anxiety Flashcards
from Abrar's Kaplan Summaries. (45 cards)
what is normal anxiety?
diffuse, unpleasant, vague sense of apprehension, often accompanied by
autonomic symptoms such as headache, perspiration, palpitations, tightness in the
chest, mild stomach discomfort, & restlessness, indicated by an inability to sit or
stand still for long.
Fear versus Anxiety
Fear is a response to a known, external, definite, or nonconflictual threat
Anxiety is a response to a threat that is unknown, internal, vague, or conflictual.
Is Anxiety Adaptive?
short answer: yes.
abrar kaplan:
“Anxiety can be conceptualized as a normal and adaptive response that has lifesaving qualities and warns of threats
It prompts a person to take the necessary steps to prevent the threat or to lessen its consequences.
This preparation is accompanied by increased somatic and autonomic activity controlled by the interaction of the
sympathetic and parasympathetic nervous systems. “
stress and anxiety (just read to rmbr, no real question here)
from kaplan, not abrar:
“ Whether an event is perceived as stressful depends on the nature of the event and on the person’s resources, psychological defenses, and
coping mechanisms. All involve the ego, a collective abstraction for the process by which a person perceives, thinks, and acts on external
events or internal drives. A person whose ego is functioning properly is in adaptive balance with both external and internal worlds; if the
ego is not functioning properly and the resulting imbalance continues sufficiently long, the person experiences chronic anxiety.
Whether the imbalance is external, between the pressures of the outside world and the person’s ego, or internal, between the person’s
impulses (e.g., aggressive, sexual, and dependent impulses) and conscience, the imbalance produces a con ict. Whereas externally caused
con icts are usually interpersonal, those that are internally caused are intrapsychic or intrapersonal. A combination of the two is possible, as
in the case of employees whose excessively demanding and critical boss provokes impulses that they must control for fear of losing their
jobs. Interpersonal and intrapsychic con icts, in fact, are usually intertwined. Because human beings are social, their main con icts are
usually with other persons”
symptoms of anxiety?
Anxiety experience has 2 components, the awareness of physiological sensations & of being nervous or frightened.
it produces confusion & distortions of perception, (of time, space & of persons and the meanings of events).
can interfere with learning by lowering concentration, reducing recall, & impairing the ability to make associations.
head: dizziness, hyperhydrosis, pupillary mydriasis
Heart: palpitations, tachycardia, syncope
extremites: tingling, tremors, restlessness, hyperreflexia,
GIT: upset stomach “butterflies” diarrhea, urinary freq/urgency,
epidemiology of anxiety
- one in four
- 17.7% prevalence
- women more
- higher socioeconomic less
what are the three major schools of psychological theory for anxiety?
Psychoanalytic
behavioral
existential
what is the psychoanalytic theory for anxiety?
Freud redefined anxiety as a signal of the presence of danger in the unconscious.
Anxiety was viewed as the result of psychic conflict between unconscious sexual or aggressive wishes and
corresponding threats from the superego or external reality.
In response to this signal, the ego mobilized defense mechanisms to prevent unacceptable thoughts and feelings
from emerging into conscious awareness.
The role of the amygdala, which sub serves the fear response without any reference to conscious memory and
substantiates Freud’s concept of an unconscious memory system for anxiety responses. From a psychodynamic perspective, the goal of therapy is not necessary to eliminate all anxiety but to increase
anxiety tolerance-that is, the capacity to experience anxiety-and use it as a signal to investigate the underlying
conflict
At the most mature level, superego anxiety is related to guilt feelings about not living up to internalized standards of
moral behavior derived from the parents.
Often, a psychodynamic interview can elucidate the principal level of anxiety with which a patient is dealing. Some
anxiety is obviously related to multiple conflicts at various developmental levels.
what is the behavioral theory for anxiety?
anxiety is a conditioned response to a specific environmental stimulus.
In the social learning model, a child may develop anxiety response by imitating the anxiety in the environment
what is the existential theory of anxiety?
It provides models for generalized anxiety, in which no specific identifiable stimulus for chronic anxious feeling.
The central concept of existential theory is that person experience feelings of living in a purposeless universe.
Anxiety is their response to the perceived void in existence and meaning.
autonomic nervous system in patients with anxiety?
The autonomic nervous systems of some pt with anxiety disorder exhibit increased sympathetic tone, adapt slowly to
repeated stimuli, and respond excessively to moderate stimuli.
The three major neurotransmitters associated with anxiety are
norepinephrine (NE), serotonin, & GABA.
Chronic symptoms experienced by anxious pt are characteristic of
increased noradrenergic function.
The cell bodies of the noradrenergic system are localized to
the locus ceruleus in the rostral pons
The cell bodies of the noradrenergic system are localized to the locus ceruleus in the rostral pons, and they project
their axons to
the cerebral cortex, the limbic system, the brainstem, and the spinal cord.
Experiments demonstrated that stimulation of …? produces fear response in the animals and that
ablation of the same area inhibits or completely blocks the ability of the animals to form a fear response.
locus ceruleus
what can provoke frequent and severe panic attacks in patients with panic disorder?
ß-adrenergic receptor agonists & α adrenergic receptor antagonists
what receptor does the drug yohimbine act on?
α adrenergic receptor antagonist
what receptor does the drug clonidine act on?
α2-receptor agonist
does yohimbine increase or decrease anxiety?
increase
does clonidine increase or decrease anxiety?
decrease
what is the noradrenergic metabolite called?
3-methoxy-4-hydroxyphenylglycol (MHPG).
which patient have increased levels of CSF or Urinary 3-methoxy-4-hydrophenylglycol?
patients with anxiety disorders, particularly panic disorder
Cortisol increased ? , ?, ?, & ?; inhibition of the ? and
?; and ?.
Cortisol increased arousal, vigilance, focused attention, & memory formation; inhibition of the growth and
reproductive system; and containment of the immune response.
