Chapter 5 - Anxiety Disorders and OCD Flashcards
(43 cards)
1
Q
How do you define anxiety?
A
- A general emotional reaction that is out of proportion with the current threats (if any) in the environment. Usually a feeling of short duration (10-20 min) but a recurrent feeling.
2
Q
What’s a good way to describe a panic attack?
A
- A fear response at the wrong time.
3
Q
Obsessions vs. compulsions?
A
- Obsessions - repeated, unwanted and intrusive thoughts. Occur suddenly and lead to increased anxiety
- Compulsions - Repetitive behaviours/mental acts done to reduce anxiety caused by obsessions
4
Q
What’s excessive worry?
A
- Relatively uncontrollable sequence of negative thoughts. Mainly self-talk, imagining unpleasant scenarios that may never happen
5
Q
What’s panic disorder?
A
- Recurrent and unexpected panic attacks
- One attack followed by at least one month or more of worry and avoidance
- Can be with or without agoraphobia
- Cannot be due to a medical condition or drug use/medication
6
Q
What’s agoraphobia?
A
- Avoidance of a cluster of situations where fear or panic may have occurred; marked apprehension that another panic attack will occur.
- Intense fear of public spaces
- Doesn’t necessarily have to be open or large
- 95% of the time it occurs with panic disorder
7
Q
How many symptoms are required for a panic disorder diagnosis?
A
- 4
8
Q
What are the different symptoms of panic disorder?
A
- Palpitations
- Sweating
- Trembling/shaking
- Dyspnea (shortness of breath)
- Paresthesias (numbness/tingling)
- Dizziness or faintness
-Derealization/depersonalization - Fear of losing control
- Fear of dying/heart attack (!)
- Choking sensations
- Chest pain/discomfort
- Nausea
- Chills/hot flashes
9
Q
Are nocturnal panic attacks real?
A
- Yes
- Between 44-71% with panic disorder experience nocturnal attacks
- May be because the brain is unable to anticipate attacks
10
Q
When is panic disorder commonly diagnosed?
A
- Usually late teens/early adult, but some don’t get diagnosed till early thirties (try to manage symptoms on their own before then)
11
Q
What are the different types of phobias?
A
- Animal type
- Natural environment type
- Blood, injection (needles, injury type)
- Situational type (ex. claustrophobia
12
Q
What’s Social Anxiety Disorder?
A
- Also known as social phobia
- The individual fears that they will act in a way or show anxiety symptoms that will be evaluated negatively
- Can involve a fear of public speaking, eating, or writing in public
- Have a general fear/concern of making mistakes, especially in front of others
13
Q
What is required to be diagnosed with Generalized Anxiety Disorder?
A
- Excessive anxiety/worry about a number of distinct situations/events more days than not over a period of at least 6 months
- A general fear of uncertainty
- Most common type of anxiety disorder
14
Q
What are the three major features of GAD?
A
1) Uncontrollability of worry
2) Intolerance of uncertainty (does not cope well with situations that have no immediate outcome)
3) Ineffective problem-solving skills (worry is often characterized by your self-talk)
15
Q
What are some common characteristics of those diagnosed with OCD?
A
- Obsessions and compulsions must be intrusive, unwanted, and unreasonable, but the patient’s insight may vary (i.e., may think they’re necessary or ruining their life)
- Compulsions must be driven by rigid rules or obsessions, and aimed at reducing anxiety (very procedural)
16
Q
What are some common obsessions/compulsions?
A
- Contamination
- Pathological doubt
- Mental comparisons
- Need for symmetry
- Somatic obsessions (ex. how long you chew)
- Sexual/aggressive obsessions
- Scrupulosity (often tied to religion/perfectionism)
17
Q
How does the neurobiological model describe OCD?
A
- The interactions between the frontal lobes and the basal ganglia (there’s dysregulation)
- Depleted memory problems and memory confidence, explaining repeated checking
- The serotonin hypothesis (not that great for OCD)
18
Q
How does the cognitive-behavioural model describe OCD?
A
- Problematic obsessions are caused by people’s catastrophic reactions to intrusive thoughts
- Treatment involves trying to help them understand these thoughts are excessive and their reactions catastrophic
- There are also excessive beliefs about personal responsibility and feelings of guilt
- These obsessions persist because of people’s maladaptive attempts to cope with them
19
Q
What is body dysmorphic disorder?
