CP: Lecture 3 Anxiety

Question 1

emotion aspects

Answer 1

expression
appraisal
feeling
physiology
action tendencies
behaviour

Question 2

primary function of emotions =

Answer 2

to mobilize the organism to deal quickly with important (interpersonal) encounters

Question 3

fear =

Answer 3

basic emotion
bij immediate danger

Question 4

physiology bij fear

Answer 4

heartrate
blood pressure
muscle tone
breathing

Question 5

behaviour bij fear

Answer 5

freeze, fight, flight, fright

Question 6

anxiety =

Answer 6

threat in the future, dus anticipatory anxiety
complex emotion
gaat om avoidance + preparation

Question 7

anxiety disorder: irrationality and distress?

Answer 7

irrationality: stimulus does not justify the fear, long duration of fear
distress: fear is very aversive, due to which avoidance or safety behaviours occur

Question 8

DSM 5 anxiety disorders

Answer 8

 Separation anxiety disorder
 Selective mutism
 Specific phobia
 Social anxiety disorder
 Panic disorder
 Agoraphobia
 Generalized Anxiety Disorder
 Substance induced anxiety disorder
 Anxiety disorder due to another medical condition
 Other specified / unspecified anxiety disorder

Question 9

prevalence anxiety per gender

Answer 9

bij vrouwen 23 bij mannen 15

Question 10

anxiety and deptression

Answer 10

high comorbidity

Question 11

relapse bij anxiety?

Answer 11

vaak relapse naar een andere anxiety disorder…

Question 12

ethiology and maintenance of anxiety: mowrer 1950

Answer 12

= learning theory!

ethiology: classical conditioning (associating neutral stimulus with unconditioned response)

maintenance: operant conditioning (reinforcement of avoidance)

Question 13

neurotic paradox =

Answer 13

short term: fear gets less temporarily
long term: pathology is maintains, sometimes grows. dus uiteindelijk meer fear terwijl ze dat juist willen vermijden.

Question 14

critism of learning theory

Answer 14

1. why more fear for certain stimuli?
2. why sometimes fear without traumatic experience?
3. why sometimes no fear after traumatic experience?

Question 15

3 antwoorden op die 3 critisms

Answer 15

certain stimuli more fear:
1. Evolutionary preparedness / Prepared learning ->Snakes, Spiders, etc waren gevaarlijk dus meer fear

sometimes fear without trauma:
2. Vicarious learning, Information transfer, Inflation -> Learning ‘through someone else’s experience’

sometimes no fear after trauma:
3. Latent inhibition & Differential learning -> Previous positive experiences & different propensities to acquisition of fear

Question 16

dus in kort kritiek + antwoorden

Answer 16

sommige stimuli meer: door evolutie
fear no trauma: vicarious learning, information transfer, inflation (via anderen)
trauma no fear: latent inhibition, differential learning (door eigen positieve experiences)

Question 17

specific phobia dsm criteria

Answer 17

marked fear or anxiety
always, immediate
avoidance or endured
out of proportion to actual danger
6 months or more
distress impairment
not better explained

Question 18

soorten specific phobias

Answer 18

animal
natural environment
blood-injection-injury
situational
other

Question 19

heritable aspects of anxiety

Answer 19

neuroticism is 40%
behavioural inhibition
specific genes voor bv panic disorder

Question 20

environmental factors for anxiety

Answer 20

positive and negative experiences
parent modeling
parenting styles

(bv ouders bang helm fietsen)

Question 21

behavioural inhibition

Answer 21

temperament; distress in novel situations/people/environments
social anxiety disorder risk later
dit is dus high reactivity!!

Question 22

low reactivity in children

Answer 22

minder kans op shyness (only 10%) en minder kans social anxiety (only 15%)

Question 23

high reactivity in children

Answer 23

= behavioural inhibition

46% shy later
45% social anxiety symptoms later

Question 24

dus… social anxiety does not always have a …. temperament

Answer 24

vulnerable!

Question 25

waarom werkt exposure voor phobia? 3 verschillende theorieen

Answer 25

- reciprocal inhibition: relaxation response causes inhibition (maar is niet zo, ook response without relaxation) - erase, replace association -> habituation (no, fear can return) - extinction -> inhibition of CS-US association by a CS-noUS association (ja!)

Question 26

inhibition of CS-US association door

Answer 26

amygdala

Question 27

CS-noUS association door

Answer 27

prefrontal cortex and hippocampus

Question 28

medical therapy specific phobia

Answer 28

 Cognitive enhancers with exposure? ◦ D-cycloserine  Disrupting memory reconsolidation? ◦ Beta-blockers

Question 29

verschil panic disorder and other anxiety disorders

Answer 29

panic disorder = unpredictable panic attacks. andere disorders hebben predictable triggers

Question 30

symptoms of a panic attack

Answer 30

surge of fear, within minutes peak 4 van deze: pounding heart sweating short breathing chest pain choking trembling nausea dizzy chills/heat paressthesisas derealisation/depersonalisation losing control/crazy fear of dying

Question 31

panic circle

Answer 31

trigger stimulus (internal or external) | perceived threat -> apprehension or worry -> bodily sensations -> misinterpreted as catastrophic -> perceived threat etc.

Question 32

wat was de oude explanation for panic disorder

Answer 32

hyperventilation causes dysregulation of blood acidity

Question 33

welke anxiety is het meest prominent bij GAD

Answer 33

worries about the future

Question 34

a criteria GAD

Answer 34

excessive anxiety and worries, more than 6 months, more than 2 domains

Question 35

B criteria GAD

Answer 35

difficult to control the worry

Question 36

c criteria

Answer 36

at least 3/6: restlessness fatigue concentration irritability muscle tension sleep disturbance

Question 37

d, e, f criteria

Answer 37

d = distress e= substance/medical? f = other disorder?

Question 38

ethiology of GAD (4 soorten)

Answer 38

- deficiency of GABA _. dus geen inhibition? (benzodiazepines lijken te werken) - Borkovec: worrying is avoidance, therefore lowers arousal - Newman and Llera: worrying induces negative mood, therefore less contrast in case of catastrophe -> reduced uncertainty (which is better than anxiety) - meta-cognitive model (Wells): 1. worrying helps 2. worrying gets out of control

Question 39

welke therapy has been proven to be better than CBT for GAD

Answer 39

metacognitive therapy

Question 40

dus worrying is basically...

Answer 40

maladaptive coping, that maintains a negative emotional state and prevents true emotional processing, which makes the anxiety persists.

Question 41

GAD and depression overlap misschien door....

Answer 41

◦ Neuroticism? ◦ Trans-diagnostic process? - Repetitive Negative Thinking - Future/ uncertain: GAD - Past / certain: Depression

Question 42

transdiagnostic =

Answer 42

gelijke symptomen bij verschillende disorders

Question 43

 Fear is adaptive, but it can derail...  Fear is also: behavior and physiology  Genes: general and specific vulnerabilities  Environment: positive vs negative modelling & experience  Fear learning: ◦ Conditioning, Vicarious, Information transfer  Maintenance: Avoidance & Cognitions  Fear memory persists in amygdala  Treatment: Exposure ◦ Inhibition by newly acquired extinction memory

Answer 43

oke