Chapter 3: Anxiety and Related Disorders

Question 1

Panic Disorder

Answer 1

type of anxiety disorder characterized by recurrent episodes of panic

Question 2

Anxiety

Answer 2

type of psychological disorder in which anxiety is the prominent feature

Question 3

Prevalence

Answer 3

overall number of cases of a disorder existing in a population during a given period of time

Question 4

Etiology

Answer 4

cause of origin; the study of causality

Question 5

Agoraphobia

Answer 5

a fear of places and situation from which it might be difficult or embarrassing to escape in the event of panicky symptoms or of situations in which help may be unavailable if such problems occur

Question 6

Generalized Anxiety Disorder (GAD)

Answer 6

type of anxiety disorder characterized by general feelings of dread, foreboding, and heightened states of sympathetic arousal, formerly referred to as free-floating anxiety

Question 7

Fear

Answer 7

unpleasant, negative emotion characterized by the perception of a specific threat, sympathetic nervous system activity, and tendencies to avoid the feared object

Question 8

Specific Phobias

Answer 8

persistent but excessive fears of a specific object or situation, such as a fear of heights or of small animals

Question 9

Acrophobia

Answer 9

excessive fear of heights

Question 10

Claustrophobia

Answer 10

excessive fear of small, enclosed places

Question 11

Social Anxiety Disorder

Answer 11

excessive fear of engaging in behaviors that involve public scrutiny

Question 12

Obsession

Answer 12

an intrusive, unwanted, and recurrent thought, image, or urge that seems beyond a person’s ability to control

Question 13

Compulsion

Answer 13

a repetitive behavior or mental act that a person feels compelled or driven to perform

Question 14

Adjustment Disorders

Answer 14

maladaptive reactions to an identified stressor or stressors that occur shortly following exposure to the stressor(s) and result in impaired functioning or signs of emotional distress that exceed what would normally expected in the situation

the reaction may be resolved if the stressor is removed or the individual learns to adapt to it successfully

Question 15

Acute Stress Disorder (ASD)

Answer 15

traumatic stress reaction occurring in the days and weeks following exposure to a traumatic event

Question 16

Posttraumatic Stress Disorder (PTSD)

Answer 16

disorder involving impaired functioning following exposure to a traumatic experience

in which the person experiences, for at least one month, such problems as reliving or re-experiencing the trauma, intense fear, avoidance of event-related stimuli, generalized numbing of emotional responsiveness, and heightened autonomic arousal

Question 17

Dissociation

Answer 17

feelings of detachment from oneself or one’s environment

Question 18

Projection

Answer 18

in psychodynamic theory, a defense mechanism in which one’s own impulses are attributed to another person

Question 19

Two-Factor Model

Answer 19

O. Hobart Mowrer’s theory that both operant and classical conditioning are involved in the acquisition of phobic responses

the fear component f phobia is acquired by means of conditioning (pairing of a previously neutral stimulus with an aversive stimulus), and the avoidance component is acquired by means of operant conditioning (relief from anxiety negatively reinforces avoidant behavior)

Question 20

Prepared Conditioning

Answer 20

belief that people are genetically prepared to acquire fear responses to certain classes of stimuli, such as fears of large animals, snakes, heights, or strangers

although the development of such phobias may have had survival value for prehistoric ancestors, such behavior patterns may be less functional today

Question 21

Anxiety Sensitivity

Answer 21

a “fear of fear”, or fear that one’s emotions or states of bodily arousal will get out of control and lead to harmful consequences

Question 22

Neuroticism

Answer 22

trait describing a general neurotic quality involving such characteristics as anxious, worrisome behavior, apprehension about the future, and avoidance behavior

Question 23

Gamma-Aminobutyric Acid (GABA)

Answer 23

an inhibitory neurotransmitter believed to play a role in regulating anxiety

Question 24

Benzodiazepines

Answer 24

class of minor tranquilizers that includes Valium and Ativan

Question 25

Fear-Stimulus Hierarchy

Answer 25

ordered series of increasingly fearful stimulus, used in the behavioral techniques of systematic desensitization and gradual exposure

Question 26

Flooding

Answer 26

type of exposure therapy in which subjects are exposed to intensely anxiety-provoking situations

Question 27

Cognitive Restructuring

Answer 27

cognitive therapy method that involves replacing irrational or self-defeating thoughts and attitudes with rational alternatives

Question 28

What is anxiety?

Answer 28

anxiety is a general state of apprehension or foreboding adaptive when it prompts us to seek medical attention, to study for an upcoming tests or avoid a dangerous situation maladaptive when the level of anxiety is out of proportion to the level of threat or when it occurs out of the blue, not in response to environmental changes common: most people experience it in varying degrees

Question 29

What are the major types of anxiety disorders?

