Chapter 5: Anxiety, Trauma- and Stressor-Related Disorders

Question 1

Anxiety

Answer 1

future oriented negative mood/state that is focused on apprehension about the future; focused on somatic and autonomic tension (muscles, heart beat, etc)

Question 2

Fear

Answer 2

an immediate alarm response to a specific stimulus, focused on sympathetic nervous system

Question 3

Yerkes-Dodson Law

Answer 3

medium anxiety/fear (arousal in general) allow for the optimal performance, but that medium is different for different people

Question 4

Panic

Answer 4

an overwhelming fear response that is unreasonable considering the stimulus/situation

Question 5

Panic Attack

Answer 5

an intense sense of discomfort accompanied by a physiological response; usually lasts under 15 minutes, and includes depersonalisation and derealisation; important indicator about anxiety across one’s lifespan

Question 6

Expected vs Unexpected

Answer 6

unexpected panic attacks are unprompted, while expected ones have a known stimulus that triggers them

Question 7

CFS

Answer 7

corticotropin releasing factor system; activates the HTPAC, and is most associated with anxiety; can activate a large network and serves as the mediator between the brainstem and the cortex

Question 8

BIS

Answer 8

behavioural inhibition system; activated by signals from the brainstem regarding unexpected events, and works with the amygdala; danger signals can also travel down and to the BIS from the cortex; causes freezing or anxiousness if danger can be confirmed

Question 9

Grey and Graeff’s FFS

Answer 9

fight or flight system; originates in the brain stem, goes to the amygdala, and hypothalamus before reaching the central grey matter; when stimulated in animals it creates this exact response; serotonin deficiencies could potentially activate this system

Question 10

Anxiety Sensitivity

Answer 10

the general tendency to fear interoceptive sensations or respond fearfully to anxiety systems

Question 11

Top-down and Bottom Up Processing for Anxiety

Answer 11

the limbic system is overly responsive to new information, and the cortex’s down regulation of this overstimulation isn’t working

Question 12

Fear vs Anxiety

Answer 12

fear usually arises from a true alarm, or a potential alarm and a mislabelling, and therefore bypasses anxiety in that aspect; also, images can travel straight to the amygdala, and while that wouldn’t cause someone who is anxious to feel more anxious, it would heighten fear

Question 13

Triple Vulnerability Theory of Anxiety

Answer 13

1. Generalised biological vulnerability (having specific, related genes, your parents having the condition, being more likely to gamble because of your brain chemistry, etc.
2. Generalised psychological vulnerability (a generalised belief that the world is a bad place, uncontrollable, unsafe, etc)
3. Specific psychological vulnerability (heard parents say this, religious upbringing, etc)

Question 14

Process-Based Therapy

Answer 14

for therapy to be the most effective, it must target the underlying process of change rather than the DSM-5’s list of signs

Question 15

Unified vs Singular Protocols

Answer 15

addresses the issues of the disorder and are equally as effective, but singular focuses on one disorder in particular while unified focuses on more than one (related) disorders

Question 16

GAD

Answer 16

generalised anxiety disorder; characterised by more than 6 months of excessive worrying about upcoming (daily) events and little to no control over this process; must have 3+ symptoms
1. age of onset ~31, but most claim to have had it all of their lives
2. chronic, waxes and wanes
3. more common in women
4. anxiety sensitivity (gbv)
5. autonomic inflexibility/autonomic restrictor: heart doesn’t “race” from what it should
6. mental images help because the cognitions (worries) are often without clear images of the actual event and realistic outcome
7. CBT or Zoloft (SSRI)

Question 17

Panic Disorder

Answer 17

experiencing severe, unexpected panic attack(s), accompanied by the anxiety of having another panic attack; don’t have to have avoidance behaviour, but 6+ months
1. median age of onset is 20-24
2. more women
3. 4.7% for prevalence
4. most happen between 1:30-3:30 AM
5. strongly related to psych factor of “internal stimulus is generally dangerous”
6. SSRI, Benzos, and SNRI; if using the drugs, relapse is highly likely
7. Gradual Exposure and PCT (panic control treatment) seem to work better
8. Interoceptive avoidance or external cue avoidance

Question 18

Agoraphobia

Answer 18

avoidance and fear of situations where a person feels as though they can’t escape to their house or the hospital in the event of a medical emergency (can include panic attacks) +6 months
1. 2/5 situations that a person avoids (closed rooms, open rooms, public areas like malls, transportation, etc)
2. agora = marketplace
3. women mostly
4. strongly related to cultural and social factors
5. interoceptive avoidance or external cue avoidance

Question 19

Specific Phobia (4)

Answer 19

fear of a specific object or situation that interferes with daily ability to function; must go to considerable lengths to avoid the stimuli that is not in proportion to the danger that it poses, must be specific and 6+ months
1. Blood Injection Injury ** special because genetic influence
2. Situational
3. Animal
4. Natural
5. Other
6. age of onset ~7, very early
7. mostly female
8. exposure-based therapy = increasing cognitions and decreasing immediate alarm response
9. fear hierarchy

Question 20

SAD

Answer 20

social anxiety disorder; severe suffering caused by social/performance situations; 6+ months
1. performance only is a subset
2. age of onset 13
3. sex ratio is nearly 1:1
4. prevalence is highly socially related
5. Shinkeshitsu!
6. amygdala is activated more so than others
7. behavioural inhibition is a sign anxiety will naturally be higher
8. maintenance behaviours are the main problem
9. SSRIs, CBT, and DCS with mixed results

Question 21

Behavioural Inhibiton

Answer 21

the tendency to withdraw from new stimuli and to be afraid of them