Anxiety Disorder

Ronny T Wirasto
Dept of Psychiatry
Faculty of Medicine-Faculty of
Dentistry
Gadjah Mada University
2012

Hope
Reward

WAKTU Kehidupan Manusia

MANIPULASI/RANGS
ANG

Acetylcholine
Aspartate
Dopamine

SENSO
R
MEMORI

Histamine
RESEPTO
R

Norepinephrine
Epinephrine
Glutamate

PERSEPSI
(Lobus)
DISTRESS/STRE
SS

Balanced
Neurotransmit
er

Disease
Dysfuncti
on

Serotonin
GABA (-Amino
butyrate Acid)
Glycine

Physiologic
al
compensat

Nitric Oxide

 Stressa reaction to a situation, not the

situation itself; not necessarily bad
Inability to cope with environmental
demands in a healthy (wholeness)
way causes the fragmentation and
disruption of our soma (body) and our
thinking (psyche).
This stressful situation makes many
people who experience it, physically ill.
By definition this reaction of stress has
the potential to cause physical harm.

 Stress can be described as a

circumstance that disturbs, or is likely
to disturb, the normal physiological or
psychological functioning of a person
diminish the impact of the stressor
and restore homeostasis
Fight or Flight response is mediated
by hypothalamus, the sympathetic
nervous system, and the adrenal
medulla.

EUSTRESS
Eustress or positive stress occurs
when your level of stress is high
enough to motivate you to move into
action to get things accomplished.

DISTRESS
Distress or negative stress occurs
when your level of stress is either too
high or too low and your body and/or
mind begin to respond negatively to
the stressors.

miR-138-2, miR-148a, and

miR-488 repress (30%
60%) several candidate
genes for panic disorder
BIOL PSYCHIATRY 2011;69:526533
2011 Society of Biological Psychiatry

Psychophysiology
STRESS
NORMAL ANXIETY
ANXIETY DISORDERS

 Stress
A reaction to a situation, not the situation itself
the arousal, both physical and mental, to
situations or events that we perceive as
threatening or challenging

Eustress is positive stress occurs when

your level of stress is high enough to
motivate you to move into action to get
things accomplished
Distress is Distress or negative stress
occurs when your level of stress is either
too high or too low and your body and/or
mind begin to respond negatively to the
stressors

Normal anxiety
Anxiety is normal for the infant who
is threatened by separation from
parents or by loss of love
for the children on their first day in
school,
for adolescents on their first date
for adults when they think about old age
and death
for anyone who is faced with illness

Anxiety Disorder
an inappropriate response to given
stimulus based on its intensity or its
duration
Prolonged Anxiety
Involved :
Physical Responses
Psychological Responses (coping
mechanism)
Social Responses

Etiology Psychophysiopathology
Biology
Psychology
Social-environment

Threatening!!!!

Types Of Anxiety

Generalized Anxiety Disorder

Social Anxiety
Post Traumatic Stress Disorder
Obsessive Compulsive Disorder
Phobic Disorders
Panic Disorder with or without
agoraphobia
Atypical Anxiety Disorder

Diagnostic Criteria for GAD

Motor Tension

Autonomic
Hyperactivity

Vigilance or Scanning

Trembling

Shortness of breath

Feeling keyed up or on
Edge

Muscle tension

Palpitations or
tachycardia

Startling easy

Restlessness

Sweating or cold clammy

hands

Difficulty concentrating

Easily fatigued

Dry mouth

Trouble falling asleep or

staying asleep

Dizziness or
lightheadedness

Irritability

Nausea, diarrhea, or GI
distress
Hot or cold flashes
Frequent urination

PHOBIC DISORDERS
Persistent irrational fear attached to an
object or situation that does not pose a
significant threat
Anticipatory anxiety avoidance of
situation
Agoraphobia
Simple/Specific Phobias
Social Phobias

SPESIFIC PHOBIA

Acrophobia
Agoraphobia
Ailorophobia
Hydrophobia
Claustrophobia
Cynophobia
Myosophobia
Pyrophobia
Xenophobia
Zoophobia

Fear of heights

Fear of
Fear of
Fear of
Fear of
Fear of
Fear of
germs
Fear of
Fear of
Fear of

open places
cats
water
closed spaces
dogs
dirt and
fire
strangers
animals

PANIC ATTACKS
Discrete period of intense apprehension or
terror without any real accompanying danger
accompanied by at least 4 of the following
symptoms:
Palpitations, sweating, trembling, shortness of
breath, feeling of choking, chest pain, abdominal
distress, dizziness, depersonalization, fear of
losing control, fear of dying, paresthesias
(numbness), chills or hot flashes

PANIC DISORDER
Recurrent unexpected panic attacks that cause
presistent
worry
about
recurrences
of
complication from attacks or behavioral
change in response to attack for at least one
month

OBSESSIVE COMPULSIVE DISORDER

(OCD)
Experience of recurrent obsessions or
compulsions that are time consuming or
cause significant distress or impairment
Obsessions
Recurrent intrusive and persistent thoughts,
ideas, images, or impulses

Compulsions
Ritualistic behaviors person is compelled to
perform
Reduce anxiety
Delay to perform ritual results in increasing tension

Nonpsychiatric Clinical Specialists Likely to

See Patients with Obsessive-Compulsive
Disorder

Dermatologist
Family Practitioner
Oncologist, infectious disease internist
Neurosurgeon
Obstetrician
Pediatrician
Pediatric cardiologist

Dentist

Symptoms of OCD
Obsessions
Contamination
Pathological doubt
Somatic
Need for symmetry
Aggressive
Sexual
Multiple obsessions
Other

Compulsions
Checking
Counting
Washing
Need to ask or confess
Symmetry and
precision
Hoarding
Multiple comparisons

POST-TRAUMATIC DISTRESS DISORDER

(PTSD)
Development of characteristic symptoms
after exposure to severe of extraordinary
stressor
Three cardinal features:
Hyperarousal, recurrent nightmares, and
flashbacks

Sign/Symptom :
Denial, re-experience of event, perceptual
distortions, feelings of disorganization when
thinking about the event, memory impairment,
overgeneralization of other sensory inputs,
exaggerated startle reaction, somatic symptoms,
altered states of consciousness, recurrent
nightmares

Selesai

Email

: ronny3w@yahoo.com

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