Anxiety Disorders

Profesor Dr. Kamarulzaman Kamaruddin

 Kecelaruan Kebimbangan
• Everyone feels anxious now and then. It is a
normal emotion. For example, you may feel
nervous when faced with a problem at work,
before taking a test, or before making an
important decision.
• The occasional experience of anxiety is
normal, it is abnormal to feel strong anxiety
chronically in the absence of a visible cause.
• adalah perasaan yg kabur dan
ketidakselesaan bahawa sst yg buruk
mungkin akan berlaku. Kecelaruan ini adalah
hasil tindak balas terhadap ketakutan
• Takut adalah perasaan (emosi) yg wujud
daripada bahaya yg konkrit (nyata) dan
sebenar.
 Ciri-ciri Kebimbangan
• degupan jantung kita akan
bertambah cepat, berpeluh, otot kita
tegang dan kita bernafas dengan
cepat.
• berada dalam keadaan tidak normal
kerana kita hilang pertimbangan dan
tidak lagi waras atau rasional.
• kebimbangan yang keterlaluan akan
menyebabkan kita fobia dan panik.
 Types of Anxiety Disorder
• Generalized anxiety disorder. You feel excessive,
unrealistic worry and tension with little or no
reason.
• Panic disorder. You feel terror that strikes at
random. During a panic attack, you may also
sweat, have chest pain, and feel palpitations
(unusually strong or irregular heartbeats).
Sometimes you may feel like you’re choking or
having a heart attack.
• Social anxiety disorder. Also called social phobia,
this is when you feel overwhelming worry and self-
consciousness about everyday social situations.
You fixate about others judging you or on being
embarrassed or ridiculed.
• Specific phobias. You feel intense fear of a specific
object or situation, such as heights or flying. The
fear goes beyond what’s appropriate and may
cause you to avoid ordinary situations.
Kebimbangan Menyeluruh
 Panik
– Kebimbangan yang mengejut dan
mendadak dan biasa berlaku dalam
dalam keadaan tegang.
– Panik juga berlaku apabila scscorang
itu berhadapan dengan situasi yang
ditakuti, seperti bercakap di hadapan
khalayak ramai.
– Seseorang diserang perasaan panik,
ketegangannya yang dialaminya
biasanya tidak dapat dikawal.
Lazimnya, orang tersebut berpeluh,
berasa pening kepala, dan mungkin
sukar bernafas, letih dsb.
– Keadaan ini mungkin berlaku sekejap
sahaja ataupun lama hingga beberapa
jam.
 What is the difference between panic
attacks and panic disorder?
• Panic attacks are fairly common and having one does not mean that
you have panic disorder. For example, if you are feeling very stressed
or overtired, or if you have been doing excessive exercise, you might
have a panic attack. This does not mean that you have panic disorder.

• Panic attacks only become a problem if you are regularly worried

about having more attacks, or if you are afraid that something bad will
happen because of a panic attack. For example, people worry that they
will faint, embarrass themselves, have a heart attack, go crazy, or die.

• In panic disorder, the panic attacks are unexpected and unpredictable.

It is common for people with other anxiety disorders to have panic
attacks, and this is not panic disorder. For example, people with a
phobia of dogs might have a panic attack whenever they are near a
dog. But in this case, the panic attack is expected, and the person is
afraid of the dog not the panic attack.
 Fobia
• merupakan satu perasaan gerun dan
takut yg keterlaluan dan tidak rasional
tentang sesuatu objek atau aktiviti atau
situasi dan diikuti oleh keinginan yg
kuat untuk mcngelakkannya
• perasaan takut yang tidak sihat yg
disebabkan oleh pelbagai situasi seperti
kekotoran, orang ramai, tempat tinggi,
air, bilik tertutup dsb
• Ssg yang mcmpunyai fobia biasanya
tidak dapat menerangkan perasaannya
semasa mengalami emosi tersebut dan
perasaan inilah yang mengawal TLaku
 Fobia
• Spesific Phobia
– rasa gerun terhadap sst objek atau
situasi spt fobia situasi, fobia
persekitara, fobia haiwan dsb
• Social Phobia
– excessive fear of social interaction e.g.
Rasa malu/hina bila.., takut bercakap ….
• Agoraphobia
– fear of open and public places e.g.
lorong, tempat terbuka, perhimpunan
 Obsesif- Kompulsif
• Obsesi
– pemikiran, imej atau impuls yang tidak
mudah hilang/tidak berupaya
melupakan
– Seseorang yang pernah membunuh, dsb

• Kompulsif
– gesaan yang tidak dapat ditahan untuk
melakukannya berulang kali spt tutup
pintu, arahan berlebihan, basuh/bersih
berulang2 dsb
 Tekanan Traumatik

• Kebimbangan yang berpanjangan

dan hebat terhadap peristiwa
yang mengerikan yang boleh
kesan yang mendalam

• Contohnya peristiwa pahit ibu

bapa dibakar semasa perang
Vietnam dulu, rumah terbakar,
sumbang mahram, perempuan yg
dirogol dsb.
 Factors - Theories
• Biological Factors
• Genetic predispositions
• Irregularities in neurotransmitter functioning
• Abnormalities in brain pathways signaling
danger or inhibiting repetitive behaviors
• Prepared conditioning

• Social Environmental Factors

• Exposure to threatening or traumatic events
• Observing fear responses in others
• Lack of social support
 Factors - Theories (samb)
• Behavior Factors
• Pairing of aversive stimuli and previously neutral stimuli
(classical conditioning)
• Anxiety relief from performing compulsive rituals or
avoiding phobic stimuli (operant conditioning
• Lack of extinction opportunities due to avoidance of
feared objects or situations
• Emotional and Cognitive Factors
• Unresolved psychological conflicts (Freudian or
psychodynamic theory)
• Cognitive factors, such as overprediction of fear, self
defeating or irrational beliefs oversensitivity to threat,
anxiety sensitivity, misattribution of bodily cues and low
self efficacy
 Treatment Approaches
• Drug Therapy
– To control anxiety symptoms
• Cognitive Bahavioral Therapy
– To unlearn phobic reactions and develop
more adaptive ways of thinking
• Psychodynamic Therapy
– To gain insight into underlying conflicts
that anxiety symptoms may symbolize
• Humanistic Therapy
– To identify and come to accept one’s
genuine feelings and needs
 SEKIAN

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