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PSC 168 > Chapter 5: Anxiety Disorders > Flashcards

Chapter 5: Anxiety Disorders Flashcards

1
Q

Define fear.

A

The CNS’s physiological and emotional response to a serious threat to one’s well-being

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2
Q

Define anxiety.

A

The CNS’s physiological and emotional response to a vague sense of threat or danger

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3
Q

What is the DSM-V definition of GAD?

A
  • Excessive anxiety and apprehension that isn’t limited to particular situations
  • Worry is difficult to control
  • Symptoms (at least 3) = muscle tension, restlessness, difficulty concentrating, feeling on edge
  • Symptoms must have been present for at least 6 months
  • Symptoms cause significant distress or dysfunction
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4
Q

When is the onset of GAD?

A

0-20 years

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5
Q

What course does GAD take?

A
  • Often onset in childhood/adolescence
  • Often a chronic course
  • Worsened by increase in life stressors
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6
Q

What is the one year prevalence of GAD?

A

3.1%

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7
Q

What is the lifetime prevalence of GAD?

A

5%

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8
Q

What is the only anxiety disorder that is found at a higher rate in the elderly than the overall population?

A

GAD

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9
Q

What is the gender ratio of GAD?

A

2:1 (female:male)

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10
Q

How does GAD tend to run in families?

A
  • Modeling of anxious behavior by overprotective, anxious parents
  • Genetic factors (serotonin, GABA)
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11
Q

What is the prevalence of GAD among low income people compared to total pop? African American? Hispanic American? Elderly?

A
  • Low income = higher
  • African American = higher
  • Hispanic American = same
  • Elderly = Higher
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12
Q

Which type of psychotherapy works best for GAD?

A

Drug therapy

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13
Q

What medication is used to treat GAD?

A
  • Antidepressants
  • Benzodiazepines
  • Buspar
  • Neurotonin
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14
Q

What is the prevalence of specific phobias among low income people compared to total pop? African American? Hispanic American? Elderly?

A
  • Low income = higher
  • African American = higher
  • Hispanic American = higher
  • Elderly = lower
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15
Q

What is the prevalence of social phobias among low income people compared to total pop? African American? Hispanic American? Elderly?

A
  • Low income = higher
  • African American = higher
  • Hispanic American = same
  • Elderly = lower
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16
Q

What is the prevalence of panic disorder among low income people compared to total pop? African American? Hispanic American? Elderly?

A
  • Low income = higher
  • African American = same
  • Hispanic American = same
  • Elderly = lower
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17
Q

What is the prevalence of OCD among low income people compared to total pop? African American? Hispanic American? Elderly?

A
  • Low income = higher
  • African American = same
  • Hispanic American = same
  • Elderly = lower
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18
Q

What is client-centered therapy? Who developed it?

A
  • Carl Rogers
  • Humanistic therapy in which clinicians try to help clients by being accepting, empathizing, accurately, and conveying genuineness
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19
Q

What are basic irrational assumptions? What disorder are they associated with?

A
  • Inaccurate and inappropriate beliefs held by people w/ various psychological probs
  • Albert Ellis suggested that these are the primary cause of GAD
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20
Q

What is rational-emotive therapy? Who developed it?

A
  • Albert Ellis
  • Cognitive therapy of GAD that helps clients identify and change the irrational assumptions and thinking causing their psychological disorder
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21
Q

What are family pedigree studies?

A

Research design in which investigators determine how many and which relatives of a person w/ a disorder have the same disorder

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22
Q

What is the most common group of antianxiety drugs?

A

Benzodiazepines

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23
Q

What is GABA? Significance of low activity?

A
  • Inhibitory neurotransmitter in the brain

- Low activity linked to GAD

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24
Q

What is the role of GABA in GAD?

A
  • Continuous firing of neurons (anxiety, fear) triggers a feedback system –> brain and body reduce levels of excitability by releasing GABA –> GABA binds to receptors and instructs neurons to stop firing –> anxiety, fear subsides
  • Peeps w/ GAD might have probs in their anxiety feedback system (too few GABA receptors, GABA receptors that don’t readily capture the neurotransmitter)
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25
Q

What comprises the brain circuit that produces anxiety reactions?

