Task 3

Question 1

What is Anxiety disorder?

Answer 1

A psychological disorder characterised by an excessive or aroused stay and feelings of apprehension, uncertainty and fear.

Question 2

In a sufferer, the anxiety response may:

Answer 2

1. Be out of proportion when in a threat situation
2. Be a state that the indivitual constantly find themselves in (no threat needed)
3. Persist chronically and be so disabling that it causes constant emotional distress. Affects planning and conducting normal day-to-day living, inability to keep a job and long-term relationships.

Question 3

Prevalence of anxiety disorder

Answer 3

Lifetime prevalence show that 28.8% of adults will be diagnosed w/ and axiety disorder in their lifetime

The average onset is 11 years

12-month prevalence is 1.9% in adults and 1.6% in children

Question 4

Fear vs. anxiety

Answer 4

Fear: emotional response to a real or percieved imminen threat
Axiety: anticipation of future threat

Question 5

What are the gender differences in the anxiety disorder?

Answer 5

It occurs more frequently in females (2:1 ratio)

Question 6

Name the different types of anxiety disorder

Answer 6

1. Generalized axiety disorder
2. Social axiety dirorder
3. Panic disorder
4. Agoraphobia

Question 7

Generalized anxiety disorder

Answer 7

Excessive anxiety and worry about a number of events or activities. The intensity, duration, or frequency of the anxiety and worry is out of proportion to the actual likelihood or impact of the anticipated event.

Question 8

Biological theories of GAD

Answer 8

The is some evidence for a genetic component in generalised anxiety disorder. Heritability of generalised anxiety disorder at around 30%

Researches found reduced regulatory activity in pregenual anterior cingulate and parietal cortices in patients with GAD

Question 9

What is Information processing bias?

Psychological theory of GAD

Answer 9

Biases in interpreting, attending to, storing or recalling information which may give rise to dysfunctional thinking and behaving.

Question 10

Treatment of GAD

Answer 10

• Attention bias modification
• Stimulus control treatment: based on conditioning principle
• Pharmacological therapy: strong effects as a first step
• Structutured psychological therapy: strong long-term effects:
–> Self monitoring - Relaxation training - Cognitive restructuring - Behavioural rehearsal

Question 11

Social anxiety disorder and its prevalence

Answer 11

The individual is fearful or anxious about or avoidant of social interactions and situations that involve the possibility of being scrutinised. The cognitive ideation is of being negatively evaluated

Prevalence: lifetime rate 12%. Gender ratio 3:2 females to males (more woman). Very heritable.

Question 12

What is self foccussed atttention?

Answer 12

Individuals with SAD show a strong tendency to shift their attention inwards onto themselves and their own anxiety responses during social performance

Question 13

DSM-5 criteria for Social Anxiety

Answer 13

1. Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. Examples include social interactions
2. The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated.
3. The social situations almost always provoke fear or anxiety
4. The social situations are avoided
5. The fear or anxiety is out of proportion to the actual threat

Question 14

Treatments of SAD

Answer 14

• Pharmacological treatments (drugs) —> selective serotonin re-uptake inhibitors
• Cognitive Behabioural Therapy CBT —> more effective in preventing relapse

Question 15

Panic disorder and prevalence

Answer 15

The individual experiences recurrent unexpected panic attacks and is persistently concerned about having more panic attacks or changes his/her behaviour in maladaptive ways.

Prevalence: 12 month prevalence rate is around 1.5 - 3%. More in woman than men.

Question 16

What are panic attacks?

Answer 16

Abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four of the symptoms occur.
Not limited to anxiety disorders.

Question 17

DSM-5 criteria for Panic disorder

Answer 17

1. Recurrent unexpected panic attacks
2. Atleast one of the attacks has bee followed by 1 month of one or both of the folliwing:
   • -> Persistent concern about additional attacks
   • -> Asignificant maladaptive behavior related to the attacks (avioding exercise)

Question 18

Biological theories of Panic Disorder

Answer 18

1. Biological challenge test: Research in which panic attacks are induced by administering carbon dioxide enriched air or by encouraging hyperventilation.
2. Suffocation alarm theories: Models of panic disorder in which a combination of increased CO2 intake may activate an oversensitive suffocation alarm system and give rise to the intense terror and anxiety experienced during a panic attack
3. Noradenergic overactivity: Panic disorder may be caused by overactivity in the noradrenergic neurotransmitter system.

Question 19

Psychological theories of Panic Disorder

Answer 19

1. Classical conditioning
2. Anxiety sensitivity: Fears of anxiety symptoms based on beliefs that such symptoms have harmful consequences (e.g. a rapid heartbeat)
3. Catastrophic misinterpretation of bodily sensations
4. Safety behaviours: Activities developed by sufferers of panic disorder as soon as they think they are having a panic attack, developed in the belief that this activity has saved them from a catastrophic outcome

Question 20

What is catastrophising?

