1
Q
What is the defintion of social anxiety ?
A
- you are afraid of being rejected judeged humiliated in public -> which leads to avoiding social situations
2
Q
What are sometimes the repsonses you get if a person with social anxiety can not avoid a social situation ?
A
- panic attacks
3
Q
What is meant by rumination ?
A
- repetively thinking about causes sitautional and consequences of ones negative experiences
- serves to consolidate negative self-perception into long-term memory
4
Q
What kind of rumination do exist ?
A
- post event rumination
- pre event rumination
5
Q
What does post event rumination mean ?
A
- negative rumination following a social situation
- thinking about the consequences after encountering
6
Q
What does pre event rumination mean ?
A
- anticipatory processing before a social situation
- Thinking allready about the bad situation beforehand
7
Q
What kind of rummination get reduced after after CBT ?
A
- reducing of post event rumination
8
Q
WHat are the DSM 5 characteristics regarding social anxiety ?
A
A. Marked by fear/ anxiety about one or more social situation
B. Fear of negative evaluation
C. Situation provoke fear and anxiety
D. Social situations are avoided or endured
E. Anxiety is out of proportion to the actual threat posed by the sitch/context
F. persistent of min 6 months
G. causes clinically significant distress or impairment in social functioning
H. not caused by substance
I. not better explained by other disorders
J. if other medical substance it must be clearly unrelated
9
Q
What are the prevalance of social anxiety ?
A
- 3-7% of the world
- 90 % of the disorder comes from humiliating experince
- woman are more severe to SA
- tends to devlop in adolesence or early pre school
- chronic
10
Q
What are the comorbidity disorders regarding SA ?
A
- mood & other anxiety disorders
11
Q
How do genetic theories explain SA ?
A
- anxiety heritable runs in families
- BUT NOT THE SPECIFIC PHOBIA
12
Q
What are the main affects on the social life regarding social anxiety ?
A
- drug dependency
- lower lvl of employment
- higher suicide
13
Q
How does the cognitive perspective explain social anxiety ?
A
- it devlops via high standards for performance
- Focus on negative aspects of social interactions & evaluate own behaviours harshly
- Tend to notice potentially threatening social cues (even though there are none such as giggling
- Devlops because of critcial negative parents
14
Q
How does a SA person encounter interpersonal skills regarding speech and converstaion ?
A
- underestimates social performance during speech and interactions
- but more for speech even though they are worse at interaction
- Reason: speech seen as more structured & unambiguous
15
Q
What is meant by the interpretation bias ?
A
- interpret ambiguous event as negative
- Example: you construct all kinds of mental model and choose teh worst one
16
Q
What is meant by the judgemnt bias ?
A
- overestimate costs and probabilities of negative events
17
Q
Are judgemntal and intrepretations content specific or can they be applied to all contents ?
A
- they are content specific
- Do not apply to non social events
- But are present Across all social events, irrespective of valence
18
Q
How does clark and wells memory hypothesis explain SA ?
A
- via the memory bias and and a cognitive model
19
Q
What is the cognitive model by clark and wells ? (four steps)
A
- You selectively retrive unfavourable information about how otheres see u (pre event rumination) -> distress before the situation
2, During the situation attention shifts from observation of others to monitoring to self - Self monitoring leads to again to more anxiety because of overestimation -> safety behaviour
- Post-event rumination -> evaluate speech only based on negative aspects
20
Q
What is the definiion of memory bias by clark and wells ?
A
- you base your pre rumination only on unfavourable memories
21
Q
How did clark and Wells figured the memory bias out ?
A
- Via the public self referent private self referent and other refernet experiment ?
- half of the participant were told to give a speech (social threat)
22
Q
What is meant by
- Public self referent
- Private self referent
- Other referent ?
A
- Public: how you think you are viewd by others
- Self: You describe yourself
- Other: You describe others
23
Q
What were the results of the Clark and wells study ?
A
- when confronted with social threat, high anxiety group retrieved less positive public self-referent encoded words to describe themself
- > only significant finding
- > it was debatable if they also used more negative words
24
Q
How is SA explained by Rapee and heimberg ?
A
- basicaly the same as Clark just that there is no pre and post rumination mentioned
- Discrepancy between mental representation & what audience expects -> anticipate negative evaluation -> symptoms
- it is about froming mental representation of external appearance based on memories form past social situations, (usually negative)
25
How does Hoffman explain SA ?
- it combines Rapee and heimbergs model
- It takes from Heimberg the negative mental pictures
- it takes from clark the rummination and the safety bahviour
- aving unrealistic social standards and poorly defined social goals
26
What are some characteristics of social anxiety people ?
- Negative performance appraisals (leistungsbewertung)
- Self-efficacy: belief that own abilities are bad
- Threat appraisals: overestimated probability & consequences
- Self-imagery: negative self-impression
- Self-focused attention – attention shifts from others to detailed monitoring of self
27
What are the treatments of anxiety ?
- Drugs and medictaion
- cognitive behavioural therapy
- Enhanced CBT
- Mindfullness based in interventions
28
What kind of medication or drugs are used to treat social anxiety ?
