Fear
Definition, Symptoms, Diagnosis, Course, Outcome, and Frequency
Fear is an emotional reaction to actual, immediate danger that intensifies fast and controls a person’s actions to face or avoid the situation. Some symptoms include a “fight or flight” response, rapid breathing, a spike in pulse rate, and dry mouth (Oltmanns & Emery, 2019). Usually, fear is a fleeting reaction to a perceived threat that goes away as the threat is eliminated.
Fear is a normal and adaptive reaction rather than a pathology, so there are no set diagnostic standards for it. Nevertheless, when fear is overwhelming or provoked in the wrong situations, as in the case of many anxiety disorders, it needs to be treated clinically (Oltmanns & Emery, 2019). The frequency of fear in the general population is hard to gauge, as it is a universal emotion.
Causes
It is believed that fear and anxiety are emotional reaction mechanisms that have evolved to help with survival. For example, healthy individuals’ emotional reactions to fear have frequently been seen in high-risk contexts, such as World War II combat scenarios (Oltmanns & Emery, 2019). Research on animal fear conditioning has revealed brain circuits that recognize threats and plan a reaction. These circuits constitute the biological basis of the evolved fear module, with the amygdala at its center.
Gender Differences and Treatment
There do not seem to be any gender differences in how fear is expressed or experienced. Treatment options for fear include exposure and systematic desensitization when it becomes maladaptive. Relaxation techniques and a methodical approach to facing and controlling fear-inducing stimuli help patients gradually lessen their fear response (Oltmanns & Emery, 2019). Treatment is individualized based on the patient, considering the biological and psychological mechanisms that underlie fear reactions.
Worry
Definition, Symptoms, Diagnosis, Course, Outcome, and Frequency
Worry, which is characterized as an uncontrollable series of negative, emotional thoughts about possible threats in the future, is a cognitive activity closely linked to anxiety. These thoughts are frequently self-initiated or brought on by persistent problems in life. Instead of conjuring up unsettling pictures in their minds, obsessive worriers usually have an ongoing internal conversation (Oltmanns & Emery, 2019). As a symptom, excessive worry is often identified as a characteristic of generalized anxiety disorder (GAD) (Oltmanns & Emery, 2019).
The diagnostic standards for worry as a separate condition are thus typically not defined. For similar reasons, the course and consequences unique to worry are typically examined together with the effects of anxiety disorders, such as diminished quality of life and impairment in social and professional spheres (Oltmanns & Emery, 2019). The frequency of worry is also challenging to measure because it is mainly addressed as a part of GAD rather than a distinct condition.
Causes
The emotional and cognitive reactions to possible threats in the future are the primary sources of worry. Biased information processing and attention to threat have been found in psychological research to be key cognitive processes in the emergence of worry (Oltmanns & Emery, 2019). The very nature of anxious thoughts can also be a source of concern. This “self-talk,” or internal conversation, is frequently negative and centered on potential tragedies in the future (Oltmanns & Emery, 2019).
The verbal nature of these thoughts makes them invasive and persistent, which makes it challenging for the person to stop worrying. People who have gone through a lot of stress or hardship could be more prone to developing threat schemas, which are mental models that emphasize possible risks and unfavorable consequences (Oltmanns & Emery, 2019). Stress or environmental cues that remind one of previous traumas quickly activate these schemas, causing worry to increase.
Gender Differences and Treatment
It is unclear if gender differences exist in how worry is experienced or expressed. The treatment of GAD and other anxiety disorders is closely related to the treatment of worry; this includes the use of medications and relaxation techniques (Oltmanns & Emery, 2019). However, it could be helpful to comprehend and treat the cognitive mechanisms that underlie worry, such as attention to threat and biased information processing.
Panic/Anxiety Attacks
Definition, Symptoms, and Diagnosis
An intense burst of terror, a panic attack, usually peaks within minutes of starting and happens suddenly. Sometimes, panic is described as a “false alarm” that goes off at the wrong time (Oltmanns & Emery, 2019). A complete panic attack typically peaks in ten minutes or less and is characterized by the presence of four or more of the thirteen distinct symptoms (Oltmanns & Emery, 2019):
- heart palpitations, thumping, or elevated heart rate;
- perspiring;
- shivering or trembling;
- breathing difficulties or a feeling of being smothered;
- a choking sensation;
- soreness or pain in the chest;
- distress in the abdomen or nausea;
- experiencing lightheadedness, vertigo, or faintness;
- the feeling of warmth or cold;
- paresthesias, or the feeling of tingling or numbness;
- depersonalization, or feeling removed from oneself, or derealization, or sensations of unreality;
- the fear of “going crazy” or losing control;
- a fear of expiring.
Cognitive symptoms like “going insane” or losing control have also been reported. Although some people experience panic attacks without warning, others can predict their panic attacks based on a specific stimulus or trigger.
Course, Outcome, and Frequency
Regarding the course, though the disorders linked to panic attacks persist for many years, the frequency and severity of panic attacks tend to decrease with middle age. However, associated avoidance behaviors usually endure over time; poorer outcomes are associated with earlier onset age and insufficient treatment (Oltmanns & Emery, 2019). Over time, the symptoms may shift, with physical complaints replacing earlier worries; the frequency of panic attacks is unknown.