A
  • Prefrontal cortex
  • Anterior cingulate cortex
  • Amygdala
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26
Q

How do benzodiazepines and GABA play a role in GAD?

A

Benzodiazepines bind to GABA-A receptors –> increase ability of GABA to bind to them –> improve GABA’s ability to stop neuron firing and reduce anxiety

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27
Q

What are sedative-hypnotic drugs?

A

Drugs that calm people at lower doses and help them fall asleep at higher doses

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28
Q

What is relaxation training? Main idea?

A
  • A treatment procedure that teaches clients to relax at will so they can calm themselves in stressful situations
  • Physical relaxation –> psychological relaxation
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29
Q

What is biofeedback?

A

A technique in which a client is given info about physiological reactions as they occur (HR, muscle tension) and learns to control the reactions voluntarily

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30
Q

What is an electromyograph (EMG)? What treatment and disorder is this associated with?

A
  • A device that provides feedback about the level of muscular tension in the body
  • Biofeedback for GAD
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31
Q

What is the DSM-V definition of phobias?

A
  • Persistent, unrealistic fears of specific objects or situations
  • Exposure to feared stimulus produces intense fear or panic attacks
  • Avoidance responses are almost always present
  • Anxiety dissipates when phobic situation is not being confronted
  • Symptoms present for at least 6 months
  • Symptoms cause significant distress or dysfunction
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32
Q

What are the 3 subcategories of phobias?

A
  • Agoraphobia
  • Specific phobia
  • Social phobia
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33
Q

What is the DSM-V definition of specific phobias

A
  • Excessive fears of particular objects or situations
  • Immediate anxiety usually produced by exposure
  • Avoidance of feared object/situation
  • Symptoms present for at least 6 months
  • Symptoms cause significant distress, impairment
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34
Q

What are the types of specific phobias?

A
  • Animal
  • Natural environment
  • Situational
  • Blood-injection/injury
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35
Q

What is the one year prevalence of specific phobias?

A

8.7%

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36
Q

What is the lifetime prevalence of specific phobias?

A

11%

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37
Q

What is the gender ratio of specific phobias?

A

2:1 (female:male)

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38
Q

When is the onset of specific phobias?

A

Usually in childhood, but can start any age

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39
Q

What is the course specific phobias take?

A
  • Young children often have phobias, but many of them are outgrown without therapy
  • Phobias later in life may be life-long if not confronted
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40
Q

Define the ways through which fears are learned?

A
  • Classical conditioning
  • Modeling = observing & imitating others’ reactions
  • Stimulus generalization = response to one stimulus also elicited by similar stimuli (Little Albert)
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41
Q

Define preparedness.

A

A predisposition to develop certain fears

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42
Q

What is exposure therapy? Describe some examples.

A

Behavioral treatments of specific phobias in which persons are exposed to the objects/situations they fear

  • flooding = repeated, intense exposure
  • systematic desensitization = relaxation training, fear hierarchy
  • participant modeling
  • virtual exposure
43
Q

What is the DSM-V definition for social phobia?

A
  • Fear of social or performance situations (especially involving exposure to unfamiliar people)
  • Concern about rejection, humiliation, or embarrassment
  • Symptoms present for at least 6 months
  • Symptoms cause significant distress or dysfunction
44
Q

What factors can predispose a person to social phobia?

A

Shyness, cautiousness, introverted temperament, sensitive NS

45
Q

When is the onset and peak of social phobia?

A
  • Onset @ 10-20 years

- Peak around age 13

46
Q

What is the one year prevalence of social phobia?

A

6.8%

47
Q

What is the lifetime prevalence of social phobia?

A

9%

48
Q

What is the gender ratio of social phobias?

A

3:2 (female:male)

49
Q

What types of medications help treat social phobias?

A
  • Antidepressants (especially SSRI’s)

- Beta blockers

50
Q

What are some psychological forms of treatment for social phobias?

A
  • Social skills training
  • Assertiveness training
  • Group therapy
  • Cognitive therapy
51
Q

What is the DSM-V definition of agoraphobia?

A
  • Excessive fear of being in public places or situations from which escape might be difficult or embarrassing or help unavailable if panic-like symptoms were to occur
  • Fear tends to be worse when alone
  • Extensive avoidance behavior which can become very generalized (house-bound)
  • Symptoms present for at least 6 months
  • Symptoms cause significant distress or impairment
52
Q

What is the etymology of agoraphobia?

