7. Anxiety and Stressor Related Problems 2 Flashcards
(22 cards)
How is generalised anxiety disorder characterised?
- worrying thoughts about everyday life
- worry about worry
- avoiding situations
- seek reassurance/distract
- constant anxiety
- physical sensations of adrenaline response
What criteria in the DSM-5 is necessary for GAD diagnosis?
- disproportionate fear/anxiety relating to different aspects of your life
- should relate to at least 2 areas of activity
- anxiety is accompanied with restlessness, agitation and muscle tension
- feelings of anxiety and worry will be associated with behaviours such as avoidance, seeking reassurance and excessive preparing
- cannot be explained by other mental health disorders
What are the biological theories of GAD?
- Heritable
- inherit personality trait
- make vulnerable to GAD - Increased amygdala activity
- greater size found
- higher amygdala response
What environmental factors explain GAD?
- negative life events
- often during childhood (trauma)
- question stability/predictability about the world - attachment style
- insecure = GAD more likely
- emotionally detached, no degree of safety - modelling
- anxious reaction exhibited in parents influences childs interpretation
How do cognitive biases explain GAD?
information:
- look for info that confirms anxiety
- focus on negative info
attention:
- focus on negative stimuli
outcomes:
- always think the worst of something
- reinforces anxiety
How can pharmacological treatment be used to treat GAD?
helps with physiological symptoms
1. benzodiazepines
- anxiety relieving properties
- stimulate GABA (inhibitory NT)
2. B blockers
- block adrenaline effects
- lower heart rate, breathing etc
3. SSRIs
- also anti-depressants
- increase serotonin in synaptic cleft, increasing levels
How can stimulus control treatment be used to treat GAD?
AIM: stop worrying in situations
- work to limit worry at specific times
- make new associations and focusses
- helps throughout the day to reduce this connection
How can CBT be used to treat GAD?
What are 3 techniques?
- helps tackle core issue (maladaptive conditions)
self monitoring: - make aware of fixed patterns of behaviour e.g triggers of anxiety
relaxation training: - relaxing needs to become conscious
- use of breathing exercises etc
behavioural rehearsal: - rehearse situation and assess coping
- develop healthier coping strategies
- builds confidence
cognitive rehearsal: - rehearse situation: how would they cope?
- develop healthier coping strategies
- build confidence
What are panic attacks, present with panic disorder?
- unexpected: spontaneous and essential to diagnose
- situationally bound: anticipation/immediately on exposure to trigger
What are signs of a panic attack?
related to fight/flight
- hyperventilation
- heart palpitations
- nausea
- chills/hot flushes
- sweating
- trembling/shaking
- numbness and tingling
- dizziness
What criteria in the DSM-5 is necessary for a panic disorder diagnosis?
- panic attacks are spontaneous/unpredictable
- should be recurrent
- worry about further panic attacks
- modify behaviours to avoid future attacks
- rule out other diagnoses
What is the hyperventilation cycle in panic disorder?
- stressor
- hyperventilation: not taking in enough O2
- lower pCO2: p = pressure in blood
- changes in blood pH level
- oxygen delivered less efficiently: leads to cardiovascular change
- symptoms
- apprehension
- need to break this cycle
What is the cognitive model of panic disorder? (Clarke)
- trigger stimulus
- perceived threat
- apprehension (worry)
- body sensation
- interpretation of sensation as catasrophic
What pharmacological treatment can be used to treat panic disorder?
same as for GAD
- benzodiazepines
- B blockers
- SSRIs
How can CBT be used to treat panic disorder?
- recognise what might cause the trigger
- structured interviews - restructure the maladaptive beliefs
- teach the client about the fight/flight response
- natural: not medical issue - prevent safety behaviours
- they reinforce anxiety
What is social anxiety?
- specific to social situations
- extreme response
What criteria in the DSM-5 is necessary for social anxiety diagnosis?
- distinct fear of social interactions
- social interactions are avoided/experienced with intense fear/anxiety
- avoidance, fear/anxiety lasts more than 6 months causing distress and difficulty in performing social/occupational activities
How does Clarke and Wells use the cognitive model to explain social anxiety?
before the social situation:
- detailed thinking (worry and negative beliefs)
- negative automatic thoughts
- physical symptoms of anxiety
during the social situation:
- focus on self
- increase in physical symptoms (blushing, avoiding eye contact)
- safety behaviours
after the social situation:
- negative thoughts
cycle
How are cognitive biases used to explain social anxiety disorder?
critical view of self and negative predictions of future lead to avoidance
What pharmacological treatment is used to treat social anxiety?
same as other anxiety disorders
- benzodiazepines
- B-Blockers
- SSRIs
How is CBT used to treat social anxiety?
- form a rapport
- work with client
- constructive feedback
- exposure
- challenging cognitions
How can individuals with anxiety cope?
- regular exercise
- invest time in rewarding activities
- plan rest time
- use relaxation skills
- reduce caffeine intake
- reduce alcohol if used as coping mechanism
