Understanding Psychology (10th Ed)

 
Module 47 
The Major Psychological Disorders 
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during an attack such as those Sally experienced in the case 
described earlier, anxiety suddenly—and often without 
warning—rises to a peak, and an individual feels a sense of 
impending, unavoidable doom. Although the physical symp-
toms differ from person to person, they may include heart 
palpitations, shortness of breath, unusual amounts of sweat-
ing, faintness and dizziness, gastric sensations, and some-
times a sense of imminent death. After such an attack, it is 
no wonder that people tend to feel exhausted (Rachman & 
deSilva, 2004; Laederach-Hofmann & Messerli-Buergy, 2007). 
Panic attacks seemingly come out of nowhere and are 
unconnected to any specifi c stimulus. Because they don’t 
know what triggers their feelings of panic, victims of panic 
attacks may become fearful of going places. In fact, some 
people with panic disorder develop a complication called 
agoraphobia, the fear of being in a situation in which escape 
is diffi cult and in which help for a possible panic attack 
would not be available. In extreme cases, people with agora-
phobia never leave their homes (Marcaurelle, Bélanger, & 
Marchand, 2005; Herrán, Carrera, & Sierra-Biddle, 2006; 
Wittchen et al., 2008). 
In addition to the physical symptoms, panic disorder affects how the brain pro-
cesses information. For instance, people with panic disorder have reduced reactions 
in the anterior cingulate cortex to stimuli (such as viewing a fearful face) that nor-
mally produce a strong reaction in those without the disorder. It may be that recur-
ring high levels of emotional arousal that patients with panic disorder experience 
desensitizes them to emotional stimuli (Pillay et al., 2006; Pillay et al., 2007).
 GENERALIZED ANXIETY DISORDER 
People with  generalized anxiety disorder  experience long-term, persistent anxiety 
and uncontrollable worry. Sometimes their concerns are about identifi able issues 
involving family, money, work, or health. In other cases, though, people with the 
disorder feel that something dreadful is about to happen but can’t identify the reason 
and thus experience “free-fl oating” anxiety. 
Because of persistent anxiety, people with generalized anxiety disorder cannot 
concentrate or set their worry and fears aside; their lives become centered on their 
worry. Furthermore, their anxiety is often accompanied by physiological symptoms 
such as muscle tension, headaches, dizziness, heart palpitations, or insomnia 
(Starcevic et al., 2007). Figure 2 shows the most common symptoms of generalized 
anxiety disorder.