PSY240 3. Anxiety Flashcards

Question

Anxiety Disorders

Answer 1

* Not a disorder * Intense fear/discomfort * Sudden onset and peaks rapidly (

Answer 2

-symptoms: sweating, heart rate, muscle tension cued: suddenly in response to specific stimulus uncued: out of the blue suddenly develop all of these symptoms at once

Answer 3

• Recurrent, unexpected panic attacks (PAs) • Followed by 1+ month of (at least one): – Persistent concern about having another PA – Persistent concern about implications of PAs – Significant change in behaviour

Answer 4

important for diagnosing panic disorder: only when there’s at least 2 uncued panic attacks at least 1 month or longer after - constant fear of having another attack and/or the implications of having a heart attack change in behaviour: e.g. stop riding the subway because it happened there last time - can’t go to work uncued becomes cued - come to fear that situation or place - would still be diagnosed as PD

Answer 5

* Anxiety about places / situations where escape might be difficult or help is unavailable * Situations avoided or endured with distress

Answer 6

-condition in itself fear of wide open space 50% of PD also have agoraphobia might be able to do it if they had someone with them

Answer 7

e.g. fear of crowds, lines, on trains, on a bridge, being in a house alone or leaving house alone

Answer 8

Excessive anxiety concerning separation from the home or primary caregiver(s) previously in developmental disorder => now anxiety disorder physical symptoms: being sick - can’t go to school complain so they can stay - can be real frequent nightmares of separation

Answer 9

4+ weeks (6 mos in adults): avoid over-pathologizing responses to transitions

Answer 10

not a lot of evidence of continuity - maybe it doesn’t continue or a measurement artifact e.g. earlier in life, parent interview, later in life, self-report generally when child first goes to school can come up later in life - can’t recall disorder

Answer 11

e.g. going to college e.g. over concern of offspring or spouse we don’t know as much about condition in adulthood

Answer 12

* Consistent failure to speak in social situations * Interfereswithachievement * Duration>1month * Not due to lack of knowledge of language * Not better accounted for by other disorders

Answer 13

emerges in childhood - likely to manifest in school age don’t know much about longitudinal course of disorder rule out other possibilities such as developmental disorder, difficulty in interaction due to anxiety or language problems

Answer 14

* Marked and persistent fear * Exposure almost invariably provokes fear/anxiety* • Situation avoided / endured with distress * Fear/anxiety ≠ actual danger posed

Answer 15

cannot under any circumstance endure situation or stimulus intense amount of distress in childhood: fear may be expressed through screaming, not speaking, tantrums similar symptoms, but tied to specific stimulus or situation

Answer 16

``` Animal Natural / Environment Blood-injection- injury Situational Other ```

Answer 17

e. g. could have been bitten by dog e. g. heights e. g. seeing blood, getting shots e. g. claustrophobia in elevators e. g. clowns, #13

Answer 18

Fear of being focus of attention/scrutiny • Fear of being humiliated – Capacity for age-appropriate relationships* – Must occur in peer settings* • Exposure almost invariably provokes anxiety • Fear is persistent (6+ months)

Answer 19

specific social situations that evoke fear common 20% of US college students report fear of public speaking wording change in DSM-V fearful of humiliation early on - other disorders may cause symptoms like Autism anxiety must be occurring not just with adults, but with peers primary concern to be judged as stupid or weak significant impairment: e.g. run out of room screaming during a presentation

Answer 20

``` Chronic/exaggerated worry / tension (6+ mos) • Unable to control worry • Physical symptoms (3+)* – Restlessness, keyed up, on edge – Easily fatigued – Difficulty concentrating – Irritability – Muscle tension – Sleep disturbance ```

Answer 21

worries about a lot of things feel like you can’t control the worry in adults at least 3, in kids (

Answer 22

Disorder l Age of Onset l Prevalence l Gender Separation Anxiety l ~ preschool l 0.9%–4.0% l F>M Selective Mutism l M Social Anxiety l 8 – 15 years l 7.0–12.0% l F>M Agoraphobia l 17 years l 1.7% l F>M Panic Disorder l 20 – 24 years l 2.0–3.0% l F>M Generalized Anxiety l M

Answer 23

-some disorders such as social anxiety are more common, while mutism is rare because we are ruling it out anxiety disorders more common in female manifestation may be different by gender boys may show indirect symptom - e.g. boys say they have nightmares instead of I don’t wanna go to school gender differences emerge depending on specific object of phobia emerge most frequently in adolescents, but in youth may show remission later on social phobia: males more often diagnosed with because it is inconsistent with expectations of masculinity

Answer 24

* Anxiety and anxiety | * Anxiety and depression (i.e., internalizing) • Anxiety and substance use disorders

Answer 25

internalizing disorders inwardly directed emotional problems externalizing: violence, acting out, substance abuse in children it’s less clear cut the difference between the two than in adults social anxiety: e.g. have a drink to calm nerves issue of self-medicate with alcohol in most cases, anxiety comes first