Answer 29

panic disorder (with or without agoraphobia) agoraphobia without history of panic disorder specific phobia social phobia generalized anxiety disorder obsessive-compulsive disorder (OCD) posttraumatic stress disorder (PTSD) acute stress disorder anxiety disorder due to a general medical condition substance-induced anxiety disorder

Question 30

What is the DSM criteria of a panic attack?

Answer 30

a discrete period of intense fear or discomfort, in which four (or more) of the list of symptoms developed abruptly and reached a peak with 10 minutes

Question 31

What are the symptoms of a panic attack that are listed in the DSM?

Answer 31

1. palpitation, pounding heart, or accelerated heart rate 2. sweating 3. trembling or shaking 4. sensations of shortness of breath or smothering 5. feelings of choking 6. chest pain or discomfort 7. nausea or abdominal distress 8. feeling dizzy, unsteady, lightheaded, or faint 9. derealization (feelings of unreality) or depersonalization (being detached from oneself) 10. fear of losing control or going crazy 11. fear of dying 12. paresthesia (numbness or tingling sensations) 13. chills or hot flushes

Question 32

What is the DSM criteria for the panic disorder?

Answer 32

recurrent unexpected panic attacks at least one of the attacks has been followed by one month (or more) of one (or more) of the following: - persistent concern about having additional attacks - worry about the implications of the attack or its consequences (e.g. losing control, having a heart attack, "going crazy") - a significant change in behavior related to the attacks the panic attacks are not due to the direct physiological effects of a substance (e.g. a drug of abuse, a medication) or a general medical condition (e.g. hyperthyroidism) the panic attacks are not better accounted for by another mental disorder 1-5% prevalence (lifetime): we are very likely to treat them anxiety sensitivity: if they are so focused on it, they set themselves up for more panic attacks

Question 33

What is agoraphobia?

Answer 33

agoraphobia (fear of the market place) accompanies panic attacks in a large minority of cases (30-50%; other writers report up to 75%) when it does, it is usually fear of having another panic attack that is most impairing makes treatment less likely unless patient gets strong support to attend, or physiologist makes house calls even without agoraphobia, panic disordered patients are often reluctant to discuss their episodes for fear of triggering another attack

Question 34

What is generalized anxiety disorder?

Answer 34

an anxiety disorder characterized by general feelings of dread, foreboding, and heightened states of sympathetic arousal not linked to any one particular fear or trigger formerly referred to as free-floating anxiety

Question 35

What is the DSM criteria for generalized anxiety disorder?

Answer 35

at least 6 months of "excessive anxiety and worry" about a variety of events and situations, generally "excessive" can be interpreted as more than would be expected for a particular situation or event most people become anxious over certain things, but the intensity of the anxiety typically corresponds to the situation there is significant difficulty in controlling the anxiety and worry, if someone has a very difficult struggle to regain control, relax, or cope with the anxiety and worry, then this requirement is met (telling them not to worry is unlikely to be enough)

Question 36

What are the symptoms of generalized anxiety disorder listed in the DSM?

Answer 36

1. feeling wound-up, tense, or restless 2. easily becoming fatigued or worn-out 3. concentration problems 4. irritability 5. significant tension in muscles 6. difficulty with sleep

Question 37

What are some common types of phobic disorders?

Answer 37

specific phobia (claustrophobia) social phobia agoraphobia

Question 38

What are the five subtypes of phobias?

Answer 38

animal type natural environment type blood-infection-injury type situational type other types (e.g. phobias of choking or contracting an illness)

Question 39

What specific phobias are more commonly present at different ages?

Answer 39

young children: animals teenagers: social adults: agoraphobia or claustrophobia

Question 40

What are the physical features of anxiety disorders?

Answer 40

jumpiness, jitters, increased perspiration and heart rate, shortness of breath, dizziness, nausea

Question 41

What are the behavioral features of anxiety disorders?

Answer 41

include the need to escape or avoid a situation, agitation, clinginess, need for reassurance

Question 42

What are the cognitive features of anxiety disorders?

Answer 42

include excessive and prolonged worrying, overly aware of bodily sensations, jumbled thoughts, nagging thoughts

Question 43

What is the DSM criteria for specific phobias?

Answer 43

marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (e.g. flying, heights, animals, receiving an injection, seeing blood) exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally pre-disposed panic attack the person recognizes that the fear is excessive and unreasonable the phobic situation is avoided or is endured with intense anxiety or distress the avoidance, anxious anticipation, or distress in the feared situation(s) interferes significantly with a person's routine, occupational (or academic) functioning, or social activities or relationships or there is a marked distress about having the phobia in individuals under the age of 18 years the duration is at least 6 months

Question 44

What is an obsession?

