NEURO Anxiety Disorders

Question 1

What are specific phobias?

Answer 1

marked anxiety specific to object or situation.
DSM-5 Definition: disproportionate fear relating to specific object or situation. Actively avoided. Significant distress in important areas of functioning. Symptoms cant be explained by other mental disorders and persist for at least 6 months.

Question 2

What are the five subgroups of specific phobias?

Answer 2

Animal phobias, natural environment phobias, blood-injection-injury phobias, situational phobias, other phobias.

Question 3

What is the psychoanalytic account of phobias?

Answer 3

Freud: Defence vs anxiety caused by repressed id impulses. Fear associated with external events of situations with symbolic relevance to repressed id impulse.
ID= I want to do that now.
EGO= Maybe we can compromise.
SUPEREGO=Its not right to do that.

Question 4

What is the classical conditioning account for specific phobias?

Answer 4

Object gets associated with negative outcome (e.g. dog bite with pain) learn to fear it.

Question 5

What are some limitations for classical conditioning?

Answer 5

Not all phobias linked to traumatic experience.
Not everyone has traumatic experience with specific object acquires a phobia.
Specific phobias not evenly distributed across all stimuli.
Doesn’t take into account incubation (why phobia gets worse over repeated phobia stimuli).

Question 6

What is the biological account for specific phobias?

Answer 6

Preparedness theory: pre-wired for certain phobias linked to real-life threatening experiences.
Seligman proposed we are born with predisposition to learn to fear these stimuli (not that we are born with the phobia).
Evolutionary perspective: biological predisposition to associated fear with stimuli that was hazardous for our ancestors.

Question 7

How does neurocircuitry underlie specific phobias?

Answer 7

Amygdala mediates fearful responding to phobic stimuli located within the medial temporal lobes.
Important role in formation + storing of memories associated with emotionally relevant events + acts as neural centre identifying emotional input + coordinating information from higher cortical areas + subcortical nuclei.

Question 8

Explain cognitive theories for phobias?

Answer 8

Phobias acquired by cognitive biases or maladaptive thinking. We pay more attention to words/ pictures associated with phobia compared to neutral words/ pictures.

Question 9

Explain exposure therapy as an intervention for specific phobias?

Answer 9

Important to address phobia beliefs that sufferers hold about their phobias event of stimuli.
Therapist will aim to develop formulation specific to clients difficulties.

Question 10

Explain the fear hierarchy as an intervention for phobias?

Answer 10

Progressively gets more exposed to the object as we go up the hierarchy.

Question 11

What are the symptoms of PTSD?

Answer 11

Only consider diagnosis if experienced extreme trauma prior to symptoms.
-direct exposure/ witness
-flashbacks/ dreams
-active avoidance of thoughts
-negative emotions. reduced interest in activates.
-hyper vigilance, difficulty sleeping.
Link to depression, suicide and self-harm but can’t be explained by other disorders.

Question 12

Outline the genetic link to ptsd?

Answer 12

War veteran studies suggest PTSD has genetic element to it (heritability component estimated at 30%).
Gene- environment interaction.

Question 13

Name some PTSD Vulnerability factors?

Answer 13

-feel overly responsible
-highly anxious
-low IQ
-mental defeat
-family history
-developmental factors

Question 14

What is the PTSD conditioning theory?

Answer 14

Classical conditioning: trauma associated with situational cues (place + time) at time of trauma. When these are accounted in the future, they elicit arousal and fear that was experience during the trauma.

Question 15

What is the dual representation theory for phobia?

Answer 15

VAM: Verbally Accessible Memory
-easily accessible information.
-i.e. memory of the trauma that is consciously processed at the time.
-integrated with biographical memories.
SAM: Situationally Accessible Memory
-perceptions based information received from sensory channels.
-record information that is not consciously processed.
-e.g. sounds, smells.

Question 16

What are the three interventions for PTSD?

Answer 16

1. Psychological debriefing: aim to prevent development of PTSD after the trauma.
2. Exposure therapies: confronting and experiencing the events relevant to the trauma. -> Graded exposure- similar to phobias.
3. Cognitive restructuring: 1. evaluate and replace intrusive or negative automatic thoughts. 2. evaluate and change dysfunctional beliefs (certain beliefs can mediate development and maintenance of PTSD).

Question 17

What is OCD?

Answer 17

Repeated and often intrusive thoughts and actions, result in distressing and disabling life.

Question 18

Outline the OCD cycle?

Answer 18

obsession-> anxiety-> compulsions-> relief-> obsessions. (cycle)

Question 19

What are obsessions?

Answer 19

Intrusive and recurring thoughts that the individual finds disturbing and uncontrollable.

Question 20

What are compulsions?

Answer 20

Represent repetitive or ritualised behaviour patterns that the individual feels driven to perform in order to prevent some negative outcome from happening.

Question 21

What are the different types of OCD?

Answer 21

-checking
-contamination
-symmetry and ordering
-rumination/ intrusive thoughts

Question 22

What needs to be present for an OCD diagnosis?

Answer 22

Presence of obsessions.
Presence of compulsions.
Individual beliefs that the behaviour will prevent a catastrophic event.
Obsessions and compulsions cause difficulty in performing other functions.
Symptoms cannot be explained by other disorders.
Symptoms need to significantly impact daily life.

Question 23

Explain the biological factors for OCD?

Answer 23

No universal explanation some can only account for obsessions and some only for compulsions.
Evidence of inherited components: twin studies have found high concordance for monozygotic twins compared with dizygotic twins. Family relative of individuals with OCD are also more likely to have diagnosis of OCD than non- family controls.

