It's Day 2 of Fear and Anxiety week! (Day 1, ⤵️) Today we'll here from @samcooper.bsky.social, a clinical psychologist and researcher who specializes in fear and anxiety. Dr. Cooper focuses on one of the crucial questions of our era: How do we conceptualize and diagnose anxiety-related conditions? - ThreadSky

nicolecrust.bsky.social • 46 days ago

It's Day 2 of Fear and Anxiety week! (Day 1, ⤵️)

Today we'll here from @samcooper.bsky.social, a clinical psychologist and researcher who specializes in fear and anxiety.

Dr. Cooper focuses on one of the crucial questions of our era: How do we conceptualize and diagnose anxiety-related conditions?

Reposted from Nicole Rust

Apropos of everything 🌎, we're declaring it "Fear and Anxiety Week" here on Bsky. It's like shark week but better!

This week, we'll hear about fear and anxiety from brain researchers, psychiatrists, clinical psychologists, and individuals with lived experience.

We invite you to chime in! 1/n

Comments

samcooper.bsky.social•46 days ago

Thanks, Dr. Rust! Right to it: what do we mean by “anxiety disorder?” There’s no one scientific answer - I will review some common approaches, some stats on prevalence (how common are these disorders?), and brief psychological treatment info. But first, an important preface 1/n

samcooper.bsky.social•46 days ago

Preface: human fear/anx *cannot* be separated from cultural context: they’re anchored to cultural/social beliefs + diff cultures describe them differently (eg, more bodily or cognitively). I’m about to discuss modern science/practice, but we still need improved representation + generalizability 2/n

tolchinsky.bsky.social•45 days ago

Can you clarify your thesis? We have evidence of innate phobias in all mammals and rodents. A single strand of car hair placed in a cage with a newborn rat pup results in a freeze response. Humans have innate phobias. Preverbal human babies have phobias. Where is culture here?

samcooper.bsky.social•46 days ago

The DSM-5 is the most common system for classifying anxiety-related disorders, and they generally fall into three categories: anxiety (eg generalized anxiety, social anxiety), trauma/stress (eg PTSD), and obsessive/tic (eg OCD) disorders. All involve fear or anxiety, and (usually) avoidance. 3/n

tolchinsky.bsky.social•45 days ago

PTSD is a complex condition, of which we know at least 3 types - acute, complex and attachment trauma and it has elements of both a phobia (an acute fear dysturbance), an anxiety disorder (of the FEAR type in Panksepp's system), a mood disorder, interpersonal disorder, sleep disorder, etc.

tolchinsky.bsky.social•45 days ago

DSM-5 is based on statistics and convention. There is no etiology. DSM-5 categories do not distinguish between FEAR system anxiety in Panksepp's framework and PANIC system anxiety.

samcooper.bsky.social•46 days ago

DSM disorders, incl. anxiety-related disorders, are categorical (yes/no diagnosis). Here are criteria for GAD. If a person is a “yes” to each item, they can receive a diagnosis. All disorders require a level of distress/impairment above healthy and helpful levels of occasional fear/anx 4/n

tolchinsky.bsky.social•45 days ago

Here is a summary of why DSM conventions about anxiety, including GAD are highly problematic.

https://www.therapyroute.com/article/the-trouble-with-psychiatry-by-m-solms

samcooper.bsky.social•46 days ago

Pros & cons: It can be helpful to have shared medical terms, and distinguishing btwn, say, anticipated anxiety vs. panic attack (a full body false alarm) is useful. But strict anx categories leave many suffering labeled as “no anx condition”, even if only didn’t meet criteria by one symptom 5/n

samcooper.bsky.social•46 days ago

More recently, we have found anxiety-related disorder might be more accurately represented as multiple continuous dimensions instead of categorical (yes/no) disorders, and more specific symptoms and behaviors can be grouped into broader dimensions. This challenges many DSM assumptions 6/n

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