EXAM 1 - ch4 - Anxiety Disorders Flashcards
Anxiety Disorders
Generalized Anxiety Disorder
Panic Disorder and Agoraphobia
Specific Phobias
Social Anxiety Disorder
Anxiety Disorders typicalities
High Incidence Rate: 17% of U.S. Adults
High Comorbidity, particularly with the mood disorders (depression)
Fear
Immediate, present-oriented
Sympathetic nervous system activation
(e.g., jump out of the way if you see a snake)
Anxiety
Apprehensive, future-oriented
Somatic symptoms: muscle tension, restlessness, elevated heart rate
(e.g. worrying you might see a snake on a future hike)
Panic attack –abrupt experience of intense fear
Physical symptoms: heart palpitations, chest pain, dizziness, sweating, chills or heat sensations, etc.
Cognitive symptoms: Fear of losing control, having a heart attack, dying, or going crazy
Two types
Expected
Unexpected
Panic attack –abrupt experience of intense fear
Panic attacks come on suddenly, they typically reach a peak within 10 minutes, and they are accompanied by uncomfortable physical sensations and catastrophic thoughts.
People may also experience “limited symptom episodes”, or panic attacks that have only a few symptoms (less than 4 total).
Panic attacks are very common. Most people have at least one panic attack in their lives. People with severe anxiety may have multiple panic attacks every day.
Unexpected attacks occur out of the blue – they could come up when you’re just watching TV at home. Expected attacks may be cued by certain situations (e.g., public speaking), especially in places where a person has had an attack in the past (e.g., while driving in the location of a previous panic attack)
Lot of people have anxiety disorder without panic attacks
Physical sensations are present until 12-15 minutes they don’t last very long unless you keep worrying about them
Expected – where you can tell why you had one
Unexpected – whe you don’t know why it happened / for no apparent reason
Biological Contributions to Anxiety
Limbic system
Behavioral Inhibition System (BIS)
Receives danger signals from:
The Brainstem (senses changes in bodily function and communicates danger signals to the cortex)
Then these signals travel to the Septal-hippocampal system
Then we tend to freeze, experience anxiety, and approach a situation with apprehension
Fight/flight (FFS) system (may be triggered, in part by low serotonin)
Panic circuit
Originates in the brain stem
Then travels through midbrain structures, including the amygdala, the ventromedial nucleus of the hypothalamus, and the central gray matter
Triggers an Alarm and escape response
Brain circuits are shaped by the environment too
Example: teenage cigarette smoking – teenage smoking is linked to increased risk for developing anxiety and panic
Interactive relationship with somatic symptoms
Psychological Contributions to Anxiety
Behaviorists
Classical and operant conditioning – symptoms are a result of learned associations
Modeling – anxious behavior
Beliefs about control over environment are shaped by early life experiences
Social Contributions to Anxiety
Biological vulnerabilities triggered by stressful life events Family Interpersonal Occupational Educational
An Integrated Model: Anxiety Disorders
Triple vulnerability
Generalized biological vulnerability Diathesis Generalized psychological vulnerability Beliefs/perceptions Specific psychological vulnerability Learning/modeling
Links with physical disorders
People with GI conditions, migraines, arthritis, allergies and more likely to have anxiety
Suicide
Suicide attempt rates
Similar to major depression
20% of panic patients attempt suicide
The Anxiety Disorders
Types of anxiety disorders Generalized Anxiety Disorder Panic Disorder and Agoraphobia Specific Phobias Social Anxiety Disorder Separation Anxiety Disorder Selective Mutism
Generalized Anxiety Disorder (GAD)
excessive amount of worrying (apprehensive expectation) occurring more than not for at least 6 months about a number of events or activities (such as work or school performance).
the individual finds it difficult to control the worry
the anxiety and the worry are associated with at least three or more of the following six symptoms present for more days than not for the past 6 months. (only one item is required of children.
-restlessness
being easily fatigued
difficulty concentrating or mind going blank
irritability
muscle tension
sleep disturbance
The anxiety or worry or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
the disturbance is not due to the direct physiological effects of a substance or a general medication
the disturbance is not better explained by another mental disorder
GAD-Clinical description
Shift from possible crisis to crisis
Worry about minor, everyday concerns
Job, family, chores, appointments
Accompanied by symptoms such as sleep disturbance and irritability
Leads to behaviors like procrastination, overpreparation
Generalized Anxiety Disorder (GAD) Statistics
3.1% (year)
5.7% (lifetime)
Similar rates worldwide
Insidious onset
Early adulthood
Chronic course
GAD in the elderly
Worry about failing health, loss
Up to 10% prevalence
Use of minor tranquilizers: 17-50%
Sometimes prescribed for medical problems or sleep problems
Increase risk for falls and cognitive impairments
Medications for GAD
Antidepressants
These can be effective and are nonaddictive (ex., zoloft, effexor, prozac) particularly when paired with exposure therapies
Anxiolytics
Benzodiazepines (ex., Valium, Librium, Xanax)
These are very addictive
