Psychological Disorders

Anxiety is a common and normal occurrence. However, a chronic, high level of anxiety indicates an anxiety disorder.

Common Anxiety Disorders

Some of the more common anxiety disorders include:

• Generalized Anxiety Disorder: A person with generalized anxiety disorder experiences persistent and excessive anxiety or worry that lasts at least six months.
• Specific Phobia: A person who has specific phobia experiences intense anxiety when exposed to a particular object or situation. The person often avoids the feared object or situation because of a desire to escape the anxiety associated with it.
• Social Phobia: A person who has social phobia experiences intense anxiety when exposed to certain kinds of social or performance situations. As a result, the person often avoids these types of situations.
• Panic Disorder and Agoraphobia: A person with panic disorder experiences recurrent, unexpected panic attacks, which cause worry or anxiety. During a panic attack, a person has symptoms such as heart palpitations, sweating, trembling, dizziness, chest pain, and fear of losing control, going crazy, or dying. Panic disorder can occur with or without agoraphobia. Agoraphobia involves anxiety about losing control in public places, being in situations from which escape would be difficult or embarrassing, or being in places where there might be no one to help if a panic attack occurred.
• Obsessive-compulsive Disorder: A person with obsessive-compulsive disorder experiences obsessions, compulsions, or both. Obsessions are ideas, thoughts, impulses, or images that are persistent and cause anxiety or distress. A person usually feels that the obsessions are inappropriate but uncontrollable. Compulsions are repetitive behaviors that help to prevent or relieve anxiety.
• Post–traumatic Stress Disorder (PTSD): A person with this disorder persistently re-experiences a highly traumatic event and avoids stimuli associated with the trauma. Symptoms include increased arousal such as insomnia, irritability, difficulty concentrating, hypervigilance, or exaggerated startle response.

Roots of Anxiety Disorders

Many different interactive factors influence the development of anxiety disorders.

Biological Factors

Many biological factors can contribute to the onset of anxiety disorders:

• Genetic predisposition: Twin studies suggest that there may be genetic predispositions to anxiety disorders. Researchers typically use concordance rates to describe the likelihood that a disorder might be inherited. A concordance rate indicates the percentage of twin pairs who share a particular disorder. Research has shown that identical twins have a higher concordance rate for anxiety disorders than fraternal twins.
• Differing sensitivity: Some research suggests that people differ in sensitivity to anxiety. People who are highly sensitive to the physiological symptoms of anxiety react with even more anxiety to these symptoms, which sets off a worsening spiral of anxiety that can result in an anxiety disorder.
• Neurotransmitters: Researchers believe there is a link between anxiety disorders and disturbances in neural circuits that use the neurotransmitters GABA and serotonin. GABA limits nerve cell activity in the part of the brain associated with anxiety. People who do not produce enough GABA or whose brains do not process it normally may feel increased anxiety. Inefficient processing of serotonin may also contribute to anxiety.
• Brain damage: Some researchers have suggested that damage to the hippocampus can contribute to PTSD symptoms.

Conditioning and Learning

Research shows that conditioning and learning also play a role in anxiety disorders:

• Classical conditioning: People can acquire anxiety responses, especially phobias, through classical conditioning and then maintain them through operant conditioning. A neutral stimulus becomes associated with anxiety by being paired with an anxiety-producing stimulus. After this classical conditioning process has occurred, a person may begin to avoid the conditioned anxiety-producing stimulus. This leads to a decrease in anxiety, which reinforces the avoidance through an operant conditioning process. For example, a near drowning experience might produce a phobia of water. Avoiding oceans, pools, and ponds decreases anxiety about water and reinforces the behavior of avoidance.
• Evolutionary predisposition: Researchers such as Martin Seligman have proposed that people may be more likely to develop conditioned fears to certain objects and situations. According to this view, evolutionary history biologically prepares people to develop phobias about ancient dangers, such as snakes and heights.
• Observational learning: People also may develop phobias through observational learning. For example, children may learn to be afraid of certain objects or situations by observing their parents’ behavior in the face of those objects or situations.

Cognitive Factors

Some researchers have suggested that people with certain styles of thinking are more susceptible to anxiety disorders than others. Such people have increased susceptibility for several reasons:

• They tend to see threats in harmless situations.
• They focus too much attention on situations that they perceive to be threatening.
• They tend to recall threatening information better than nonthreatening information.

Personality Traits

The personality trait of neuroticism is associated with a higher likelihood of having an anxiety disorder.