CH 6 Panic, Anxiety, Obsessions, and Their Disorders Flashcards

1
Q

Anxiety

A

General feeling of apprehension about possible danger

Future-oriented, diffuse

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2
Q

Fear vs. Anxiety
Cognitive/subjective Component

A

F: “I am in danger!”
A: “I am worried about what might happen.”

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3
Q

Fear vs. Anxiety
Physiological Component

A

F: Increased heart rate, sweating
A: Tension, chronic over-arousal

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4
Q

Fear vs. Anxiety
Behavioral Component

A

F: Desire to escape/run
A: General avoidance

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5
Q

What 5 primary types of anxiety disorders are recognized in the DSM-5?

A
  1. Specific Phobia
  2. Social Anxiety Disorder (Social Phobia)
  3. Panic Disorder
  4. Agoraphobia
  5. Generalized Anxiety Disorder
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6
Q

Biological causes of anxiety disorders

A

Strong genetic heritability, Limbic system (emotional regulation), Low neurotransmitter levels (Serotonin, GABA, Norepinephrine)

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7
Q

GABA

A

Primary inhibitory neurotransmitter

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8
Q

Psychological causes of anxiety disorders

A

Classical and operant conditioning (associate stimuli with anxiety response), Neuroticism, Perceived lack of control

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9
Q

Describe the DSM Criteria for Specific Phobias

A

A. Marked fear or anxiety about a specific object or situation
B. The phobic object/situation almost always provokes immediate fear/anxiety
C. The phobic object/situation is actively avoided or endured with intense fear or anxiety
D. The fear/anxiety is OUT OF PROPORTION to the actual danger
E. 6 Months or longer
F. Clinically significant distress or impairment in functioning

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10
Q

List the 5 Subtypes of Specific Phobias

A

Animals (snakes, dogs, etc.)
Natural Environment (storms, water, etc.)
Blood injection injury (Needles, fainting, etc.)
Situational (Vomiting, public speaking, etc.)
Other (Mayo, etc.)

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11
Q

Psychoanalytic viewpoint: Specific phobias

A

Repressed impulses from the Id are displaced onto external stimuli

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12
Q

Phobias as learned behavior

A

Learned fear from parents/peers’ reactions to stimuli

Viewing stimuli as inescapable/unavoidable increases fear

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13
Q

Phobias explained through Evolutionary preparedness

A

Evolutionary programming to avoid death leads to fearing stimuli that present these risks (snakes have venom, dogs are like wolves)

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14
Q

Treatment for specific phobia

A

Exposure therapy (in vivo, imaginative)

Participant modeling (learning from others)

Virtual reality exposure

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15
Q

What diagnosis is given to someone who almost meets the criteria for a disorder?

A

Other Specified _________. (name of disorder in the blank)

ex. Other specified social anxiety disorder

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16
Q

DSM Criteria for Social Anxiety Disorder

A

A. Persistent fear of one or more social or performance situations (unfamiliar people, scrutiny from others, embarrassing/humiliating potential)
B. Exposure to the feared situation almost invariably provokes anxiety
C. Person recognizes this fear is unreasonable or excessive
D. Feared situations are avoided/endured with intense anxiety
E. Avoidance, anxious anticipation, or distress interferes significantly with normal routine, occupational functioning, social activities, or relationships, or there is marked distress about having the phobia
F. The fear, anxiety, or avoidance is persistent (6 months or longer)

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17
Q

Causal Factors in Social Anxiety Disorder

Psychosocial Causal Factors

A

Learned behavior (experiencing or witnessing the social defeat of others)

Perceptions of uncontrollability and unpredictability in the world > protect self through isolation

Cognitive biases towards “danger schemas”
1. Self-fulfilling prophecy
2. Interpret ambiguous stimuli as negative

Neuroticism and introversion

18
Q

Treatment for Social Anxiety Disorder

A

Antidepressants
CBT - Cognitive restructuring
Exposure therapy

Getting involved is key

19
Q

DSM Criteria for Panic Disorder

A

A. Recurrent unexpected panic attacks with 4+ of the following: Palpitations or pounding heart, sweating, trembling, sensations of shortness of breath/smothering, feelings of choking, chest pain, nausea, dizziness, chills/heat, paresthesias (numbness), derealization, fear of losing control, fear of dying

B. 1 Month or more following 1+ panic attack:
Persistent concern/worry about additional attacks and/or significant maladaptive changes in behavior

