5. Generalised Anxiety Disorder

Question 1

For a diagnosis of GAD from the DSM-5, e____ a____ and w____ and __ p____ symptoms are needed

Answer 1

excessive anxiety, worry (apprehensive expectation), ≥ 3 physical

Question 2

According to the DSM-5, GAD involves:
1. A chain of thoughts and images, n____ a____-l____ and relatively u____
2. An attempt to engage in mental p____ s____ of real or fictional issues whose outcome is u____ but contains the possibility of one or more n____ o____

Answer 2

1. negatively affect-laden, uncontrollable
2. problem solving, uncertain, negative outcomes

Question 3

According to the DSM-5, physical symptoms of GAD include:
1. R____ or feeling k____ up or on e____
2. Being easily f____
3. Difficulty c____ or mind going b____
4. I____
5. M____ t____
6. S____ d____

Answer 3

1. Restlessness, keyed, edge
2. fatigued
3. concentrating, blank
4. Irritability
5. Muscle tension
6. Sleep disturbance

Question 4

For a diagnosis of GAD from the DSM-5, the following are needed:
1. M____ days than n____ for at least __ m____
2. Clinically significant i____ or d____
3. The focus of the anxiety and worry is n____ c____ to the features of an Axis I disorder

Answer 4

1. More, not, 6 months
2. impairment, distress
3. Not confined (e.g. worry only about social situations in which they must perform/be evaluated by others, worry only about spiders/vomiting (specific phobia))

Question 5

A GAD diagnosis will not be given if worry occurs exclusively during:
1. A m____ disorder
2. B____ disorder
3. P____ disorder

Answer 5

1. mood
2. bipolar
3. Psychotic
   Also no diagnosed if is better explained by symptoms of Post-traumatic stress disorder or Adjustment disorder (identifiable stressor).

Question 6

OCD involves o____ and is e____, compared to depression which involves r____, and GAD which involves w____, which are both e____.

Answer 6

obsessions, egodystonic
ruminations, worries, egosyntonic
“ego-syntonic” refers to thoughts, feelings, and behaviors that are consistent with and acceptable to one’s self-image and values, while “ego-dystonic” describes those that are inconsistent and unacceptable, causing distress or conflict

Question 7

Worry themes of GAD involve tendency to worry about m____ d____ things. the same things everyone else does but more about m____ matters and more about u____ or r____ f____ events (c____). Might differ depending on s____ background

Answer 7

many different
minor, unlikely, remote future events (catastrophising)
sociodemographic

Question 8

GAD sufferers have great difficulty l____ in the m____. They have a tendency to have thought beginning with ….

Answer 8

living in the moment
“What if…?” (Living in the future)

Question 9

GAD is predominated by n____ v____ t____ a____

Answer 9

negative verbal thought activity

Question 10

GAD sufferers attempt to avoid being s____ by n____ e____ or show a means to p____ for the w____

Answer 10

surprised, negative events
prepare, worst

Question 11

Pathological worries are more p____ and more d____ to c____ than normal worries

Answer 11

pervasive
difficult to control

Question 12

GAD has a l____ o____ and is a highly c____ illness with a low probability of r____ and a high likelihood of r____. It has a c____ course with f____ in s____ severity

Answer 12

late onset (~ early 30s), chronic, recovery (58%), recurrence (39-45%), chronic, fluctuations, severity

Question 13

Epidemiology of GAD:
1. Lifetime prevalence: __.6-__.7%
2. 12-month prevalence: __.1%
3. __:__ female male ratio
4. More frequently in previously m____, h____ and not working o____ the h____ respondents

Answer 13

1. 3.6-5.7
2. 3.1
   2:1
3. married, homemaker, outside, home

Question 14

Gad is associated with f____ i____, m____ t____ and p____ d____

Answer 14

further impairment, marital tension, personality disorders

Question 15

B____, p____ and s____ factors are involved in the p____/c____ of GAD

Answer 15

biological, psychological, social, predisposition/cause

Question 16

GAD is m____ regulated by genetic factors. More likely in individuals with a f____ d____ r____ with the disorder

Answer 16

moderately (twin studies, 30% variance due to heritability)., first degree relative

Question 17

C____ c____ theory and o____ c____ theory are important in GAD

Answer 17

Classical conditioning, operant conditioning

Question 18

Social modelling states that anxiety is a product of i____ a____

Answer 18

insecure attachment

Question 19

Cognitive theories of GAD (cognitive biases as risk factors):
1. A____ model of w____ and GAD
2. I____ of u____ model
3. C____ model of p____ w____