Question 24

Explain the psychological factors of OCD?

Answer 24

Doubting is a central feature. Suggested that PCD may be characterised by memory deficit that give rise to doubting.

Question 25

Outline OCD interventions?

Answer 25

Graded exposure + ritual prevention treatment most common and most successful treatment. Cog behavioural therapies target and modify dysfunctional beliefs that OCD sufferers hold about their fear, thoughts and significance of their rituals. Pharmacological treatment- cheaper short-term effective way of treating OCD. SSRI's commonly prescribed drug increase serotonin in synaptic cleft. Neurosurgery if all other treatments fail.

Question 26

What is GAD (Generalised Anxiety Disorder)?

Answer 26

Uncontrollable worry about all things, expect the worst. Worries extremely upsetting and stressful. Worry disrupts your job and social life. Lasts at least 6 months. (more common in men than women)

Question 27

What is the DSM-5 definition of GAD?

Answer 27

Disproportionate fear or anxiety relating different aspects of your life. Anxiety to two areas of anxiety. Feelings of anxiety will be accompanied by symptoms of restlessness, agitation, muscle tension. Worry will be associated with behaviours such as avoidance, seeking reassurance, excessive preparing etc. Symptoms cannot be explained by other mental health disorders.

Question 28

Explain the biological theories surround GAD?

Answer 28

Heritable Influences: runs in families but heritability is low. Suggests there is genetic or biological elements. Found GAD sufferers show hyper-responsivity in the amygdala.

Question 29

Explain the environmental factors surrounding GAD?

Answer 29

Negative life events, attachment styles (from parents), modelling (parents act in anxious way, can affect interpretation of things).

Question 30

Explain the cognitive biases in GAD?

Answer 30

Information focus on negative information, don't give enough time to positive information. Attention focused on negative stimuli, research happy faces vs sad faces, those with GAD focus more on negative.

Question 31

What are the pharmacological treatments for GAD?

Answer 31

-Benzodiazepines: stimulates GABA; inhibitory neurotransmitters. Dampens anxiety like how alcohol works. BUT can be addictive properties- unpleasant withdrawals. -B-Blockers: dampen adrenaline activity responses, reduces fight or flight response which causes heavy breathing and heart rate. -Selective Serotonin Re-uptake inhibitors: anti-depressants shown to relieve some of the symptoms. BUT don't tackle cause of symptoms.

Question 32

What is stimulus control treatment?

Answer 32

Comes from principle of conditioning. Becomes conditioned to worry everything because that is their normality. Work with therapist to limit worry to specific time of day in specific location. Dedicate time to it, reduces connection with everything and worrying and stops it ruining all day.

Question 33

Outline GAD interventions?

Answer 33

CBT for distorted cognition. Exposes ppt to worst possible option- exposes them to their distorted cognition. -self-monitor -relaxation training forgotten how to relax cause not used to experiencing it. -cognitive restructuring. -behavioural rehearsal, asked to imagine or rehearse a situation, think about how would cope, help them develop more healthy coping strategies.

Question 34

What are panic disorders?

Answer 34

Repeated anxiety or panic attacks. Spontaneous. Recurrent, includes worrying about future panic attacks. Modify behaviours to avoid future attacks.

Question 35

What is hyperventilation?

Answer 35

Associated with panic disorders. Dysfunctional breathing patterns create full on panic attacks. Panic breathing limits oxygen intake. Letting out more air than breathing in. Results in drop in Co2 pressure in blood, altering our blood pH. Oxygen not being delivered as effectively leading to cardiovascular change.

Question 36

What is the Clarke's Panic Cycle (1986)?

Answer 36

Trigger stimulus gets perceived as a threat, we feel apprehension, bodily sensation, interpretation of sensation as catastrophic.

Question 37

What are Panic Disorder interventions/ treatments?

Answer 37

Same as GAD. Benzodiazepines, B-Blockers, Selective Serotonin Re-uptake inhibitors.

Question 38

How can CBT be used to treat panic disorders?

Answer 38

Recognise what might cause the trigger. Restructure the maladaptive beliefs. Teach the client about the fight- flight response. Prevent safety behaviours.

Question 39

What is social anxiety disorder?

Answer 39

Often includes panic attacks, but differ from panic disorders in that it is specifically social situations that trigger the anxiety. DSM-5 Distinct fear of social interactions. Avoided or experienced with intense fear or anxiety. Avoidance fear/ anxiety last more than 6 months. Other disorders ruled out.

Question 40

Outline Clarke + Wells (1995) cognitive theory?

Answer 40

Before social interaction: negative beliefs reinforce beliefs about social situations. During social interaction: feel negative physical symptoms, focus on these negative feelings. After social interaction: negative thoughts, overthinking.

Question 41

What are cognitive bias's?

Answer 41

Tend to focus on all negative aspects of social situation and struggle to process and accept anything positive. Likely to maintain individuals' dysfunctional beliefs about the social situation and about themselves.

Question 42

What process does CBT use to treat social anxiety disorder?

Answer 42

1. Forming a rapport. 2. Working with the client. 3. Constructive feedback. 4. Exposure. 5. Challenging cognitions.

Question 43

What is the link between anxiety and comorbidity?

Answer 43

Many of symptoms of anxiety are common to number of different anxiety disorders, and therefore, it is common for an individual to suffer from more than one anxiety disorder.