Anxiety Disorders

Recent epidemiological research has shown that anxiety disorders, collectively, are the most common set of psychiatric disorders. Lifetime prevalence estimates suggest that nearly 30 percent of the population will experience an anxiety disorder at some point in their life (Kessler, et al. 2005, cited under Phobias). Bolstering the concern, anxiety disorders (as a group) tend to be associated with a host of cognitive impairments (e.g., perseveration, visual memory deficits), diminished quality of life (e.g., in areas of work and social functioning), and both psychiatric and medical comorbidities. Anxiety disorders may be roughly classed into two groups: (1) those characterized primarily by acute fear (e.g., phobias) and (2) those associated with lower level, but chronic, anxiety and apprehension (with the clearest example being generalized anxiety disorder). Cognitive and behavioral explanations of anxiety predominate, with related treatments showing most consistent research support among psychosocial interventions. (While standard pharmacological practices are mentioned wherever relevant, a more in-depth discussion of pharmacological interventions for anxiety disorders is outside the scope of this chapter.) In general, the etiology of anxiety disorders is likely best understood through the lens of the diathesis-stress model—such that individuals have a genetic predisposition/vulnerability and situational factors mediate symptomatology. (Certainly, a sudden expression of symptoms following brain damage would be an exception. However, as these presentations—albeit fascinating—are in the minority, a related discussion will be beyond the scope of this bibliography.) Within this article, the following anxiety disorders will be discussed in detail: phobias, panic with and without agoraphobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder. Factors of current interest in the field will be attended to specifically—for instance, comorbidity in obsessive-compulsive disorder and differential risk in posttraumatic stress disorder. Throughout the discussion, pertinent works will be delineated and summarized.