Answer 44

an intrusive unwanted, and recurrent thought, image, or urge that seems beyond a person's ability to control can't stop thinking about it, it's a symptom

Question 45

What is a compulsion?

Answer 45

a repetitive behavior or mental act that a person field compelled or driven to perform this is a sign of OCD, anxious if they don't engage in the behavior

Question 46

What is acute stress disorder (ASD)?

Answer 46

a traumatic stress reaction occurring in the days and weeks following exposure to a traumatic event

Question 47

What is posttraumatic stress disorder (PTSD)?

Answer 47

a prolonged reaction to a traumatic event that threatened death or serious injury to one's own or another's physical safety

Question 48

What are the features of traumatic stress reactions?

Answer 48

extreme anxiety or dissociation (feelings of detachment from one's self or one's environment) intrusive memories and flashbacks (chronic re-experiencing, extremely vivid, may feel like they're back in the situation) heightened arousal or vigilance difficulty concentrating

Question 49

What is the psychodynamic perspective on anxiety disorders?

Answer 49

anxiety is a warning eign that some unconscious conflict is approaching consciousness projection: anxiety is brought about by the perception that some external threat is posed by someone or something else anxiety likely to be more specific in focus displacement: anxiety more likely to be generalized

Question 50

What is the learning perspectives on anxiety disorders?

Answer 50

two-factor model prepared conditioning: the reason we seem to develop phobias to some things more readily than others (a diathesis) superstition

Question 51

What is an example of the two factor model of anxiety?

Answer 51

man is on street (CS) barely escapes being run down (US) --> fear reaction (UR) subsequently experiences fear upon walking roadside (CR) road (Sd): walks away (R) --> fear reduction (Rf) subsequently he finds he can minimize anxiety/fear symptoms by avoiding roadways

Question 52

What is the cognitive perspective on anxiety disorders?

Answer 52

self-defeating or irrational beliefs oversensitivity to threat (perceive people on the street as threats, paranoia) anxiety sensitivity (internal thoughts of how they're feeling) misattributions for panic attacks (scared of inducing panic attacks, so avoid things they believe will trigger it, SSRIs might make it worse)

Question 53

What is the biological perspective on anxiety disorders?

Answer 53

genetic factors: higher concordance rates MZ twins (high concordance), neuroticism (scale of stability to instability, this trait is really what's being inherited) neurotransmitters: GABA (inhibitory), Benzodiazepines biological aspects of panic disorder: hyperventilation (can bring about panic-like symptoms) biological aspects of OCD

Question 54

What are the social-environmental factors of anxiety disorders?

Answer 54

threatening or traumatic events observing fear responses in others challenging demands in new situations cultural factors leading to socialization in passive or dependent roles lack of social support

Question 55

What are the behavioral factors of anxiety disorders?

Answer 55

conditioning experiences lack of extinction opportunities

Question 56

What are the emotional and cognitive factors of anxiety disorders?

Answer 56

unresolved psychological conflicts (Freudian or psychodynamic) cognitive factors (anxiety sensitivity, self-defeating or irrational thinking, catastrophic misinterpretations of bodily cues, oversensitivity to threats, low self-efficacy)

Question 57

What are the biological factors of anxiety disorders?

Answer 57

genetic predisposition disturbances in neurotransmitter activity or suffocation alarm system abnormalities in brain circuits involved in signaling danger or inhibiting repetitive behaviors

Question 58

What are psychodynamic approaches to the treatment of anxiety disorders?

Answer 58

free association and psychoanalysis to resolve the deeper conflict phobic objects are symbolic of those conflicts

Question 59

What are humanistic approaches to the treatment of anxiety disorders?

Answer 59

unconditional positive regard allows integration of inauthentic social presentation with authentic self

Question 60

What are biological approaches to the treatment of anxiety disorders?

Answer 60

antidepressants (SSRIs and SNRIs) less likely to have enduring benefit than CBT

Question 61

What are cognitive approaches to the treatment of anxiety disorders?

Answer 61

irrational beliefs, bolstering self-efficacy, individual meaning, regular "worry periods"

Question 62

What are learning-based approaches to the treatment of anxiety disorders?

Answer 62

combine with relaxation training best approaches combine exposure with response prevention

Question 63

What is virtual reality research?

Answer 63

for combat vets with PTSD the system contains eye-tracking software to study a person's response when exposed to a virtual combat environment