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Anxiety Flashcards

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1
Q

what is anxiety

A

intense fear of events/situation that are avoided/endured with sense of dread/distress

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2
Q

what is anxiety motivated by

A

future events which are more abstract

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3
Q

what is fear motivated by

A

imminent threats

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4
Q

similarities between fear and anxiety

A

arousal via sympathetic nervous system (involuntary response to dangerous or stressful situation)

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5
Q

what is the resulting feeling from anxiety

A

long, sustained affective state which is diffused

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6
Q

epidemiology of anxiety

A

most commonly experienced psych condition in US

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7
Q

lifetime prevalence of anxiety

A

29%

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8
Q

is anxiety comorbid, and with what

A

50% with anxiety meet criteria for another anxiety disorder
66% meet criteria for another psych disorder
60% with depression

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9
Q

sex differences in anxiety

A

2:1 female to male ratio

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10
Q

sex differences in anxiety explaineed

A

women more likely to get help
more factors which induce anxiety
- trauma exposure, mood amplification

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11
Q

heritability of anxiety

A

20-40% of anxiety disorder

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12
Q

environmental factors and anxiety

A

childhood trauma increases risk
cultural context influence prevalence and focus

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13
Q

common criteria of anxiety

A

interferes with functioning - should cause impairment
not caused by drug or medical condition
should persist for 6 months
symptoms cannot be explained by another disorder

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14
Q

specific phobia ?

A

form of anxiety targeted on specific stimulus or situation

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15
Q

specific criteria for anxiety

A
  • marked/disproportionate fear constantly triggered by specific objects or situations
  • object/situation is avoided or endured with intense anxiety
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16
Q

lifetime prevalence of specific phobias

A

7-15%

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17
Q

when and how do specific phobias begin

A

in childhood
avg age 8
often linked to specific experiences

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18
Q

social anxiety disorder - criteria

A

marked and disproportionate fear consistently triggered by exposure to potential social security
exposure to trigger leads to intense anxiety about being evaluated negatively
triggering situations are avoided or endured with intense anxiety

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19
Q

what are the effects of social anxiety disorder

A

more serious as socialising is crucial for navigating a normal and healthy life
poeple miss out on experiences, social connections, relationships
ruminate extensively about future scenarios and possible outcomes

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20
Q

when does social anxiety disorder begin

A

usually adolescence but sometimes childhood
not from one event but broad childhood experiences which could subsume variety of social experiences

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21
Q

panic disorder

A

recurrent and unexpected panic attacks
the misfiring of fear system, symptoms begin and cycle, brings on onset of panic attack

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22
Q

criteria of panic disorder

A

at least 1 month of concern/worry about experiencing attacks or fearing the consequence
maladaptive behvaioural changes

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23
Q

what are panic attacks

A

unexpected and uncontrollable episodes of terror, apprehension, sense of dread, accompanied by physiological changes

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24
Q

physiological changes of panic attacks

A

breathlessness, dizziness, nausea, palpitations

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25
how common are panic attacks
25%
26
agoraphobia
consistent fear and anxiety about situations where it would be embarrassing or difficult to escape if anxiety symptoms occurred
27
characteristics of agoraphobia
situations are either avoided or suffered using maladaptive coping mechanisms, or with intense anxiety
28
what was agoraphobia formerly noted as
special case of panic disorder
29
why is agoraphobia now its own disorder
only 50% of sufferers of this have panic attacks
30
generalised anxiety disorder - characterising feature
the phenomena of worry, diffused and spread to many contexts
31
why is GAD difficult to treat in therapy
because there is not immediate stimuli to target like in specialised anxiety disorders
32
chronicity of GAD
half patients experience perseverance over 8 years
33
GAD and comorbidity
~80% of patients meet criteria for other anxiety disorders
34
GAD - special criteria
- excessive anxiety and worry at least 50% of days about a number of events - hard to control the worry, not active and intentional rumination - diffused experience - no specific target
35
anxiety and worry are associated with what
restlessness easily fatigued difficulty concentrating / mind going blank irritability muscle tension sleep disturbance
36
what is the key framework for causes of anxiety disorders
associative learning
37
what is associative learning
how people learn from events which occur in environments - connections made with events which occur together
38
fear extinction
process where association between condition stimulus and uncondition stimulus is unlearnt over time
39
DSM 5 - pathological anxiety, why do anxieties remain
due to maladaptive avoidance - the adaptation to life style perpetuates the fear over time
40
what is Mowrer's 2 factor model
Pavlovian conditioning - learning gets fear started instrumental conditioning - keeps the fear alive
41
what is instrumental conditioning
how we act in the context of rewards
42
positive reinforcement
desired behaviour elicits reward
43
negative reinforcement
desired behaviour, no punishment
44
trait vulnerability
stressors which increase risk for mood disorders people are more or less susceptible to developing phobia
45
anxiety and fear conditioning
anxious people tend to be more fearful of neutral stimuli, if in threatening context more likely to develop fear than healthy people slower to extinguish fear
46
stimulus generalisation
process whereby neutral stimuli that are distinct from, but similar to, original conditioned stimulus can partially elicit conditioned response
47
amygdala - brains fear circuit
important for fear acquisition, storage and expression to what is already learned
48
medial PFC - brains fear circuit
works with amygdala, important for learning and controlling for fears extinguishing fear
49
general risk factors for GAD
behavioural inhibition neuroticism attention to threat negative bias
50
behavioural inhibition - GAD
tendency to become distressed and withdraw when faced with novel situation
51
neuroticism - GAD
tendency to experience frequent and intensive negative affect increases risk for future anxiety and depression
52
attention to threat - GAD
paying more attention to negative cues in environment
53
negative bias - GAD
interpreting of neutral stimuli as negative
54
risk factors for SAD
2 factor theory negative self evaluations catastrophizing monitoring performance
55
negative self evaluations - SAD
negative view of self, and of what might happen
56
monitoring performance - SAD
feeds into reinforcing cycle, interferes with performance in social interactions
57
risk factors for panic disorder
2 factory theory physiological factors triggers
58
physiological factors - panic disorder
noradrenaline is attention related, stress triggers noradrenaline release - increase activity of SNS increases likelihood of having panic attack drugs increase noradrenaline cause panic attacks
59
triggers for panic disorder
situations which induce symptoms and internal states
60
interpretation of physical symptoms - panic attacks
states of breathlessness
61
triggers for agoraphobia
exteroceptive (places) rather than interoceptive (bodily states)
62
risk factors for GAD
generalised distress and worry strong association with MDD intolerance of uncertainty - worry more reinforcing properties of worry - distracts from real and intense emotions
63
behavioural treatment for phobias
exposure therapy, start with manageable task and increase intensity - prevent safety behaviours
64
cognitive treatment for phobias
challenging beliefs about fear and possible damage - build coping abilities, prevent fear of consequence
65
CBT approach for GAD
relaxation training, cognitive restructuring, mindfulness
66
GAD - relaxation training
accesses interaction of physiology and psych learning to relax self (muscles etc)
67
GAD - cognitive restructuring
reduce catastrophizing and discuss realistic consequences reduce negative bias decrease time spent worrying
68
GAD - mindfulness
being in the present
69
response rate of CBT on ADs
~50%
69
anxiolytics
drugs which reduce anxiety
70
main types of AD medication
benzodiazepines (valium, xanax) antidepressants
71
issues with benzodiazepines for ADs
induces tolerance so increase needed over time to maintain effects can lead to dependence

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