Flashcards in Chapter 5 - Anxiety and Obsessive Compulsive Related Disorders Deck (42):
Fear vs. Anxiety
Fear: more focused and specific
Anxiety: more diffuse and generalized, both fear and apprehension
What are the anxiety disorders?
*Generalized Anxiety Disorder (GAD)
Characteristics of GAD?
Chronic, prolonged, "free-floating" anxiety and dread
According to DSM, what are the criteria for diagnosis of GAD?
Must report symptoms for at least 6 months
GAD types of symptoms
1) Motor Tension - muscular tension
2) Autonomic Reactivity - increased heart rate, BP, arousal
3) Apprehension about the future - sense of impending doom
50% of those diagnosed are diagnosed during childhood/adolescence
Panic Disorder characteristics
*Can be cued or un-cued
*Sudden intense arousal - symptoms may resemble heart attack
*Must experience some un-cued episodes
GAD vs. PD
*Onset more abrupt for PD
*Onset typically later for PD (avg 20-24 yrs old)
*More heredity evidence for PD
*Higher rates of alcoholism and depression for PD
What is PD comorbid with?
Comorbid with agorophobia
Characteristics of phobias
Irrational unrealistic fear of an object, event, or situation
How can phobias be acquired?
May begin with real trauma, GAD, or be vicariously acquired (like being around mother who has phobia)
What is the effect of avoidance in a phobia?
When you avoid a feared stimulus, it negatively reinforces the fear and avoidance. Treatment for this is exposure treatment
*Animal type - spiders, snakes, dogs, cats
*Natural environment type - storms, wind, bodies of water, heights
*Blood-injection-injury type - seeing blood/injury, injection, medical procedure, may induce fainting
*Situational type - elevators, tunnels, bridges, flying, driving, enclosed spaces
*Other type - cued by other stimuli, fear of situations that could lead to choking, vomiting, or illness
What is a social phobia? What is the basis?
*Fear and embarrassment (extreme discomfort) around other people
*Basis: fear of being observed and evaluated negatively in our culture
*Most common manifestation: public speaking and meeting new people
What is Taijin Kyofusho?
Japanese social anxiety disorder about offending or embarrassing other people
Diagnosis requirements for Taijin Kyofusho?
*Fear of blushing
*Fear of emitting odors or being flatulent
*Fear of staring inappropriately
*Fear of making inappropriate facial expressions
*Fear of having physical deformity
What is agoraphobia?
Fear of open spaces, the marketplace, novel situations, losing control in public
*Onset: 20-40s, more common among females
*Co-morbid with PTSD and GAD
What is the difference between compulsions and obsessions?
Obsessions: Intrusive, unwanted, related thoughts
Compulsions: repetitive acts/behaviors
What is "magical thinking"?
Thoughts during OCD that defy logic - patient believes performing the compulsion will enable them to control their outcomes, reduces anxiety
Common forms of compulsions?
Counting, ordering/organizing, checking (locks at front door), touching, washing/cleaning
What is hoarding? How is it categorized?
Collecting and keeping a large amount of things
*Now is its own category in DSM-5 as an OCD-related disorder, used to just be a compulsion
Late adolescence to early adulthood
Equal among males and females, more common with higher income and intellectual functioning
What are OCD spectrum disorders?
Disorders that co-vary with rates of OCD - co-morbid with OCD or run in OCD families (trichotillomania, motor tics) - characterized by problems with impulse control
What is body dysmorphic disorder?
Preoccupation with perceived defect in appearance - exaggerated or imagined flaws
When is BDD diagnosed?
When it causes significant distress or impairment of functioning
Gender differences in BDD?
Equal prevalence between genders, but differ by sites:
*Males: body build, genitalia, hair, height
*Females: breasts, hips, thighs, weight
Early adolescence to early adulthood
What is the course of BDD?
Will continue without treatment
Comorbidity with BDD
* ~1/3 with BDD also have OCD
*Social anxiety disorders
*Avoidant personality disorders
*Major depression and suicidality
How does BDD differ with culture?
*American men vs Taiwanese men - Americans express significantly more body dissatisfaction than Taiwanese men
*College students in Germany vs. US - Germany: 5.3%, US: 13% with BDD symptoms
Basis of behavioral treatment of anxiety/OCD?
If anxiety is learned and avoidance negatively reinforces these behaviors, anxiety can also be extinguished by removing this reinforcement
What are exposure treatments?
*Systematic desensitization: gradual exposure to source of anxiety - establish fear hierarchy, train in relaxation, "walk-through" hierarchy
*Reciprocal inhibition - underlying principle is that two incompatible responses cannot coexist and that they would reciprocally inhibit one another
What is flooding?
Sudden, intense exposure to fear. Person must remain with stimulus until anxiety subsides, so that avoidance is not negatively reinforced
What is virtual reality exposure?
Virtual stimulus exposure - seems to work by classical conditioning
What is exposure response prevention therapy (ERP)?
For OCD treatment - expose patient to anxiety of obsession and prevent compulsive behavior
What is modeling?
Observing someone engaging in desired behavior - most effective in participant modeling where they watch a model, then work up to a point when participant can do the behavior
What is cognitive restructuring?
Learning to "construct" situations differently
What is thought-stopping?
1) Train participant to recognize maladaptive thoughts
2) Teach to tell self "stop" when they come up
What is cognitive rehearsal?
Anticipates anxiety-provoking situation and rehearses thought process to do when situation occurs
What is acceptance commitment therapy?
"3rd gen" cog therapy
*Acceptance: accept and not avoid thoughts/feelings
*Mindfulness: be present in the moment, increased awareness of what is current
*Studies: ACT is effective for mild to moderate anxiety problems