Hockenbury Discovering Psychology 5th txtbk

538 CHAPTER 13 Psychological Disordersrange of life circumstances, sometimes with little or no apparent justification(Craske & Waters, 2005; Sanfelippo, 2006). The more issues about which a personworries excessively, the more likely it is that he or she suffers from generalizedanxiety disorder (DSM-IV-TR, 2000).Normally, anxiety quickly dissipates when a threatening situation is resolved. Ingeneralized anxiety disorder, however, when one source of worry is removed, anotherquickly moves in to take its place. The anxiety can be attached to virtually anyobject or to none at all. Because of this, generalized anxiety disorder is sometimesreferred to as free-floating anxiety.Explaining Generalized Anxiety DisorderWhat causes generalized anxiety disorder? As is true with most psychological disorders,environmental, psychological, and genetic as well as other biological factors areprobably involved in GAD (Allen & others, 2008; Heimburg & others, 2004). Forexample, a brain that is “wired” for anxiety can give a person a head start towarddeveloping GAD in later life, but problematic relationships and stressful experiencescan make the possibility more likely. Signs of problematic anxiety can be evidentfrom a very early age, such as in the example of a child with a very shy temperamentwho consistently feels overwhelming anxiety in new situations or when separatedfrom his parents. Often, but not always, such individuals grow to become adultswith anxiety disorders such as GAD (Weems & Silverman, 2008).Jeff Tweedy and Panic Disorder Founder ofthe alternative rock band Wilco, JeffTweedy has suffered from severe panic attacksfor years. Tweedy (2008) explains thevicious cycle that underlies panic disorder:“You’ll have an actual panic attack and forweeks or months after that you’ll have afear of a panic attack that can heightenyour anxiety and heighten your stress levelsto the point where you end up havinganother panic attack.” After psychologicaltreatment, Tweedy is now better able tomanage his symptoms of panic disorder.Panic Attacks and Panic DisordersSudden Episodes of Extreme AnxietyGeneralized anxiety disorder is like the dull ache of a sore tooth—a constant, ongoingsense of uneasiness, distress, and apprehension. In contrast, a panic attack is asudden episode of extreme anxiety that rapidly escalates in intensity. The most commonsymptoms of a panic attack are a pounding heart, rapid breathing, breathlessness,and a choking sensation. The person may also sweat, tremble, and experiencelight-headedness, chills, or hot flashes. Accompanying the intense, escalating surgeof physical arousal are feelings of terror and the belief that one is about to die, gocrazy, or completely lose control. A panic attack typically peaks within 10 minutesof onset and then gradually subsides. Nevertheless, the physical symptoms of a panicattack are so severe and frightening that it’s not unusual for people to rush to anemergency room, convinced they are having a heart attack, stroke, or seizure (Beidel& Stipelman, 2007; Craske & Barlow, 2008).Sometimes the first panic attack occurs after a stressful experience, such as an injuryor illness, or during a stressful period of life, such as while changing jobs or during aperiod of marital conflict (Watanabe & others, 2005). In other cases, however, the firstpanic attack seems to come from nowhere. In a survey of panic disorder patients, 40percent could not identify any stressful event or negative life experience that mighthave precipitated the initial panic attack (Shulman & others, 1994).When panic attacks occur frequently and unexpectedly, the person is said to be sufferingfrom panic disorder. In this disorder, the frequency of panic attacks is highlyvariable and quite unpredictable. One person may have panic attacks several times amonth. Another person may go for months without an attack and then experiencepanic attacks for several days in a row. Understandably, people with panic disorderare quite apprehensive about when and where the next panic attack will hit (Craske& Waters, 2005; Good & Hinton, 2009).As a result, some panic disorder sufferers go on to develop agoraphobia, a fearof having a panic attack in a place from which escape would be difficult or impossible(Craske & Barlow, 2008). Crowds, stores or elevators, public transportation,standing in lines, and traveling in a car may all be avoided because of the fear of sufferinga panic attack and being unable to escape the situation. Consequently, manypeople with agoraphobia live like prisoners in their own homes.