Answer 19

1. avoidance, worry
2. Intolerance, uncertainty
3. Cognitive, pathological worry

Question 20

The Avoidance Model of Worry and GAD says that worrying is v____ l____ and t____-b____

Answer 20

verbal linguistic, thought-based

Question 21

Three pieces of evidence for the Avoidance Model of Worry and GAD:
1. People who experience GAD display increased m____ t____ at r____
2. Worry is primarily a v____-l____ process rather than i____ based
3. Worry is r____ by increased p____ b____ about worry

Answer 21

1. muscle tension, rest
2. verbal-linguistic, imagery
3. reinforced, positive beliefs

Question 22

The intolerance of uncertainty model of GAD (IUM) says uncertainty is a p____ s____ of n____ k____. Intolerance of uncertainty means an individual’s d____ i____ to endure the a____ r____ triggered by the perceived absence of s____, k____ or s____ information, and s____ by the associated perception of uncertainty

Answer 22

psychological state, not knowing
dispositional incapacity, aversive response, salient, key, sufficient, sustained

Question 23

Intolerance of uncertainty has also been defined as a tendency to be b____ or u____ by the (as yet) u____ elements of a situation, whether the possible outcome is n____ or not

Answer 23

bothered, upset, unknown, negative

Question 24

Reducing behaviours (to reduce u____ and the associated a____ i____ s____) are e____ in the s____ t____ but m___ the p____ in the l____ t____, as they lead to increased perceptions of u____ about the o____ and s____ of t____

Answer 24

uncertainty, aversive internal state
effective, short term, maintain, problem, long term
uncertainty, outcome, severity, threat

Question 25

Information processing in GAD is b____ for attending to t____ cues. There is an exaggerated tendency to make t____ i____ of a____ information

Answer 25

bias, threat, threatening interpretations, ambiguous

Question 26

Positive beliefs about worrying include "worrying h____ to find solutions to problems" and "it i____ m____ to get things done"

Answer 26

helps, increases motivation

Question 27

"Worrying can prevent bad things from happening" is an example of m____ t____ or t____-a____ f____

Answer 27

magical thinking, thought-action fusion

Question 28

Negative problem orientation is a tendency to view p____ as t____, to d____ their problem-solving ability, and to be p____ about problem-solving outcomes

Answer 28

problems, threatening, doubt, pessimistic

Question 29

Worries as a way to a____ m____ i____ about a threatening situation is an i____ cognitive avoidance strategy

Answer 29

avoid mental images, implicit

Question 30

Examples of explicit cognitive avoidance strategies: 1. S____ worrisome thoughts --> e____ and r____ effects 2. Using d____ as a way to i____ worrying 3. A____ s____ that can lead to worrisome thinking --> c____ of negative beliefs about anxiety

Answer 30

1. suppressing, enhancement, rebound 2. distraction, interrupt 3. avoiding situations, consolidation

Question 31

The two key processes in the Cognitive Model of Pathological Worry are: 1. C____ b____ - . A____ b____ (s____ a____ to threat at the cost of attending to p____ or b____ information) . I____ b____ 2. A____ c____ - . Limited c____ r____ . Allows us to exert g____ d____ c____ over a____ of a____

Answer 31

1. Cognitive biases . attentional bias, selective attention, positive, benign . interpretation bias 2. Attentional control . capacity resource . goal directed control, allocation, attention

Question 32

Evidence for the Cognitive Model of Pathological Worry includes: 1. Habit to a____ to t____ p____ worry 2. Making n____ i____ of a____ information p____ worry 3. Increasing worry reduces a____ c____ 4. Engaging in i____ when worrying (vs verbal worry) r____ worry

Answer 32

1. attend, threat promotes 2. negative interpretations, ambiguous, promotes 3. reduces attentional control 4. imagery, reduces

Question 33

NICE guidelines state to move onto level 3 for GAD when there is m____ to s____ f____ i____. Step 3 includes Individual h____-i____ p____ i____ (CBT or a____ r____) and d____ treatment (SSRIs or BDZ)

Answer 33

moderate to severe functional impairment high-intensity psychological intervention, applied relaxation drug

Question 34

Two treatment approaches to GAD are: 1. CBT treatment targeting i____ of u____ 2. P____ m____ r____, usually combined with c____ therapy

