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BRIEF DESCRIPTION OF THE ANXIETY DISORDERS
All descriptions are based on the diagnostic criterias of the DSM-IV (APA, 2000):
PANIC DISORDER WITH OR WITHOUT AGORAPHOBIA:

Panic disorder is caracterized by the presence of unexecpected panic attack. A panic attack is an experience occurring during a well delimited period of time, marked by sudden occurrence of intense apprehension and a fear or terror often associated with feelings of imminent catastrophe. During these attacks, which generally reach their peak intensity over the course of 10 minutes, an individual may experience one or more of the following symptoms:

  • palpitations, chest pain, tremors, perspiration, etc;
  • feelings of unreality, fear of dying, of becoming insane or losing control.

Panic disorder with agoraphobia, on the other hand, can be characterized by the simultaneous co-occurrence of unexpected panic attacks and agoraphobia. Agoraphobia is related to the avoidance of places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having a panic attack.

It should be noted that a diagnosis of panic disorder requires that the individual experienced a minimum of four panic attacks occurring in the past month.

Agoraphobia without panic disorder can be defined by the presence of agoraphobia and panic-like symptoms without a having a prior history of unexpected panic attacks.

SPECIFIC PHOBIA:

Specific phobia is characterized by the presence of a clinically significant level of anxiety, provoked by an exposure to an object or to a specific dreaded situation, often leading to avoidance behaviors. The importance of accurately distinguishing the fear reaction from the phobic symptoms is often mentioned in case studies of phobic disorder.

Exposure to the feared stimulus causes an immediate quasi-systematic anxious reaction that can take the form of panic attacks independent or facilitated by the situation. The phobias are generally grouped within five class-types:

a) animal phobias (dogs, insects, mice, etc.)
b) nature-related or environmental phobias (storms, height, water, etc.)
c) blood-related phobias e.g. injection, accident (wounds, punctures, vaccinations etc.)
d) situation-related phobias (public transportation, tunnel, airplane etc.)
e) other phobias (fear of suffocation, fear of vomiting, etc.)

Specific Phobia vs. Normal Fear:

Fear is a normal human response; children experience certain non-pathological fears during the course of their development. According to Andre (1999) children under one year of age normally experience a fear of strong noises, strangers and suddenly appearing objects. Until the age of four, the fears most commonly experiences are those related to animals, the dark, nighttime noises and fear of being separated from their parents. From five years of age and onward, typical fears experienced by children are those related to physical wounds, thunder and “malicious people”, etc. From a developmental point of view, childhood fears appear to follow an age related sequence. Indeed, when very young, children fear for their survival; towards 5-6 years of age, they fear for their integrity. Although the possibility of a fear developing into a phobia always exists, childhood fears generally disappear by the age of 8-9.

An empirical study carried out by Öst (1987) demonstrated that the development of certain types of clinically significant phobias come into play according to age specific categories. For example, animal phobias begin around age 7, blood phobias around age 9 and the dental phobia around age 12.

Towards age 6-7, as the child’s development progresses, “normal” childhood fears tend to disappear as a result of psychological maturation and an increasing appreciation of their exaggerated nature. Children are considered phobic if they present with symptoms mentioned above before the age indicated, for the duration of at least six months and if their fear significantly affects their daily functioning (school performance, relations with parents and peers, etc.).

References:

  • André, C. (1999). Les phobies. Paris: Dominos Flammarion.
  • Öst (1987). Age of onset in different phobias. Journal of Abnormal Psychology, 96(3), 233-229.

Symptoms of anxiety related to the phobic reaction:

Following exposure to a fear stimulus, a panic attack provokes in the phobic individual a number of anxiety-related symptoms. These include cardiac palpitations, perspiration, trembling, a sensation of choking, nausea, thoracic pain, hot flashes, etc. The panic attack may also cause the individual to develop false beliefs linked to the fear of losing control, of dying, of making a social infraction or of fainting. The person will consequently tend to increasingly avoid situations that can provoke an anxious reaction. Among children, the anxiety often manifests differently compared with adults: crying, excessive anger, becoming immobile or clingy.

SOCIAL PHOBIA:
The central element of social phobia is the presence of a marked fear of social situations or of situations in which the individual's performance is evaluated. When confronted with these situations, the individual may feel the fear or being judged negatively, of being ridiculed etc. In addition, exposure to feared social situations involves a strong reaction of anxiety, which pushes the person to avoid these situations altogether or to experience a deep feeling of discomfort when in such situations.
 
OBSESSIVE-COMPULSIVE DISORDER:
The main element associated with obsessive-compulsive disorder is the presence of reoccurring obsessions and/or compulsions. The obsessions are characterized by thoughts, images, or impulses (e.g. being contaminated by microbes) that are perceived by the individual as being intrusive in their thought process and that prove contradictory to their values. As for compulsions, they are characterized by repetitive behaviours or mental acts, which the person generally performs to decrease the anxiety associated with the compulsion or to make it disappear (e.g. repetitive hand washing).
POST-TRAUMATIC STRESS DISORDER:

Post-traumatic stress occurs following a traumatic event (after 4 weeks), during which an individual experienced intense fear, horror, or a feeling of profound powerlessness. The traumatising event is then relived sporadically in the form of obsessive thoughts, repetitive nightmares, intrusive memories etc. Moreover, to decrease the anxiety associated with this event, the individual avoids any stimulus directly related to the trauma, or any event or situation that may provoke memories of the traumatic event. The post-traumatic state of stress is accompanied by persistent symptoms of neurovegetative hyperactivity (e.g. sleep related problems, irritability or excess anger, exaggerated startle reflex).

The state of acute stress is characterized by symptoms similar to those of post-traumatic stress but ones that occur during the time period immediately following the trauma (minimum 2 days and maximum 4 weeks).

GENERAL ANXIETY DISORDER:

Generalized anxiety disorder is characterized by a period of at least six months of anxiety and persistent and excessive concern, regarding a certain number of events or activities (e.g. family, work). An individual who suffers from this disorder has difficulty managing their anxiety and may cognitively ruminate over possible negative scenarios.

The anxiety and the nervousness must be accompanied by at least three of the six following symptoms: agitation, fatigue, disturbed memory, irritability, sleep disorder, muscular tension. Moreover, the individual may present with hyper vigilance as well as increased sensitivity to environmental stressors.