In this video I describe the symptoms and prevalence of several disorders in the Anxiety Disorders category of the DSM-5 including specific phobia, social anxiety disorder, panic disorder, agoraphobia, generalized anxiety disorder, and separation anxiety.
Video Transcript
Hi, I’m Michael Corayer and this is Psych Exam Review. In this video we’re going to talk about some disorders that fall into the category of anxiety disorders in the DSM-5. Now it’s worth noting that there are other disorders in other categories that still have anxiety as a symptom but in the case of these anxiety disorders anxiety, panic, or excessive fear is a characteristic symptom.
So we’ll start with specific phobias and in a specific phobia a person has an irrational fear of a specific object or a specific situation. So that object might be something like snakes or that situation, it could be something like being in an enclosed space like an elevator. Now in this specific situation or in the presence of this specific object, the person will have an intense panic reaction. I mean they’ll having elevated heart rate, they’ll be sweating, and they’ll have difficulty breathing. Now it’s important to note that this is an irrational fear and what that means is that there’s no actual threat or danger. So if you’re hiking and you come across a rattlesnake, you might have this intense panic reaction but in that case that would be considered to be a rational fear. Whereas somebody with a specific phobia has an irrational fear because they might have that same intense panic reaction to just seeing an image of a snake, or seeing a snake in a movie, where there’s no real danger present.
And it is more common for us to see specific phobias for things like snakes, spiders, and other insects rather than for things like cats, or puppies , and this relates to what’s called preparedness theory. This suggests that there would be an evolutionary advantage for us to learn certain associations more easily than others. So it makes more sense to have a fear reaction to things that are potentially dangerous like snakes or spiders rather than things that are probably not so dangerous and so we could think of this perhaps explaining why certain types of phobias are more common than others. Now the estimated 12-month prevalence for specific phobias is about 7 – 9% and they’re twice as common in women compared to men. And the prevalence is highest amongst people who are about ages 13 to 16 with an estimated prevalence about 16% and then considerably lower for children, at about 5% or for adults at about 3 to 5%.
Now you might see the use of Greek terms to refer to specific phobias; so maybe you’ve heard of arachnophobia, which would be a fear of spiders, or claustrophobia which would be a fear of enclosed spaces and it’s worth noting that psychiatrists don’t actually use these terms. You can create these terms just by taking the Greek word for whatever these specific phobias are and adding phobia to it but in the diagnosis the person would just receive a diagnosis of a specific phobia. And if you want you can go to phobialist.com where you can find all these different Greek terms and you can find specific phobia terms like coulrophobia or something like fear of clowns. But of course these are not actually found in the DSM-5.
Okay another anxiety disorder we have is social anxiety disorder and this refers to anxiety related to situations that involve the potential for threat of scrutiny or evaluation or the anticipation of those situations. So having to make a speech in public would be a situation where you might feel this threat of evaluation or just a social gathering might carry this threat. And this social anxiety disorder is associated with substance abuse and this is often seen as a means of coping. So somebody drinks alcohol as a means of trying to reduce their anxiety before certain social situations, this could lead them to the abuse of alcohol and so they might get a diagnosis of a substance abuse problem and of social anxiety disorder. The prevalence of social anxiety disorder is about 7% in the US and this is considerably higher than other places. The median prevalence for European countries is around 2.3 percent and the onset age for social anxiety disorder is usually between ages 8 and 15 and in this case we don’t see any real difference between the diagnosis rates for males or females.
Next we have panic disorder and the main characteristic symptom of panic disorder is the occurrence of what are called “panic attacks” and these are sudden episodes of intense fear or terror, these intense panic reactions. But in this case they’re not happening because of a specific trigger like a specific object or a specific situation. They occur unpredictably a person may suddenly have this panic attack, intense fear, and they won’t necessarily know why it’s occurring. And these attacks can occur at fairly regular intervals like maybe once every week or two or they can occur in rapid succession perhaps daily but then with breaks of several months with no panic attacks. The prevalence of panic disorder is about 2 to 3 percent and it’s twice as common in women than men.
Now the next anxiety disorder we have is a specific phobia that has its own diagnostic label and this is agoraphobia and so agora is the Greek term for “marketplace” or “public square” and so you’ll sometimes see this translated as fear of the marketplace or fear of open spaces or something like that, but what it refers to is avoidance of situations where the person feels they’d have difficulty escaping or receiving assistance if they needed it and so that could be something like fields or parking lots or it could be crowded situations like public transport or sports stadium or something like that. And so the person will avoid those situations; they withdraw to places where they feel safe they feel that they could escape or receive assistance if necessary. Now there’s comorbidity here with panic disorder and part of the reason for this is that people might have a panic attack in a public space and as a result they now have anxiety associated with that; they’re worried that they’ll have another panic attack in a situation where will be hard for them to get help and so it’s fairly common to see diagnoses of panic disorder, the person’s having panic attacks, and as a result of these panic attacks they begin to withdraw from certain situations and in extreme cases they may stay in their home or apartment for extended periods of time and feel that they have too much anxiety to go anywhere else. Now the prevalence for agoraphobia is about 1.7 percent and like several other anxiety disorders it’s about twice as common in women compared to men and the onset generally occurs in late adolescence or early adulthood.
All right, next we have generalized anxiety disorder and the previous disorders that we’ve looked at have had these intense episodes of fear or anxiety right whether it’s a panic attack or in the presence of a specific object but in generalized anxiety disorder the anxiety is ever-present and it happens in a broad range of situations. So people feel continuous wary, perhaps they are constantly feeling worried about the health or safety of their family members, or they experience ever-present nervousness maybe at work, and as a result of this constant worry and nervousness they often are irritable. They’ll have difficulty concentrating, they often have a sleep disturbance, and as you’ll see in future videos sleep disturbance is common in a broad range of mental disorders. And they also experience fatigue as a result of being constantly on edge. Now the prevalence of generalized anxiety disorders about 0.9% in adolescents and it’s been higher in adults about 2.9% and generalized anxiety disorder is slightly more common in females than males but not much. But in males it’s more likely to be comorbid with a substance abuse problem. So as we saw people might be self-medicating using something like alcohol in an attempt to reduce their feelings of anxiety, and it seems that males are more likely to do that in females in the case of generalized anxiety disorder.
Okay and lastly we have separation anxiety and so this refers to a persistent and excessive fear when separated from home or from loved ones. Now it is common for there to be temporary anxiety in these situations and this is especially true in infants, so when infants are separated from their mom or their primary caregiver then they often experience anxiety but this usually doesn’t last particularly long and so in the case of separation anxiety this anxiety occurs but it’s considered to be either of an extended duration or what’s called “developmentally inappropriate“. And so this might be children who are past the age where they should have this level of anxiety when separated from their mother and yet they’re still experiencing it. And so if this lasts for 4 weeks in children or 6 months in adults then it might warrant a diagnosis of separation anxiety. And this anxiety leads to impairment of social, academic, or occupational functioning and the estimated prevalence of this separation anxiety is about 4% in infants about 1.6% in adolescents, and 0.9-1.9% in adults.
Okay so those are some examples of anxiety disorders and some details about their symptoms and prevalence. I hope you found this helpful, if so, please like the video and subscribe to the channel for more. Thanks for watching!