A
  • “Agora” = center of public life in ancient Athens

- “fear of the marketplace”

53
Q

What is the one year prevalence of agoraphobia?

A

0.8%

54
Q

What is the lifetime prevalence of agoraphobia?

A

5%

55
Q

What is the gender ratio of agoraphobia?

A

5:2 (female:male)

56
Q

When is the onset of agoraphobia?

A

Ages 20-35

57
Q

What are the treatment options of agoraphobia?

A
  • Exposure therapy (behavior)
  • Cognitive therapy
  • Antidepressants (especially SSRI’s)
58
Q

What is the DSM-V criteria for a panic attack?

A

A discrete period of intense fear or discomfort in which 4 or more of the following symptoms develop abruptly and reach a peak w/in a few mins:
-pounding heart/palpitations, sweating, trembling, shortness of breath, choking feeling, chest pain, nausea, feeling dizzy, depersonalization, fear of going crazy, fear of dying, numbness, chills or hot flashes

59
Q

What is the etymology of panic?

A

Pan = Greek & Roman god of nature, the wild, often associated with sexuality and fertility

60
Q

What is the DSM-V definition of panic disorder?

A
  • Repeated and unexpected panic attacks
  • Fear of recurring panic attacks or losing control
  • Avoidance of situations associated w/ prior attacks
  • Symptoms present for at least 6 months
  • Symptoms cause significant distress or dysfunction
61
Q

What is the one year prevalence of panic disorder?

A

2.7%

62
Q

What is the lifetime prevalence of panic disorder?

A

5%

63
Q

What is the gender ratio of panic disorder?

A

2:1 (female:male)

64
Q

When is the onset of panic disorder?

A

Ages 15-35 (rarely before puberty)

65
Q

What is the etiology of panic disorder?

A
  • Often biological predisposition (genetic, hypersensitive NS, oversensitive locus ceruleus)
  • First panic attack may be triggered by street drugs, meds, medical condition, trauma
  • Conditioning process
66
Q

What is norepinephrine?

A

A neurotransmitter whose abnormal activity is linked to panic disorder and depression

67
Q

What is the locus ceruleus? Significance in panic attacks?

A
  • A small area of the brain that seems to be active in the regulation of emotions
  • Many of its neurons use norepinephrine
68
Q

What comprises the brain circuit that produces panic attacks?

A
  • Amygdala
  • Ventromedial nucleus of the hypothalamus
  • Central gray matter,
  • Locus ceruleus
69
Q

What are biological challenge tests?

A

A procedure used to produce panic in participants by having them exercise vigorously or perform some other potentially panic-inducing task in the presence of a researcher or therapist

70
Q

What is anxiety sensitivity?

A

A tendency to focus on one’s bodily sensations, assess them illogically, and interpret them as harmful

71
Q

What are the educational treatments of panic disorder?

A
  • Breathing exercises to prevent hyperventilating
  • Relaxation training to reduce overall stress
  • Reducing caffein intake
  • Regular eating
  • Encourage moderate aerobic exercise
  • Conditioning process
  • Knowing that panic is a normal fight/flight process
72
Q

What are the cognitive exercises that help restructure thinking about panic?

A
  • Identify negative thoughts and learn how to combat them
  • Devise coping statements
  • Distraction techniques
  • Humor, distanciation
73
Q

What are behavioral exercises to eliminate avoidance behavior related to panic disorder?

A

Exposure therapy and desensitization

74
Q

What medications are used to treat panic attacks? When does each start working?

A
  • Antidepressants = start working after weeks of daily intake
  • Benzodiazepines = start working after 30-60 mins
75
Q

Define obsession.

A

Intrusive, repetitive, anxiety-arousing thought or image

76
Q

What are common themes of obsession?

A
  • Contamination
  • Harming somebody
  • Driving off bridges
  • Sexual ideas
  • Order
  • Symmetry
77
Q

Define compulsion.

A

Need to perform acts to reduce anxiety

78
Q

What are common behaviors/rituals of compulsion?

A
  • Cleaning, washing
  • Checking
  • Counting
  • Ordering
  • Touching
  • Licking
  • Praying
  • Seeking verbal reassurances from others
79
Q

What is the DSM-V definition of OCD?