Answer 20

An example of magnification in which the individual takes a single fact to its extreme, one example being catastrophic worrying

Question 21

Treatment of Panic Disorder

Answer 21

• Psychoactive medication is usually the first line of treatment provided for sufferers
–> Tricyclic antidepressants and benzodiazepines may be effective in controlling symptoms

• Structured exposure therapy is as effective as the pharmacological treatment

Question 22

Agoraphobia and prevalence

Answer 22

Individuals are fearful and anxious about two or more of the following situations:
- Using public transportation
- Being in enclosed places; standing in line or being in a crowd
- Being outside of the home alone in other situations.
Fears this because escape of situation might be difficult

Prevalence: 12 month revalence rate 0.4 - 3%. More in woman than men.

Question 23

What is the general DSM-5 criteria?

Answer 23

1. Excessive fear or anxiety concerning separation from those who the individual is attatched
2. The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and adolescents. 6 month or more in adults.
3. Causes significant distress or impairment in social, academic occupational or other areas of functioning
4. Disturbance is not better explained by another mental disorder or effects of a substance/medication

Question 24

Genetic and physiological factors for causing axiety.

Answer 24

Separation axiety disorder in children may be heritable - 73% in girls

Question 25

DSM-5 criteria for Agoraphobia

Answer 25

1. Marked fear or anxiety about 2 or more of the following 5 fistuations: public transportation, open places, enclosed places, stading in line or being ina crowd, being outside of home alone. 2. Fears or avoids these situations because of thought that help might not be available and showing the symptoms 3. Agoraphobic situations almost always provoke fear or anxiety 4. These situations are avoided, require the presence of a companion or are endure with intense fear 5. The experience is out of proportion to actual danger

Question 26

Comorbidity

Answer 26

High comorbidity among the axiety disorders, and also PTSD, OCD and Personality disorders

Question 27

Specific phobias

Answer 27

Marked fear or anxiety about a specific object or situation. The phobic trigger usually elicits extreme fear and often panic. Common phobias: - Social phobia 3,2% - Blood- injury injection phobia 3,5% - Animal phobia generally 1,1% - Dental phobia 3-5% - Water phobia 3,3% - Height phobia 4,7% - Claustrophobia 2,4%

Question 28

What is the CCQ-M?

Answer 28

The Catastrophic Cognition Questionaire modified | --> designed to measure catastrophic cognitions on 3 factors: emotional, physical and mental

Question 29

What are the self-monitoring studies and what did they proved on PD?

Answer 29

Studies where participants record own cognitions during a panic attack using a panic diary. Results show that 79% of panic attacks can be associated w/ fearful cognitions of danger

Question 30

What are IN VIVO Cognitive Assesment studies?

Answer 30

Studies where participants verbalize ongoing thought --> record the thoughts

Question 31

What were the result obtained by Mansell and Clark?

Answer 31

* Axious individuals selectively retrieved and processed more negative info * Highly socially anxious individuals use perceptiom of anxiety-related body sensations to overstimate how anxious they appear to observers.

Question 32

What is the Clark and Wells cognitive model of SAD?

Answer 32

SAD patient enters a social situation --> activates dysfunctional/maladaptive assumptions about themselves (e.g. I must appear intelligent; if I make a mistake others will reject me) --> perception of social situation as dangerous --> attention is shifted towards self-monitoring and careful observations of own actions --> increased focus on the anxiety and maladaptive processing of the situation --> negative mental representation of the self; What is worse, any social cues that do not support the representation are disregarded

Question 33

What are safety behaviors?

Answer 33

Behaviours to reduce the risk of negative evaluations, e.g. memorising things to say or completely avoiding the situation --> can lead to opposite effects

Question 34

What is Pre- and Post- event rumination (evaluación)?

Answer 34

* Pre-event rumination: recall of past failures and engaging in negative self imagery before entering a social event * Post-event rumination: individual focuses on negative aspects of social situation and their failures, thus consolidation beliefs of social incompetence

Question 35

What is the Rapee and Heimberg cognitive model of SAD?

Answer 35

Enter a social situation - -> formation of mental representation of external appearance, based in memories, internal cues (e.g. physical symptoms) and external cues (e.g. audience feedback) - -> comparison between mental representation and what others expect of them - -> any external cues are perceived as a threat (e.g. someone yawns ! boredom from the audience) - -> behavioural, cognitive and physical symptoms of anxiety (This model does not reference pre and post rumination)p

Question 36

What is the cognitive model of SAD proposed by Hofmann?

Answer 36

Enter a social situation - -> activation of unrealistic social standards and poorly defined social goals - -> attention shift to oneself - -> formation of negative self-image which is believed to be accurate - -> overestimate consequences of own behaviour, believe they have little control over own anxiety and that it will be noticed by others - -> anticipate negative social outcomes - -> engage in avoidance or safety behaviours; After leaving social situation ! engage in post-event rumination

Question 37

Treatment that deal with rumination

Answer 37

CBT: cognitive restructuring and invivio exposure to challenging beliefs about own social competence and the true probability of experiencing a negative evaluation

Question 38

What was found in the article of Voncken & Bögels?

Answer 38

SAD patients believe that they show worse performance in a speech than in a conversation but it is indeed the other way around.