20
Q

Paresthesias

A

Numbness or tingling sensations

21
Q

DSM Criteria for Agoraphobia

A

Marked fear/anxiety about 2+ of the following: public transportation, open spaces, enclosed spaces, lines or crowds, leaving home alone

Fear that escape might be difficult

Situations consistently produce fear

Avoidance of the situations

Disproportionate fear and anxiety

22
Q

Panic & Agoraphobia

Biological & Psychosocial Causal Factors

A

Moderate heritability

Amygdala (negative emotional processing)

Biochemical abnormalities: low GABA

Tendency to catastrophize

Reliance on safety behaviors

Overperception of threats

23
Q

The Panic Circle

A

Perceived threat > Apprehension/worry > Body sensations > Interpretation of sensations as catastrophic > Perceived threat

24
Q

Panic and Agoraphobia Treatments

A

Exposure Therapy
CBT - Interoceptive Exposure, Panic Control Treatment
Anxiolytics
SSRIs

25
Q

DSM Criteria for GAD (A-C)

A

A. Excessive anxiety and worry about several events or activities (6 months+)

B. Difficult to control the worry

C. 3+ of the following symptoms:
Restlessness, easily fatigued, difficulty concentrating/blank mind, irritability, muscle tension, sleep disturbance

26
Q

Causal factors for GAD

A

Perceptions of uncontrollability and unpredictability

Misinterpretation of worry as a good thing (chronic worrying is HARMFUL)

Sense of mastery: a greater sense of mastery is linked to reduced risk of GAD

Low GABA, CRH/ high cortisol

27
Q

Treatment for GAD

A

Anxiolytic Drugs:
Xanax, Klonopin (highly addictive)
BuSpar
SSRIs

CBT: Behavioral techniques, cognitive restructuring techniques

28
Q

DSM Criteria for OCD

A

Obsessions: Recurrent and persistent thoughts, urges, or images; intrusive and unwanted; cause marked anxiety or distress; individual attempts to suppress or neutralize them (compulsions)

Compulsions: Repetitive behaviors or mental acts that the individual feels driven to perform in response to an obsession or according to rules that MUST be applied rigidly; aimed at preventing/reducing anxiety/distress or preventing some dreaded event or situation (though not actually reasonably connected to the situation)

29
Q

Obsessions

Examples

A

Contamination fears, fear of harming self/others, need for symmetry, sexuality, religion, aggression

30
Q

Compulsions

A

Cleaning, checking, repeating, ordering/arranging, counting

31
Q

Causal Factors for OCD

A

Learned behavior (neutral stim. > conditioning > frightened by once neutral stim.)

3-12x more likely with parent who has OCD

Basal ganglia abnormalities

Low serotonin

32
Q

T or F
OCD is more common in women.

A

FALSE, gender makes no significant difference

33
Q

Mowrer’s 2-process theory of avoidance learning

A

Phase 1: Classical Conditioning
The individual transforms a neutral and innocuous stimulus (an airplane, a spider, an event at work, a crowded supermarket, etc.) into a painful or traumatic stimulus.

Phase 2: Instrumental Conditioning
The individual isn’t just avoiding the original aversive stimulus but everything that comes close to it.

34
Q

Which condition is most often comorbid with OCD?

A

Depression

35
Q

Treatment for OCD

Psychological & Biological

A

Exposure and Response Prevention ERP

Medications that affect serotonin
High dose Prozac (SSRI), relapse high when discontinued

Behavior treatment x Meds = Best

36
Q

Body Dysmorphic Disorder BDD

Define & List treatments

A

Obsessed with perceived or imagined flaw in appearance, causes clinically significant distress

Treatment: SSRIs, ERP (CBT)

37
Q

Hoarding Disorder

A

Acquire and fail to discard limited value possessions, disorganization in living space interferes with daily life, poorer prognosis for treatment than OCD both with meds and CBT

Comorbid with agoraphobia and other anxiety disorders

Associated with poor overall health

38
Q

Trichotillomania

A

Compulsive hair pulling

Urge to pull out hair from any body location, preceded by tension, followed by pleasure, must cause clinically significant distress

Onset can be childhood or later, post-puberty onset followed by MORE SEVERE course

39
Q

Ataque de nervios

A

Latin American, Peurto Rican

Attack of the nerves

Commonly reported symptoms are trembling, shaking uncontrollably, attacks of crying, feeling of heat rising from chest to head, and becoming physically or verbally aggressive

40
Q

Koro

A

China and Southeast Asia

The belief that genitals or breasts are retracting into the body, leading to death