A
  • Recurrent intrusive thoughts/images and/or compulsions
  • Attempts made to suppress the thoughts or behaviors
  • Symptoms present for at least 6 months
  • Symptoms cause significant distress or dysfunction
80
Q

When is the onset of OCD? When is it rare?

A
  • Ages 4-25

- Rare after age 40, unless comorbid depression or pregnancy

81
Q

What course does OCD take?

A

“Waxing and waning” = chronic course if not treated

82
Q

What is the lifetime prevalence of OCD?

A

2.5%

83
Q

What is the gender ratio of OCD?

A

1:1

84
Q

What things are comorbid with OCD?

A
  • Depression
  • Other anxiety disorders
  • Alcohol and cannabis abuse
85
Q

What is the etiology of OCD?

A
  • Biological (genetic predisposition, etc,)

- Conditioning process

86
Q

Define isolation.

A

An ego defense mechanism in which people unconsciously isolate and disown undesirable and unwanted thoughts, experiencing them as foreign intrusions

87
Q

Define undoing.

A

An ego defense mechanism whereby a person unconsciously cancels out an unacceptable desire or act by performing another act

88
Q

What is reaction formation?

A

An ego defense mechanism whereby a person suppresses an unacceptable desire by taking on a lifestyle that expresses that opposite desire

89
Q

What is exposure and response prevention?

A

A behavioral treatment for OCD that exposes a client to anxiety-arousing thoughts or situations and then prevents the client from performing his compulsive acts

90
Q

Define neutralizing.

A

A person’s attempt to eliminate unwanted thoughts by thinking or behaving in ways that put matters right internally, making up for the unacceptable thoughts

91
Q

What is serotonin?

A

A neurotransmitter whose abnormal activity is linked to depression, OCD, and eating disorders

92
Q

What comprises the brain circuit that produces OCD?

A
  • Orbitofrontal cortex
  • Caudate nuclei
  • Thalamus
  • Cingulate cortex
  • Amygdala
93
Q

What is the behavioral treatment of OCD?

A

Exposure with Response Prevention

94
Q

What is the cognitive treatment of OCD?

A

Habituation training

95
Q

What medications help treat OCD?

A

Medications that increase serotonin levels (Clomipramine, SSRI’s)

96
Q

What is the DSM-V definition of hoarding disorder?

A
  • Strong need to accumulate possession regardless of value
  • Persistent difficulty or distress associated w/ discarding them
  • Leads to cluttering of the home and associated physical safety and relationships probs
  • May feel a sense of emotional security from being surrounded by stuff
  • Person may fail to recognize that the hoarding behavior is a problem
97
Q

What is the DSM-V definition for excoriation disorder?

A
  • Compulsive or repetitive picking of skin, resulting in sores
  • May involve scratching, picking, rubbing, or digging into the skin
  • May be attempt to remove slight skin imperfections or as a coping response to stress or anxiety
98
Q

What is the DSM-V definition of trichotillomania?

A
  • Compulsive or repetitive hair pulling resulting in hair loss
  • Hair pulling may involve the scalp, eyebrows, or other parts of the body
  • Hair pulling has soothing effects and is used as coping response to stress or anxiety
99
Q

What is the DSM-V definition of body dysmorphic disorder?

A
  • Preoccupation with an imagined or grossly exaggerated bodily defect
  • Person believes others think less of him because of this “defect”
  • Compulsive checking in mirror, excessive grooming
100
Q

When is the onset of body dysmorphic disorder?

A

Usually begins during adolescence

101
Q

What is the prevalence of body dysmorphic disorder in the U.S. general and college population?

A
  • General = 2%

- College = 4%

102
Q

What is the gender ratio of body dysmorphic disorder?

A

1:1

103
Q

What is the etiology of body dysmorphic disorder?

A
  • Family history of anxiety disorders, especially OCD
  • Shyness and social phobias
  • Cultural emphasis on perfection and beauty
104
Q

What is the treatment for body dysmorphic disorder? What doesn’t work

A
  • SSRI meds
  • Exposure and response prevention
  • Cognitive therapy
  • Cosmetic surgery doesn’t work

PSC 168 (18 decks)

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