Chapter 5 - Anxiety and Related Disorders Flashcards Preview

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Flashcards in Chapter 5 - Anxiety and Related Disorders Deck (94):
1

anxiety

affective state whereby an individual feels threatened by the occurrence of a possible future negative event

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fear

Occurs in response to a real or perceived current threat

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what kind of an emotion is fear

"present oriented"

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"fight or flight" response

fear prompts a person or organism to either flee from a dangerous situation or stand and fight

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panic

similar to fear, making these two emotional states difficult to distinguish in terms of their physiological and behavioural components

6

until 1980 what were anxiety disorders classified with

somatoform and dissociative disorders

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what did Freud theorize about the difference in anxiety

difference between objective fears and neurotic anxiety

8

what did Freud theorize about anxiety

proposed that neurotic anxiety is a signal to the ego that an unacceptable drive (mainly sexual in nature) is pressing for conscious representation

9

how much more likely is an individual who's family member is diagnosed with anxiety disorder to have on as well

4-6x more likely

10

where is the information from the amygdala sent to

areas in the hypothalamus and then through a midbrain area to the brain stem and spinal cord

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what kinds of autonomic and behavioural components do the brain stem and spinal cord connect with in expression of fear

autonomic: increased heart rate, blood pressure, body temperature
behavioural: freezing, fight/flight

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what areas are not directly involved in the fear circuit?

higher cortical areas

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two-factor theory

suggests that fears develop through the process of classical conditioning and are maintained of anxiety

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what does the two-factor theory not do a good job of explaining

the development of all phobias

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vicarious learning

develop fears by observing the reactions of other people

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what relationship may be important in the development of anxiety

early attachment relationship

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what do anxiety disorders tend to be without treatment

chronic and recurrent and are associated with significant distress and suffering

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panic attacks

involves recurrent attacks of overwhelming anxiety that occur unexpectedly - have the physical symptoms of anxiety

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symptoms of panic attacks

1) sweating
2) trembling or shaking
3) feelings of choking
4) nausea or abdominal distress
5) chills or heat sensations
6) fear of dying
7) pounding heart

20

how many symptoms must be present for panic attacks

at least 4 symptoms with at least two unexpected attacks are required for this diagnosis

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agoraphobia

anxiety about being in places or situations where an individual might find it difficult to escape

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what two disorders are highly comorbid?

panic disorder and agoraphobia

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gender differences in panic disorder

women are twice as likely

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behavioural avoidance test (BAT)

patients are asked to enter situations that they would typically avoid - provide a rating of their anticipated anxiety and actual anxiety

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symptom induction test

patient may be asked to do something to bring on symptoms of panic (ex. hyperventilate) - this will let them assess symptom severity and be a strategy for exposure treatment

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how much more likely is an individual who's family member is diagnosed with panic disorder to have on as well

5x more likely

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nocturnal panic

attacks that occur while sleeping (most often during lighter stages of sleep)

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catastrophically misinterpret

one misinterprets normal bodily sensations as signals that one is going to have a heart attack, go crazy etc.

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anxiety sensitivity

with the belief that the somatic symptoms related to anxiety will have negative consequences that extend beyond the panic episode itself

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alarm theory

theory proposes that a "true alarm" occurs when there is a real threat - bodies produce an adaptive physiological response

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what kinds of phobias do women report more often

animal and situational

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5 types of phobias

animal, natural environment, blood injection-injury, situational, other/illness

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animal type

phobic object is an animal or insect

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natural environment type

phobic object is part of the natural environment (ex. thunderstorms, height)

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blood injection-injury type

person fear seeing blood or an injury, or fears an injection or other type of invasive medical procedure

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situational type

person fears specific situations ex. public transportation

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other type

phobias not covered in the other categories, ex choking, clowns, also contains illness phobia

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illness phobia

intense fear of developing disease that the person currently does not have

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Equipotentiality premise

all neutral stimuli have an equal potential for becoming phobias

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nonassociative model

proposes that the process of evolution has endowed humans to respond fearfully to a select group of stimuli (ex. water) and thus no learning is necessary to develop these fears

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biological preparedness

process of natural selection has equipped humans with the predisposition to fear objects and situations that represented threats to our species over the course of our evolutionary heritage

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disgust sensitivity

the degree to which people are susceptible to being disgusted by a variety of stimuli ex. bugs, food

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social anxiety disorder

fear of interacting with others in most social settings

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performance only social phobia

fear specific social situations or activities, which may include casual speaking, eating or writing in public, or giving formal speeches

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what does the onset of social anxiety predict regarding comorbid disorders

predicts the onset of comorbid disorder

46

what kind of form does social anxiety assessment take

structured or semi-structured

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what do individuals with social anxiety exhibit

abnormal social information processing

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what do individuals with social anxiety show increased brain activity in?

amygdala when viewing others' facial expressions which suggests increased threat monitoring