Answer 26

Dual pathway model of fear | Stimulus => Thalamus => Amygdala

Answer 27

Stimulus => Thalamus => Cerebral Cortex

Answer 28

-understand how brain processes fear get info from environment that triggers fear response thalamus: gateway amydala: registers danger, stores emotional memory triggers fast reaction cerebral cortex: to brain for more thoughtful processing of info

Answer 29

* Poorly regulated fight-or-flight responses | * Overreactive autonomic nervous system

Answer 30

-might be sensitive to bodily reactions when exposed to fear stimulus same experience of hyperventilating can cause more intense reactions in other ppl might be sensitively attuned to bodily reactions when exposed to fear stimulus

Answer 31

``` twin studies: genetic transmission more frequent in families with probands of anxiety disorders range of heritability: PD - more narrow confidence intervals SAD - larger range across studies- ```

Answer 32

Molecular Genetics Studies • Serotonergicsystem (5-HT;SLC6A4) • Dopaminergicsystem (DRD4;DRD2) • Modulation of monoamine metabolism (MAOA; COMT)

Answer 33

-serotonergic: involves negative emotions dopaminergic: excessive or lack of receptors through generations degradation of serotonin proposed to be related proposed for candidate gene studies due to expense - not enough replication

Answer 34

Poor regulation of NTs – NE (stimulating) – 5-HT (mood regulation) – GABA (inhibitory) • GAD: Deficiency of GABA or GABA receptors

Answer 35

Norepinephrine - physiological hyperactivity in anxiety disorders serotonin - insufficient may be implicate in anxiety disorders GABA: calming effect - regulating emotion insufficient not being able to habituate to novel stimuli related to GAD - worrying about everything because we’re not getting used to them

Answer 36

• Neuroticism/Negative Affectivity (Kotov et al., 2010) • Behavioral inhibition (Kagan) – Risk for social phobia

Answer 37

-more phenotypic, but influenced by heritable genes high in neuroticism: more prone to anxiety disorder tendency to display inhibition high: more likely to be extremely inhibited in new situations e.g. vulnerable to social phobia

Answer 38

* High anxiety sensitivity * Hyper-vigilant to potential threat * Cognitive self-evaluation model (social phobia)

Answer 39

attribution to physical symptoms catastrophic interpretation of events misinterpretation of events people with extremely high standards in social performance situations assume everyone will judge them harshly sensitive to misinterpreting social judgement cues

Answer 40

Biological Vulnerability Heritable contribution to negative affect Specific Psychological Vulnerability Catastrophic interpretations (e.g., of physical sensations) Generalized Psychological Vulnerability External locus of control

Answer 41

possession of all three most at risk to developing a disorder specific psychological vulnerability: maladaptive interpretations

Answer 42

Acquired through classical conditioning – Can occur via observational learning • Maintained through operant conditioning

Answer 43

e. g. got stung by bee, conditioned to fear them e. g. or seeing someone get stung by a bee e. g. running away from bee, anxiety subsides so operantly conditioned to run away

Answer 44

Tricyclic antidepressants  Increase levels of NTs (e.g., norepinephrine)  Serotonin reuptake (SSRIs)  Increase levels of serotonin  Benzodiazepines  Suppress CNS and influence NT functioning ▪ NE, 5-HT, and GABA systems

Answer 45

shown to work on certain anxieties e.g. but don’t give tricyclic to PD, but maybe to GAD improve regulation of negative disorders increase GABA - inhibiting physiological responses addictive, so not given as first treatment

Answer 46

* Modelling * Flooding (aka Implosive Therapy) * Systematic desensitization

Answer 47

most effective modelling: therapist models appropriate reaction flooding: exposing it all at once e.g. sending them to a bee farm not preferred approach bodies can only sustain reaction for so long, then they realize that it’s not so bad more gradual exposure

Answer 48

1. Develop a fear hierarchy Behavioural Strategies 2. Teach relaxation and breathing exercises 3. Practice gradual exposure to feared situations 4. Practice relaxation while experiencing panic symptoms Cognitive Strategies • Identify maladaptive cognitions • Challenge catastrophizing thoughts

Answer 49

1. least feared to most feared 2. teach relaxation, only when they can perform it can they move on to gradual exposure 3. start small so they can extinguish fear to smallest fear and show they can manage it e.g. fear of spider bite, gradual exposure provides evidence that it’s not gonna kill them

Answer 50

• GAD: – Treatment > No treatment (Cuijpers et al., 2014) – Improve in short-term, but not at follow-up (Westen & Morrison, 2001) – Best results for CBT (Dugas et al., 2003) • Panic: – Improve and remain improved at follow-up (Westen & Morrison, 2001) – CBT = pharmacotherapy (Mitte, 2005)

Answer 51

attacking maladaptive thoughts and replacing them gains are sustained as effective as medication cessation of medication, the symptoms return

Answer 52

Either obsessions OR compulsions | • Time-consuming (>1hr/day) • Cause distress/impairment

