiety disorders. It ... More

This chapter examines how memory might be influenced by a variety of emotional states and conditions experienced by people with anxiety disorders. It reviews research performed with people who describe themselves as generally anxious (without formal diagnosis), as well as with people who have been diagnosed as experiencing generalized anxiety disorder, post-traumatic stress disorder, phobias, obsessive-compulsive disorder, and panic disorder. In the context of research on “mood congruent” memory, one might expect that these individuals will better remember stimuli that “fit” with their anxious thoughts and beliefs. In some cases, anxious people do show evidence of anxiety-related memory bias, but these probably result from special instances of emotional interpretation of events with ambiguous meaning. Under conditions less prone to interpretive ambiguity, anxious people tend not to remember in emotionally special ways.Less

Diverse Diagnoses And Special Populations

Harriet P. Lefley

in Family Psychoeducation for Serious Mental Illness

This chapter presents FPE models and research findings for various conditions, beginning with mental illness and substance abuse. Mueser and Fox's Family Intervention for Dual Disorders (FIDD) ... More

This chapter presents FPE models and research findings for various conditions, beginning with mental illness and substance abuse. Mueser and Fox's Family Intervention for Dual Disorders (FIDD) includes both single and multi-family formats. Programs for obsessive-compulsive disorder, borderline personality disorder, easting disorders, and brain and spinal cord injury are presented. Family psychoeducation (FPE) for specialized groups or different family members include families of veterans, spouses, young parents with mental illness and their children, and elderly caregivers. Research findings on the concerns of older parents, and the role of siblings in subsequent caregiving, are presented and discussed.Less

Stimulating Brains, Altering Minds

Walter Glannon

in Brain, Body, and Mind: Neuroethics with a Human Face

This chapter considers the use of deep-brain stimulation as a treatment for neurological and psychiatric disorders. It addresses the question of whether a person with a disease of the mind can ... More

This chapter considers the use of deep-brain stimulation as a treatment for neurological and psychiatric disorders. It addresses the question of whether a person with a disease of the mind can consent to stimulation of the brain, and how patients and medical teams weigh the potential benefits and risks of the treatment. It also describes some of the trade-offs between physical and psychological effects of stimulation. The medical and moral justification of this technique depends not only on whether it corrects brain dysfunction but also on how it affects all the psychological properties of the person.Less

Decision-making mechanisms

Edmund T. Rolls

in Emotion and Decision-making Explained

The brain mechanisms involved in reward-related and other decision–making in the brain are described. The attractor network mechanism described has randomness or noise that makes the decision-making ... More

The brain mechanisms involved in reward-related and other decision–making in the brain are described. The attractor network mechanism described has randomness or noise that makes the decision-making probabilistic. The same stochastic dynamics model provides a unifying account too of long-term and short–term memory. Many advantages of this probabilistic mechanism of decision-making and memory operation are described, as are disorders of such systems including neuropsychiatric disorders such as schizophrenia and obsessive–compulsive disorder.Less

Obsessive-Compulsive Disorder and Moral Agency

Timothy Schroeder

in Oxford Studies in Agency and Responsibility: Volume 3

Neo-Humeans hold that to act for a reason, to act in a way for which one might be morally responsible, praiseworthy, or blameworthy, is to act on a desire. One familiar objection is that this commits ... More

Neo-Humeans hold that to act for a reason, to act in a way for which one might be morally responsible, praiseworthy, or blameworthy, is to act on a desire. One familiar objection is that this commits the neo-Humean to holding that acting on a compulsion is acting on a desire, and so acting in a way for which one might be responsible, though this seems the wrong conclusion to draw. People with the sort of obsessive-compulsive disorder in which their obsessions and compulsions center around moral scrupulosity present what appears to be a particularly pressing version of this objection. This chapter considers the options available to the neo-Humean hoping to avoid this potential counterexample.Less

Borderline, schizotypal, avoidant, obsessive–compulsive, and other personality disorders

Andrew E. Skodol

in A Life Course Approach to Mental Disorders

Personality disorders (PDs) have traditionally been conceptualized as enduring and stable, despite many early follow-up studies that showed that 〈50% of patients with PDs retained these diagnoses ... More

Personality disorders (PDs) have traditionally been conceptualized as enduring and stable, despite many early follow-up studies that showed that 〈50% of patients with PDs retained these diagnoses over time. Because of the methodological limitations of these studies, a new generation of rigorous follow-along studies was spawned. The results of three such studies, the Collaborative Longitudinal Personality Disorders Study, The McLean Study of Adult Development, and The Children in the Community Study are reviewed here. By contrast with the traditional view of PDs as stable forms of psychopathology, these methodologically rigorous longitudinal studies, in both clinical and epidemiological populations, indicate that patients with PDs improve over time and have a clinical course that is likely more waxing and waning than chronic. Results on the course of functional impairment in PDs suggest that impairment is more stable than personality psychopathology itself, but that when PD improves, improvement in functioning follows.Less

Obsession in Our Time

in Obsession: A History

This introductory chapter begins with a discussion of the concept of obsession. It then sets out the book's purpose, which is to show us how it is that obsession now defines our culture. There was a ... More

This introductory chapter begins with a discussion of the concept of obsession. It then sets out the book's purpose, which is to show us how it is that obsession now defines our culture. There was a moment in the Western world when obsession became itself something so problematic that people began to write about it, study it, turn it into a medical problem, and then try to cure it. That defining moment, beginning in the middle of the eighteenth century in England and France, is worth looking at. Before that divide, some people were seen either as eccentrics, or in a more religious mode as “possessed.” After that time, the age of obsession begins as a secular, medical phenomenon. The chapter discusses the clinical definition of obsession, the problem of obsession, biocultural view of obsession, obsession as a modern consciousness, the content of obsessions and compulsive activities, the methodological problem in this book, and obsession viewed through technology.Less

Common Mental Disorders

R. Raguram

in Psychology: Volume 4: Themes in Contemporary Mental Health Research

This chapter focuses on common mental disorders (CMDs). These disorders include a wide range of conditions that are frequently noticed in the community. It is essentially a convenient, functional ... More

This chapter focuses on common mental disorders (CMDs). These disorders include a wide range of conditions that are frequently noticed in the community. It is essentially a convenient, functional grouping of conditions. The chapter analyses the trends on the basis of researches in this area over the past decade. The classification of CMDs for primary health care, according to ICD-10, includes depression, phobic disorder, panic disorder, generalized anxiety, mixed anxiety and depression, adjustment disorder, dissociative disorder, and somatoform disorders. Irrespective of the nature of the disorder, these patients often present with somatic complaints: some patients may admit to having emotional symptoms. It was observed that there is a high degree of co-morbidity among them, leading to significant levels of disability and increased health-care costs.Less