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public self-consciousness

awareness of oneself as an object of attention

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interpersonal disorder

a condition that is commonly associated with marked disruption in the ability to relate with other people

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generalized anxiety disorder

uncontrollable and excessive worry

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gender differences in GAD

more common in women

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how many symptoms are needed for GAD

3 or more for adults, and one for children

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symptoms for GAD

1) restlessness or feeling keyed up or on edge
2) being easily fatigued
3) difficulty concentrating or mind going blank
4) irritability
5) muscle tension
6) sleep disturbance

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primary criterion for GAD

presence of excessive worry which must be present for more days than not for a period of at least 6 months

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intolerance of uncertainty

individual's discomfort with ambiguity and uncertainty

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obsessions

recurrent and uncontrollable thoughts, impulses, or ideas that the individual finds disturbing and anxiety-provoking ex. doubting if someone locked the door and checking it

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compulsions

repetitive behaviours or cognitive acts that are intended to reduce anxiety ex. counting numbers

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neutralizations

behavioral or mental acts that are used by individuals to try to prevent the feared consequences and distress caused by an obsession

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thought-action fusion

refers to two types of irrational thinking:
1) the belief that having a particular thought increases the probability that the thought will come true
2) belief that having a particular thought is the moral equivalent of a particular action

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subtypes of OCD

contamination and washing/cleaning, checking, hoarding, ordering/symmetry

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serotonin hypothesis for OCD

abnormalities in the serotonin system are responsible for OCD symptoms

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cognitive-behavioral conceptualization for OCD

problematic obsessions are caused by the person's reaction to intrusive thoughts

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why are obsessions believed to persist

person's maladaptive attempts to cope with them

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why are compulsions believed to persist

1) the lower the severity of anxiety
2) lower the frequency of obsessions
3) "prevent" obsessions from coming true

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PTSD

experienced, witnessed or learned about the traumatic event of a loved one, or have experienced repeated exposure to the aftermath of traumas

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4 domains symptoms of PTSD are categorized into

1) intrusion symptoms
2) avoidance symptoms
3) cognition and mood symptoms
4) hyperarousal and reactivity symptoms

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intrusion symptoms

memories, nightmares etc.

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avoidance symptoms

avoiding memories, avoiding places or people that are associated with the trauma etc.

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cognition and mood symptoms

amnesia, negative cognitions etc.

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hyperarousal and reactivity symptoms

hypervigilance, self-destructive behaviour etc.

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emotional numbing

inability to experience emotions

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what do individuals with PTSD also experience

sleep difficulties, concentration problems, irritability, significant anger problems etc.

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what kind of trauma is more likely to provoke PTSD

interpersonal traumas

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volume of hippcampus in individuals with PTSD is lower or higher

lower

76

what kind of medications are the best for treatment of anxiety disorders

antidepressants drugs

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what do individuals with anxiety disorders usually overestimate

probability and severity of various threats

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what do individuals with anxiety disorders usually underestimate

ability to cope with threats

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goal of cognitive restructuring

to help patients develop healthier and more evidence-based thoughts

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systematic desensitization

patients imagine the lowest feared stimuli and combine it with relaxation response - work their way up

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fear hierarchy

list of feared situations or objects that are arranged in descending order according to how much they provoke anxiety

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worry imagery exposure

identify the patient's main areas of worry, vividly imagining these unpleasant scenes and concentrating on them

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intense exposure

starting at a very high level of intensity rather than working gradually through the fear hierarchy

84

interoceptive exposure

exposure to internal cues - effective for panic disorders

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ritual prevention for OCD

involves promoting abstinence from rituals that reduce anxiety in the short term and reinforce obsessions in the long run

86

3 components of anxiety

physiological, cognitive, behavioral

87

symptoms of phobic disorders

1) persistent and irrational fear of an object or situation that presents no realistic saner
2) fears interfere with everyday life
3) physical symptoms
4) often aware that fears are irrational

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classical conditioning regarding anxiety

anxiety response can be acquired through pairing of an initially neutral stimuli with a frightening event

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operant conditioning regarding anxeity

once fear is acquired, the stimulus is avoided, and the avoidance is negatively reinforced due to the anxiety reduction

90

symptoms for OCD

1) obsessions: persistent, uncontrollable intrusive thoughts
2) compulsions: urges to engage in rituals to alleviate such thoughts

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hoarding

difficulty discarding possessions, regardless of actual value

92

ASD

experienced, witnessed, or learned about the traumatic event of a loved one, or have experienced repeated exposure to the aftermath of traumas

93

5 domains for symptoms of ASD

1) intrusion symptoms
2) negative mood
3) dissociative symptom
4) arousal symptoms
5) avoidance symptoms

94

how long must the symptoms for ASD be present

must have started or worsened after traumatic event and must be present for 3 days to 1 month prior to diagnosis