Answer 53

-has to interfere with functioning or distress

Answer 54

• Recurrent and persistent thoughts, urges, or images • Intrusive and unwanted, cause anxiety/distress • Thoughts,impulses,orimagesthat: – Are not simply excessive worries about real life problems – The person recognizes are a product of own mind – The person attempts to ignore or suppress or to neutralize with some other thought or action

Answer 55

thoughts of germs, killing someone, need for symmetry reality testing excessive - required that they realized it was out of proportion with kids you don’t expect this insight

Answer 56

• Repetitive behaviours or mental acts that the person feels driven to perform in response to an obsession or rigid rules • Aimed at preventing/reducing distress or preventing some dreaded event or situation – Unrealistic – Excessive

Answer 57

-fit well with obsessions e.g. entire elaborate ritual of handwashing if not done right causes substantial anxiety checking counting up cleaning or washing doing things in order ordering and organizing neutralize obsessive thought

Answer 58

Stimulus (Internal / External) => Obsession Stimulus (Internal / External) => Distress & Anxiety Obsession Distress & Anxiety

Answer 59

Distress & Anxiety => Ritualized Behaviour (Compulsion) | Temporary Relief Ritualized Behaviour (Compulsion)

Answer 60

• Brain dysfunction in areas that control primitive behaviour • Linkedto5-HT • Evidence for a genetic predisposition (Nestadt et al., 2010) – 7-15% in first-degree relatives of probands – Limited knowledge of potential candidate genes

Answer 61

-e.g. aggression and sex serotonin function - linked to negative emotions common within families with OCD don’t know which genes

Answer 62

Cognitive-Behavioural • PeoplewithOCDcannot“turnoff”obsessivethoughts Psychodynamic (Chlebowski & Gregory, 2009) • Obsessionsandcompulsionsrepresentsymbolicconflicts

Answer 63

brains are wired differently manifestations of underlying conflict

Answer 64

• 22-year-old single female • Feels guilty about past mistakes • Obsessions of contamination • Cleansingcompulsions Formulation:

Answer 65

BiologicalTreatments – 5-HT-enhancing drugs (e.g., Paxil, Prozac, Zoloft) – Psychosurgery • Anterior Cingulotomy • Anterior Capsulotomy

Answer 66

-similar to ones used for depression 50% success rates only in very severe cases where remission does not occur for other forms of treatment

Answer 67

• BehaviouralTreatments – Exposure and Response Prevention • CognitiveTherapy – Encourage change in thinking (e.g., acceptance)

Answer 68

trigger obsessive thoughts and prevent them from engaging in ritual see that response will subside even when still exposed to stimulus accepting that my brain is wired differently

Answer 69

MEDICATION Stimulus (Internal / External) => Obsession Stimulus (Internal / External) => Distress & Anxiety Obsession Distress & Anxiety

Answer 70

Distress & Anxiety => Ritualized Behaviour (Compulsion) | Temporary Relief Ritualized Behaviour (Compulsion)

Answer 71

- cognitive therapy: labelling thoughts as not facts | exposure: reduce anxiety response without performance of ritual

Answer 72

* Experienced traumatic event * Actual/threatened death or injury * Fear/anxiety persisting after trauma (> 4 weeks) – If

Answer 73

1. Exposuretotraumaticevent 2. Intrusivesymptoms 3. Avoidance of stimuli associated with trauma 4. Negative alterations in cognitions and mood 5. Marked alterations in arousal/reactivity

Answer 74

Adjustment Disorder: • Maladaptivereactionsandimpairedfunctioning/distress following exposure to a stressor – Within 3 months of stressor(s) Acute Stress Disorder: • A traumatic stress reaction occurring in the days and weeks following exposure to a traumatic event. –

Answer 75

CBTapproach: – Systematic desensitization (extinguish fear reactions) – Cognitive techniques (challenge irrational thoughts) • Stressmanagement: – Assist in problem solving (reduce stress) – Use “thought stopping” strategies (reduce intrusive thoughts) • Biologicaltherapies: – Anti-anxiety and antidepressant drugs

Answer 76

``` Sociocultural factors • Severity, duration, & proximity • Social Support Psychological factors • Personal Assumptions • Distress • Coping Styles ```

Answer 77

Biological factors • Physiologicalhyperactivity • Genetics • Epigenetics • HPA-axishypoactivity

Answer 78

Eye Movement Desensitization and Reprocessing (EMDR) – Side-to-side eye movements (saccades) while the client attends to traumatic stimuli, thoughts about the trauma, and the physical sensations of anxiety aroused by the trauma. – Highly controversial

Answer 79

Disorder l Description | Phobia l Fear and avoidance of objects or situations that do not present any real danger

Answer 80

Panic Disorder l Recurrent panic attacks involving a sudden onset of physiological symptoms. Generalized Anxiety Disorder l Persistent, uncontrollable worry, often about minor things.

Answer 81

Separation anxiety l The anxious arousal and worry about losing contact with and proximity to other people, typically significant others. Agoraphobia l A fear of being in public places.

PSY240 3. Anxiety Flashcards

(205 cards)