Anxiety Disorders

Question 1

What are the 4 D’s used to define psychological abnormality?

Answer 1

1. deviant
2. distressing
3. dysfunctional
4. dangerous

Question 2

What is meant by “deviant”?

Answer 2

Being different to what you would expect

e.g. behaviour that may be unusual, extreme

Question 3

What is meant by “distressing”?

Answer 3

Having unpleasant experiences that are very upsetting to the individual

Question 4

What is meant by “dysfunctional”?

Answer 4

The inability to conduct daily activities and maintain social relationships

Question 5

What is meant by “dangerous”?

Answer 5

The individual poses a danger both to themselves and to others

Question 6

What is the main problem with defining abnormality?

Answer 6

Abnormality is relative to society/ cultural norms and values

What may appear “abnormal” or deviant to one group may be completely normal for another group

Question 7

What is the problem with having agreed definitions for abnormality?

Answer 7

They are often not applied consistently

e.g. for alcohol dependence, the recommended healthy alcohol intake is often changed and what defines dependence is changed

Question 8

What is the ICD-10?

Answer 8

International classification of disease

It has diagnosis criteria and treatment options of every disease

Question 9

What are the 7 broad categories of mental health disorders under ICD-10?

Answer 9

1. organic disorders - e.g. dementia
2. psychoactive substance use
3. psychotic disorders
4. mood, stress and anxiety disorders
5. physiological disorders e.g. eating disorders
6. development disorders
7. disorders of childhood e.g. ADHD, autism

Question 10

According to the Adult Psychiatric Morbidity Survey, how many adults in England have a common mental disorder?

Answer 10

Around 1 person in 6

Question 11

In which groups was the prevalence of mental disorders higher?

Answer 11

1. single or divorced individuals
2. living alone
3. in receipt of state benefits (lower income)

Question 12

How were mental disorders seen to relate to physiological disorders?

Answer 12

There is a comorbidity with chronic physical illness

e.g. cancer, asthma, diabetes, epilepsy, high blood pressure

Question 13

What is the “key high risk group” when it comes to mental illness?

Answer 13

Young women

Question 14

What percentage of GP appointments are taken up by mental health disorders?

Answer 14

30%

The appointments also require more time per appointment

Question 15

What are the most prevalent mental health disorders?

Why are they difficult to diagnose?

Answer 15

1. generalised anxiety disorder
2. depressive episodes
3. mixed anxiety and depressive disorder

The presentations of anxiety and depression overlap - and they may be symptoms of an underlying physical health problem

Question 16

What are the 5 categories of anxiety disorders?

Answer 16

1. panic disorder
2. post-traumatic stress disorder (PTSD)
3. generalised anxiety disorder
4. obsessive compulsive disorder (OCD)
5. phobias

Question 17

What do the 5 anxiety disorders have in common in terms of character?

Answer 17

There are 4 quadrants of features that are shown in mental health disorders

1. physiological/somatic (heart racing, muscle tension)
2. subjective experience (terror, dread)
3. behaviour (escape, unable to move)
4. cognition (“I’m dying”)

Question 18

What is the biological focus to treatment for mental health disorders?

Answer 18

1. neurotransmitters and brain imaging

2. pharmacological management
e. g. benzodiazepines, SSRIs

Question 19

What is the psychological focus to treatments for mental health disorders?

Answer 19

1. learning mechanisms

2. psychological interventions such as education, relaxation and CBT

Question 20

What are the stages in the self-maintaining cycle of symptoms of panic disorder?

Answer 20

1. physical sensation, thought or image perceived as threatening
2. anxiety
3. physical sensations (e.g. rapid heart beat, chest pain, etc.)
4. catastrophic interpretation of physical symptoms
5. amplification of anxiety and physical sensations
6. hyper-vigilance

Question 21

What is involved in the maintenance of panic disorder?

Answer 21

1. person pays selective attention to bodily events
2. they have in-situation safety behaviours
3. avoidance of the situation in future

Question 22

How do people try to cope with anxiety, which leads to maintenance of the condition?

Answer 22

They avoid situations that they know will cause them to become anxious

They will increase the performance of behaviours that reduce anxiety

Question 23

What is the main experience of generalised anxiety disorder?

Answer 23

There is excessive and uncontrollable worry about future events and outcomes

People fell anxious about everything, not just one particular area

Extreme anxiety is present at all times

Question 24

How many people are affected by generalised anxiety disorder?

What does it often co-occur with?

Answer 24

Affects 1-5% of the population in the last 12 months

It often co-occurs with other anxiety disorders, depression and many medical conditions

Question 25

What are the main symptoms of generalised anxiety disorder?

Answer 25

Tension and dread alongside somatic symptoms

Question 26

What is meant by intolerance of uncertainty?

Answer 26

It is the "what if" process that drives worry People overestimate the risk of something happening and the negative consequences of this happening

Question 27

What are the features of intolerance of uncertainty?

Answer 27

1. seeking excessive reassurance 2. list-making 3. double checking 4. refusing to delegate tasks to others 5. procrastination/avoidance 6. distraction

Question 28

Why are particular actions performed by someone with intolerance of uncertainty?

Answer 28

Performing these actions gives a temporary reduction in their anxiety

Question 29

What will the lives of someone with OCD be dominated by?

Answer 29

1. obsessions this is intrusions of thoughts, images and impulses that produce anxiety (e.g. fear of contamination) 2. compulsions these are behaviours or rituals that reduce anxiety (e.g. washing, checking)

Question 30

What happens to the behaviours that people use to reduce anxiety in OCD?

Answer 30

These behaviours become dominating, repetitive and ritualistic They begin to dominate people's lives - if they don't perform the behaviours they become more anxious

Question 31

What is meant by a phobia?

Answer 31

There is an irrational fear of specific objects or situations

Question 32

Why is a phobia characterised by an "irrational fear"?

Answer 32

It is irrational as there is realisation that the fear is disproportionate to the effect

Question 33

How do people tend to respond to a phobia? What process does this lead to?

Answer 33

There is a desire to avoid the object/situation This avoidant behaviour is negatively reinforced by a reduction in anxiety

Question 34

What is meant by negative reinforcement in phobias?

Answer 34

Avoidance maintains the phobia Behaviours that reduce anxiety are increased (this includes avoiding the feared object) This is negative reinforcement

Question 35

What is always involved in treatment of a phobia?

Answer 35

Encountering the thing that you are fearful of Unless you learn that the object is harmless, you will never overcome the phobia

Question 36

What are the stages involved in classical conditioned acquisition of a phobia?

Answer 36

1. Signal (CS) - sight of needle 2. Trauma (UCS) - injection/pain 3. Reaction (UCR) - fright/withdrawal 4. Result (CR) - needle phobia ``` UCS = unconditioned stimulus UCR = unconditioned response ```

Question 37

What is involved in negatively (operant conditioning) reinforced maintenance of a phobia?

Answer 37

1. there is an avoidance or escape from the aversive event (e. g. avoidance of hospital) 2. this leads to a reduction of fear (reinforcement)

Question 38

What are the two types of fear involved in agoraphobia?

Answer 38

1. fear of crowded/enclosed places and open spaces | 2. fear of panic attack and resultant embarrassment

Question 39

What is meant by social anxiety disorder?

Answer 39

This is a social phobia It involves an extreme and persistent fear of embarrassment and humiliation

Question 40

Who is more affected by social anxiety disorder? How do they cope with this?

Answer 40

Onset in teens and affects more men It involves avoidance of social and public activities