Causes, Gender Differences, and Treatment
Anxiety disorders can arise as a result of stressful life events; gender differences in this relationship are unknown. Cognitive factors such as misinterpreting bodily sensations and feeling helpless can also lead to these disorders (Oltmanns & Emery, 2019). Specific neural pathways, such as those in the amygdala, which are teachable through classical conditioning, are responsible for fear reactions. One type of treatment for panic attacks is called interoceptive exposure, in which patients confront the physical sensations associated with panic attacks through a range of exercises (Oltmanns & Emery, 2019). These exercises could involve spinning around in a chair or breathing through a straw to elicit the feared sensations.
Specific Phobias
Definition, Symptoms, Diagnosis, Course, and Outcome
An intense fear of a specific circumstance or object characterizes specific phobias. These reactions are excessive, given the item’s or situation’s actual threat. Phobic names have historically come from Greek words associated with the feared object.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has criteria for diagnosing specific phobias. In particular, a diagnosis is made when there is an intense fear connected to a specific situation that regularly generates anxiety and leads to avoidance or extreme distress (Oltmanns & Emery, 2019). The condition must be a chronic illness that interferes with the person’s day-to-day functioning and lasts six months or more. Specific phobias can hinder a person’s functioning; the course of phobias lasts for years or even a lifetime if they are not treated.
Frequency, Causes, Gender Differences, and Treatment
One of the most common types of anxiety disorders is specific phobias. The National Comorbidity Survey Replication revealed that 9% of adult Americans had a one-year prevalence (Oltmanns & Emery, 2019, p. 150). Regarding causes, in addition to having a hereditary component, specific phobias can also be learned through classical conditioning (Oltmanns & Emery, 2019). Women are three times more likely than men to experience specific phobias, making it a much more common condition for them (Oltmanns & Emery, 2019).
Behavioral therapies—systematic desensitization and exposure therapy, in particular—are effective for treating some phobias. By introducing the feared object or situation gradually and under supervision, these treatments seek to reduce the fear response (Oltmanns & Emery, 2019). The advantages of cognitive therapy have also been established; changes in cognitive processing often accompany symptom improvements (Oltmanns & Emery, 2019). In addition, pharmacological treatments are also employed for specific phobias.
Social Phobia
Definition, Symptoms, and Diagnosis
Social phobia also referred to as social anxiety disorder, is represented by an emphatic fear of being evaluated by others in social circumstances. It involves bypassing situations where one might be scrutinized or asked to perform, per the DSM-5 (Oltmanns & Emery, 2019). These symptoms can be physical and emotional; examples comprise shaking, perspiring, or pounding in the heart.
The degree of anxiety must be out of proportion to the actual threat that the social setting suggests for social phobia to be diagnosed. The anxiety or avoidance behaviors must be persistent, usually for six months or more (Oltmanns & Emery, 2019). A person might go to great lengths to evade social situations.
Course, Outcome, Frequency, Causes, and Gender Differences
Social phobia makes it exceedingly problematic to engage in day-to-day social or professional activities and causes tremendous anguish if left untreated. After a year of occurrence, the prevalence of social phobia in adults is approximately 7% (Oltmanns & Emery, 2019, p. 150). Social phobia may stem from various facets, such as inherited characteristics, learned behaviors brought on by conditioning, or even evolutionary processes. It is more common for women than for men to suffer from social phobia (Oltmanns & Emery, 2019). Although the frequency of social phobia varies with gender, it is less pronounced than in other phobias.
Treatment
Social phobia and anxiety have been successfully treated with cognitive therapy. It often implies cognitive restructuring to manage maladaptive thought patterns and controlled exposure to feared social situations. Therapy is essential for managing the illness because manifestation improvements usually coincide with cognitive processing changes (Oltmanns & Emery, 2019). In general clinical practice, selective serotonin reuptake inhibitors, or SSRIs, are widely used to treat social phobia.
Agoraphobia
Definition, Symptoms, and Diagnosis
An anxiety disorder known as “agoraphobia” is distinguished by an illogical apprehension of circumstances from which escape may be intricate. The name of the phobia means “fear of the marketplace” in Greek (Oltmanns & Emery, 2019). A pattern of unease associated with being in unstable circumstances, the main symptom of agoraphobia is the fear of being by oneself in open or enclosed areas. This symptom can make someone reliant on a companion for reassurance during frightening conditions. A formal diagnosis can only be supplied if the avoidance or anxiety is so unbearable that it impedes functioning, lasts for at least six months, and is disproportionate to the actual threat.
Course, Outcome, Frequency, Causes, Gender Differences, and Treatment
Agoraphobia usually results from pre-existing panic disorders and is uncommon in older adults. If untreated, people living with agoraphobia may avoid positions that make them feel tense for a protracted period. This could lead to a debilitating lifestyle where avoidance is the main focus. Agoraphobia is estimated to concern 1% of the population by the National Comorbidity Survey Replication (Oltmanns & Emery, 2019, p. 150). The cause might be a blend of genetic propensities and environmental stimuli.
Traumatic events in the past, specifically those involving panic attacks in situations where escape was challenging, can give rise to agoraphobia. There is a distinct gender discrepancy in the prevalence of agoraphobia, with women being twice as likely as men to encounter the disorder (Oltmanns & Emery, 2019). One treatment choice for agoraphobia is cognitive therapy, which has been shown to have clinically consequential benefits. Given the elevated rates of relapse that happen when intake is interrupted, exposure therapy is an effective treatment alternative in addition to medicines (Oltmanns & Emery, 2019). Systematic desensitization, in which patients are slowly exposed to stimuli that make them feel more anxious, is another compelling phobia treatment technique.
Reference
Oltmanns, T. F. & Emery, R. E. (2019). Abnormal psychology(9th ed.). Pearson.