{ "@context": "https://schema.org", "@type": "Organization", "name": "Brainscape", "url": "https://www.brainscape.com/", "logo": "https://www.brainscape.com/pks/images/cms/public-views/shared/Brainscape-logo-c4e172b280b4616f7fda.svg", "sameAs": [ "https://www.facebook.com/Brainscape", "https://x.com/brainscape", "https://www.linkedin.com/company/brainscape", "https://www.instagram.com/brainscape/", "https://www.tiktok.com/@brainscapeu", "https://www.pinterest.com/brainscape/", "https://www.youtube.com/@BrainscapeNY" ], "contactPoint": { "@type": "ContactPoint", "telephone": "(929) 334-4005", "contactType": "customer service", "availableLanguage": ["English"] }, "founder": { "@type": "Person", "name": "Andrew Cohen" }, "description": "Brainscape’s spaced repetition system is proven to DOUBLE learning results! Find, make, and study flashcards online or in our mobile app. Serious learners only.", "address": { "@type": "PostalAddress", "streetAddress": "159 W 25th St, Ste 517", "addressLocality": "New York", "addressRegion": "NY", "postalCode": "10001", "addressCountry": "USA" } }

Lecture 4 (Anxiety disorders) Flashcards

(19 cards)

1
Q

Fear vs Anxiety

And why anxiety can be helpful

A

Fear = stress response from immediate danger, builds up quickly or intensely -> motivates behavioural responses

Anxiety = anticipation of future problems, emotional experience is out of proportion to threat

Anxiety can act as a positive warning system that threat is imminent, and signals to activate protective responses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Anxiety disorders: general considerations and features

A

Considerations:
-> differ from norm responses by being excessive, persisting beyond developmentally appropriate periods
-> are not transient fears (do not pass) they are persistent
-> impact life functioning
-> Physiological, cognitive, and behavioural responses fall under emotions

Features:
-> subjective feelings of anxiety
-> expectation of disaster
-> avoidance
-> disturbances in thinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Epidemiology

A

Anxiety disorders most common under 12 month mental disorders
Social phobia most common for males and females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Specific Phobia and specifiers

A

Marked fear or anxiety about specific object or situation
-> exposure to stimuli almost always provokes fear
-> stimuli is actively avoided or endured with intense feelings of anxiety
-> out of proportion to stimuli
-> 6 months or longer

7-9% prevalence
Females 2 x more likely to have

Specifiers
Can be animals, environment (e.g. storm), situational, blood related

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Social anxiety disorder and clinical features

A

->Marked fear about social situation where you are being negatively evaluated or fears they will show anxiety that will be negatively evaluated
-> social situations almost always provoke fear (6 months longer) and results in significant impairment
-> can be performance related only (e.g. speaking in front of crowd) or can be more broad e.g. eating in public, using public toilets, being in situation where someone thinks they may do something foolish

Clinical features:
->belief others see them as stupid
-> Avoidance or use of safety behaviours to reduce anxiety
-> pre and post event analysis
-> focus on internal situations e.g. focus on heart rate and think others notice you have a high heart rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Panic disorder criteria/epidemiology/symptoms

A

Recurrent and unexpected panic attacks
-> one attack followed by a month of one or more
-> concern about additional attacks
-> maladaptive change in behaviour (e.g. avoidance of going somewhere to avoid panic attack)

Minor increase in prevalence
3-5% of population experience panic attacks but do not meet criteria for panic disorder

Panic attack =
-> pounding heart
-> sweating / trembling
-> shortness of breath
-> chest pain
-> nausea
-> chills / heat
-> parasthesias (numbing)
-> derealisation / depersonalisation
-> fear of losing control
-> fear of dying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Panic attack to panic disorder (fear of fear cycle) and more

A

stuck in fear of fear cycle -> fear -> FFF symptoms -> ‘something is wrong’ -> body sensations -> “im dying”

catastrophize physical sensations
-> avoid situations that may produce body sensations e.g. coffee, exercise
-> react to any bodily sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Agoraphobia

A

Fear of being a space where it may be hard to exit when needing to e.g. having anxiety or having panic attack

Anxiety is about being in places because of the thought that escape will be too difficult

6 months or longer

Double in prevalence nearly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

GAD and features

A

Excessive anxiety and worry for more days than not for 6 months about a number of events or activities