Answer 34

1. intolerance, uncertainty 2. Progressive muscel relaxation, cognitive

Question 35

General phases of a CBT GAD program: 1. P____ and w____ a____ training (__ steps) 2. R____ of the u____ of worry (__ step) 3. R____ of n____ b____ about u____ (__ steps) 4. P____-s____ training (__ steps) 5. W____ e____ 6. R____ p____

Answer 35

1. Psychoeducation, worry awareness, 3 2. Reevaluation, usefulness, 1 3. Reevaluation, negative beliefs, uncertainty, 5 4. Problem-solving, 2 5. Written exposure 6. Relapse prevention

Question 36

Psychoeducation and worry awareness training is used to present the p____ of C____ (a____ collaboration between client and therapist, includes completion of w____ b____-s____ exercises) and to e____ GAD (helps n____ their experience)

Answer 36

principles, CBT, active, weekly between-session explain, normalise

Question 37

In the short-term safety behaviours r____ anxiety and f____ o____. In the long-term, safety behaviours m____ fears

Answer 37

reduction, feared outcomes, maintain

Question 38

Psychoeducation and worry awareness training involves s____ q____

Answer 38

socratic questioning

Question 39

Worry awareness training involves: 1. R____ symptoms before attempting to a____ them 2. H____, __ times a day 3. In session r____ and d____ of r____ worry t____

Answer 39

1. recognise, address 2. homework, 3 3. review, discussion, recurring, themes

Question 40

Worry chains can last for m____ or h____ and c____ a signifiant amount of t____. Worries often centre around f____ events, even when rooted in p____ events

Answer 40

minutes, hours, consume, time future, past

Question 41

The goal of treatment is not to s____ people from worrying, all people worry. The goal is to a____ the clients' perceptions of u____, shifting their tendency to c____ anticipated threats towards a more b____ and n____ perspective

Answer 41

stop, alter, uncertainty, catastrophise, balanced, neutral

Question 42

Certainty-seeking behaviours can be: 1. U____ e____ (i____, a____ until it's too late to make a choice...) 2. O____ e____ (strive for m____ i____, plan, plan, plan!!...) They address the "u____" or u____ of a situation. They don't seek to make the t____ outcome more or less like, they just seek to r____ the u____ about it

Answer 42

1. Under engage (ignore, avoid) 2. Over Engage (more information, plan plan plan!!) Unknown-ness, uncertainty, threat, reduce, uncertainty

Question 43

Developing behavioural experiments includes: 1. Set s____ experiments in s____ 2. R____ the o____ 3. R____ in s____

Answer 43

1. specific, session 2. Review, outcome 3. review, session

Question 44

Improving problem orientation includes: 1. "R____" excessive worry with a____ p____ s____ 2. D____ r____ 3. Seeing problems as a n____ part of l____ 4. Starting to view problems as s____ that can carry an o____

Answer 44

1. “Replace” excessive worry with actual problem solving. 2. Discuss research. For example, excessive worriers are just as skilled at problem solving as people who worry less. 3. Seeing problems as a normal part of life. 4. Starting to view problems as situations that can carry an opportunity.

Question 45

Resolution of a problem form: Step 1A: Problem d____ Step 1B: Goal f____: short-term and long-term goals Step 2: Generation of a____ s____ Step 3: D____ m____ - chosen s____ Step 4A: Solution i____ Step 4B: Solution v____

Answer 45

1a. definition 1b. formulation 2. alternative solutions 3. decision making, solution 4a. implementation 4b. verification

Question 46

Applied relaxation for GAD involves: 1. Worry a____ and s____-m____ 2. Relaxation t____ 3. C____ therapy 4. I____ r____ of c____ strategies

Answer 46

1. awareness, self-monitoring 2. training 3. cognitive 4. imagery rehearsal, coping

Question 47

Progressive muscle relaxation is based on the premise that chronic worry is associated with: 1. Deficiency in p____ t____ 2. Excessive m____ t____

Answer 47

1. parasympathetic tone (e.g. reduce heart rate variability) 2. Muscle tension

Question 48

In training of progressive muscle relaxation: 1. individuals s____ tense and release muscle g____ - learning the difference and... 2. eventually tensing and releasing are e____, and individuals must create relaxation by r____ how the muscles felt when released

Answer 48

1. systematically, groups 2. eliminated, recalling