A
- Intense dissatisfaction with certain aspects of one’s appearance
- Only diagnosed if the concern with slight defects is markedly excessive
- Characterized by intense suffering. BDD patients tend to be more severely disturbed than those with OCD
- Shares traits with anorexia nervosa
20
Q
What describes the trauma required by those to be diagnosed with PTSD later on?
A
- The experience of both an event involving actual and/or threatened injury or death, and the response of intense fear, helplessness and/or horror to the event. The traumatic event may include oneself or another person, usually someone close
- Must experience event in REAL-TIME
21
Q
What are the common symptoms of PTSD?
A
- Flashbacks of past trauma
- Avoidance (common in anxiety disorders)
- Increased autonomic arousal (body stress responses)
- Symptoms last for more than one month
- The HPA axis is continually turning
22
Q
What’s Acute Stress Disorder (ASD)?
A
- Can occur within 4 weeks of trauma exposure
- Completely made-up disorder by clinicians to identify potential signs of PTSD early on.
- Other symptoms may include dissociative symptoms such as dissociative amnesia, depersonalization, and derealization
23
Q
What’s the Innate Alarm System (IAS)?
A
- Loops in the brain characterized by the brainstem, amygdala, and frontal cortex. Provides basic emotional reactions and movements in response to threats
- May be unconsciously activated in those with PTSD
24
Q
What are the risk factors (pre/post-event) for PTSD?
A
- Pre-event: Being female, low SES, low education, low tested intelligence, having a previous psychiatric history, ACEs
- Post-event: Severity of event, lack of support, whether more traumatic events occur after the fact
25
T/F: Interpersonal traumas (ex. sexual abuse) tend to provoke PTSD more often than non-interpersonal traumas (ex. natural disasters).
- TRUE
26
What social factors contribute to anxiety disorders?
- Social factors
- Childhood adversity
- Anxious attachment; separation anxiety
27
What two psychological theories may contribute to anxiety disorders?
- Classical conditioning, potentially encouraged by biological preparedness
- Observational (social) learning
28
What cognitive theories may contribute to anxiety disorders?
- Perception of a lack of control
- Disgust sensitivities (more for phobias)
- Catastrophic misinterpretation
- Thought-action fusion (OCD
- Intolerance of uncertainty
- Dual representation theory
29
What's thought-action fusion?
- Mainly in OCD
- The belief that the thoughts they have will increase the probability of these bad things actually happening
30
What's dual representation theory?
- Mainly seen in PTSD
- Trauma is mainly encoded in the brain as images while regular memories are encoded as words, helping explain why flashbacks occur
- Why PTSD treatment involves having patients write down what happened to them
31
What is composed of the fear circuitry in the brain?
- The sensory cortex > thalamus > amygdala <> Pre-frontal cortex, and hippocampus
32
What is the major treatment for anxiety disorders?
- EXPOSURE
33
What are the different types of in-vivo desensitization?
- Systematic desensitization - working through a fear hierarchy
- Flooding - Intense exposure
- Interoceptive exposure - used for panic disorder, mimic physiological stress responses
- Exposure + ritual prevention for OCD
34
What are the different types of imagery-based exposure?
- Systematic desensitization (in your head) - an option when real stimuli are unavailable/difficult to manage
- Worry imagery exposure (GAD)
- Writing and telling an integrated story of trauma (PTSD)
- Eye-movement desensitization and reprocessing (EMDR) - Often controversial, used for PTSD
35
T/F: Benzodiazepines can work as an antianxiety medication.
- TRUE
- Repeated use can lead to addiction, so not highly recommended
- Antidepressants now more common
36
What are the three distinct components of emotion?
- Physiological, cognitive, and behavioural
37
Between men and women, whose more likely to be diagnosed with panic disorder?
- Women (x2 more likely)
38
What medical conditions can mimic panic disorder?
- Hypoglycemia, hyperthyroidism
39
What's tachycardia?
- Increased heart rate
40
What are neutralizations?
- Related to OCD
- Behavioural/mental acts used by people to try to prevent, cancel, or undo the feared consequences and distress caused by an obsession
41
How much time spent on OCD behaviours a day does the DSM-5 merit a diagnosis of OCD?
- Spending more than one hour per day engaged in OCD behaviours
42
T/F: 25% of those diagnosed with body dysmorphia disorder will commit suicide.
- TRUE
43
What's the most effective treatment for panic disorder?
- CBT