Difficulty in controlling worry

3 or more
-> restlessness
-> fatigue
-> concentration
-> irritability
-> muscle tension
-> sleep disturbance due to anxious thoughts

Features:
-> less tolerance for uncertainty (e.g. want to have full weekend planned out)
-> overestimation of negative consequences
-> underestimate coping abilities
-> believe worry is helpful but also dangerous
-> always expecting the worse to happen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

OCD -> obsessions and common obsessions

A

Compulsions = intrusions
-> recurrent and persistent
-> having intrusions are normal but in OCD those intrusions are further evaluated
-> attempts to ignore or suppress or neutralise with some thoughts or actions

common obsessions
-> contamination
-> symmetry
-> harm to self or others
-> taboo or forbidden thoughts e.g. sexual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

OCD -> Compulsions

A

Compulsions are known as neutralising behaviours
-> repetitive behaviours or mental acts
-> real drive to complete these behaviours have to do it the same way
-> aimed at preventing or reducing anxiety or preventing situations
-> not realistically connected or are clearly excessive

e.g. checking, rituals, washing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

OCD criteria and epidemiology

A

Presence of obsessions, compulsions or both
obsessions/consumptions are time consuming (>1 hour a day)
Obsession is not related to another disorder e.g. food related to ED
Have to specify their insight

Double in prevalence

usually starts early and usually a gradual response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PTSD epidemiology/criteria/features

A

6.4% in general population, but 20% in veterans
veterans usually have high comorbidity with depression/anxiety/substance
Characteristics not required for diagnosis
-> presence of fear, hopelessness, horror, shame or guilt

Criteria
Exposure to something traumatic
Presence of one or more intrusions
-> involuntary distressing memories
-> dreams
-> psychological / physiological distress in response to cues

Avoidance with thoughts/feeling/memories or external reminders of event

Negative alterations 2 or more
-> inability to remember aspects of the event
-> exaggerated negative beliefs about oneself or the world
-> distorted cognitions about the event e.g. i am to blame
-> persistent negative emotional state
-> diminished interest in activities
-> feelings of detachment
-> inability to experience positive emotions

Physiological arousal two or more
-> irritability
-> self-destructive behaviour
-> hypervigilance
-> startle response
-> concentrating
-> sleep disturbance

Has to be longer than one month
Distinguish between distress or dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Aetiology of anxiety from historical psychodynamic approach

A

Not contemporary thinking for current diagnosing

-> anxiety arises from psychic conflict between id and threats from the super ego
-> anxiety is signal that indicates an impulse is about to be acted on and triggers defense to prevent recognition of impulse
-> if impulse too strong, anxiety overwhelms system and person develops disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Evolutionary/biology/genetics/neuro

A

Evolutionary
-> anxiety developed in response to threat (protective behaviour when activated at appropriate times)
-> anxiety apart of adaptive system
-> disorders are problems in regulation of system which evolved to deal with threats

Biological
-> MZ highest for panic disorder and agoraphobia

Neuro
-> limbic activation (amygdala)
-> HPA axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Psychosocial perspective

A

Event based explanations
Stressful life events
Childhood adversity
Parenting style
Temperament -> problems if their is a mismatch in child and parent temperament
Attachment problems and separation anxiety

17
Q

Conditioning and Learning models

A

Classic -> the phobia is the NS (e.g. dog) and is paired with an aversive stimulus (e.g. dog bite) provoking fear reactions
-> model does not explain maintenance of fear response and why some develop it and others dont

Operant -> aversive stimulus -> become anxious -> run away (run away reduces anxiety (e.g. -ve reinforcement so you keep doing it)

Observational learning -> we learn through modelling and learn to avoid stimuli of modelled by sig. others

18
Q

Cognitive processes and anxiety disorders

A

Appraisals, expectations, attention and cog avoidance associated with development and maintenance of disorder

Catastrophic misinterpretation -> overestimate stimuli as threatening

Attentional bias to threat -> hypervigilant to cues signalling future threats

Chronic thought suppression -> struggle to suppress and control thoughts which provoke anxiety, rebound effects

19
Q

Treatment

A

Meds first treatment

Use of free association and dream association -> use psychoanalysis to discover and work through conflicts

IPT -> targeting interpersonal conflicts, role transitions etc.

CBT -> use of psychoeducation to find triggers, cog restructuring, and ABC model

EXPOSURE THERAPY -> gradual and repeated exposure

Mindfulness and relaxation based therapies to help reduce anxiety levels