L4 - Panic Disorders Flashcards
1
Q
What is Panic Disorder?
A
- Recurrent unexpected panic attacks
2
Q
What is a panic attack?
A
- Abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four or more of different symptoms occur
- At least one of the attacks has been followed by 1 month of one or both of the following:
1) Persistent concern or worry about additional panic attacks or their consequences
2) A significant maladaptive change in behaviour related to the attacks
3
Q
What is agoraphobia?
A
- Marked fear or anxiety about using public transportation, being in open spaces, being in enclosed places, standing in line or being in a crowd or being outside or home alone.
- The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms
- Almost always provoke fear/anxiety
- Actively avoided, require the presence of a companion
4
Q
What are features of PD?
A
- 80-90% panic attacks develop after negative life event
- Prevalent in women
- Female prevalence increases with higher avoidance
- Expression of fear is more acceptable in women, men cope by drinking, smoking and enduring panic attack
- Women cope by increasing avoidance = agoraphobia
5
Q
What is the behavioural perspective for PD?
A
- Interoceptive conditioning: Initial Panic Attack & Internal stimulus (physical/cog symptoms)= Recurrent Panic Attack
- Exteroceptive conditioning: Initial panic attack & external stimulus (specific situation) = Recurrent panic attack
6
Q
What is generalisation of conditioning to all?
A
- Places, situations where panic attack occurred
- Internal stimulus experienced
7
Q
What do individuals with PD show?
A
- Greater generalisation of conditioned response
- Slower extinction of conditioned anxiety
8
Q
What is the behavioural therapy?
A
- Prolonged exposure to feared situations, useful for 60-75% of people with agoraphobia and effects maintained
- Interoceptive exposure to feared internal sensations
9
Q
What is the cognitive perspective? (Panic cycle)
A
- Trigger stimulus = perceived threat = apprehension = body sensations = interpretations of sensations as catastrophic = perceived threat
- Automatic thoughts about the meaning of body sensations
10
Q
What was a study looking at a cognitive distortion?
A
- Questionnaire and experimental paradigm study
- Body sensations interpreted more seriously, especially with those who panic
- Vulnerability factor/anxiety sensitivity AND maintenance factors that lead to automatic thoughts about the meaning of the body sensations
11
Q
What was a study looking at anxiety sensitivity in PD? (Depression)
A
- 1400 adults followed during 5 week military training
- The higher the panic attack frequency, the higher the mean rate of depression
12
Q
What are safety behaviours in PD?
A
- People with panic disorder frequently engage in safety behaviour inc breathing slowly.
- Provide short-term anxiety relief but reinforce avoidance behaviour
- Prevent disconfirmation of catastrophic beliefs
- Eliminating safety behaviour is central in CBT or can be used to increase perceived control during therapy
13
Q
What are nocturnal panic attacks?
A
- 50-60% experience a panic attack during sleep
- Different from nightmares and other night terrors
- Cannot be explained by cognitive theory as it is hard to understand how catastrophic cognitions may develop during sleep
- Explained by interceptive conditioning
14
Q
CBT in PD:
A
- Recognise that catastrophic thoughts help maintain panic attacks and begin to challenge and restructure cognitions
15
Q
What does psycho-education teach?
A
- Adaptive value of anxiety
- Function of flight-or-flight response
- Panic cycle