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- no long term effect
29
How does CBT tries to treat patients ?
- Exposure to social situation
- recognition and elimination of saftey behaviour
- elimination of negative cognitive patterns
- Has long term effects
- can also be done in groups
30
How does enhanced CBT work ?
- Specifically target underlying processes proposed to maintain social anxiety
31
What is the defintion of panic attacs ?
- short but intense period during which on experiences symptoms of anxiety
- out of the blue
32
What is the defintion of a panic dissorder ?
- part of an anxiety dissorder
- but it is more suddendly and does not build up
- feeling unsafe in public place with unknown people being afraid of having a panic attack
33
What are the DSM 5 characteristics regarding panic disorder ?
- abrupt /unexpected (plötzlicher ansteig) of intense fear
- has to contain four of the follwing criterias (body reaction) but als depersonalisation, fear of dying and fear of loosing control
- Must be persisent at least by 1 month regarding:
1. Perisent concerns of additional panic attacs
2. Change in behvaiour
- can not be better explained by culutural or other mental disorders
- can not be explained by substances
34
What are the prevalance of PD ?
- 28/ have it occasionaly when correlated to stress -> not a disorder
- 3-5% have the disorder
- usually between adolesence and mid 30
- more comman in woman
- chronic
35
What are the comorbiditys of PD ?
- abuse of alc anxiety and depression and agrophobia
36
What is meant by agoraphobia ?
- fear of the dangerous consequences associated with specific sitch where one has panicked before
37
How does the gentic theory explain PD ?
- Heritability: 43-48%
- Poorly regulated fight-or-flight response
- during premenstrual periods high risk of PD so there is a connection to hormones and gaba and serotonin
- Dysregulation of norepinephrine systems in locus coeruleus (brainstem) which has well defined pathways to limbic system (limbic system involved in stress respond)
38
How does the cognitive mediation hypothesis explain PD ?
- pay attention to bodily symptoms
- misinteprtet them in a negative way
- leads to catastrophic thinking
- which then creates exaggerating symptoms & their consequences
- having high anxiety sensitivity
- also experience Interoceptive conditioning
39
What is menat by anxiety sensitivty ?
- unfounded belief that bodily symptoms have harmful consequences
40
What is meant by Interoceptive conditioning ?
- bodily cues occurred at the beginning of previous panic attacks and have become conditioned stimuli signalling new attacks
41
How does the integrated model explain PD ?
- Integrates genetic biological and cognitive factors and behavioural factors
- says there is genetic vulnerabillity
- mild stimulus and catastrophic thinnking lead to attack
- mild stimulus are not enough the triggeres are catastrophic misinterpretation of body systems
42
What do panic disorder leads to ?
- Conditioned avoidance response
43
What is meant by conditioned avoident response ?
- associate certain situations with symptoms and try to reduce those by avoidance
44
What are the treatment options in PD regarding medictaion and drugs ?
- SSRIs, SNRIs, antidepressants -> improving norepinepherine lvl
- Benzodiazepines suppress CNS -> they influence the lvl of they influence GABA, norepinephrine & serotonin
- short term
45
How does CBT (cognitive behavioural theraphy) treat PD ?
- Identify catastrophising thoughts and challenge them
- Practice with easy symptoms
- Relaxation techniques
- Systematic desensitization therapy (step by step)
- long term
46
What is the generall defintion of generalised anxiety disorder ?
- Anxious all the time in all kinds of situations
47
What are the DSM 5 criteria regarding generlalized anxiety ?
- anxiety and worries must be presnt for at least 6 months
- no control over the worry
- Anxiety & worry are associated with three or more symptoms
- clinically significant distress or impairment in social functioning
- can not be explained by the use of drugs
- can not be better explained by other disorder
48
What are the symptoms according to DSM 5?
1. Restlessness or feeling keyed up/ on edge
2. Being easily fatigued
3. Difficulty concentrating/ mind going blank
4. Irritability
5. Muscle tension
6. Sleep disturbance
49
What is the prevalance of general anxiety disorder ?
- 14% will have it ats ome point in there life
- more woman
- chronic
- onset is in childhood or adolesence
50
What kind of comorbifity disorder does generalized anxity have ?
- 90% of GAD have another mental disoder
51
How can biological tehories explain GAD ?
- Greater reactivity of amygdala
- Abnormality in GABA system (too less receptor or GABA -> results in excessive firing in limbic system
- higher activit sympathetic nervous system (fight or flight respond)
52
How can cognitive theories explain GAD ?
- More intense negative emotions
- higher reactivet to negative events
- Maladaptive assumptions (allways expect the worse)
- Might’ve experienced uncontrollable stressors without warning
53
How does Cognitive bahvioural thearpy treat GAD ?
- Involved confronting the issues the patient worries about
54
What are the biomedical treatment options regarding GAD
- Benzodiazepines provide short-time relief from anxiety symptoms
- 2. antidepressants, SNRI’s and SSRI’s reduce anxiety symptoms
55
Why are people with social anxitey worse in being part of a conversation in comparison tol hold a speach ?
- lack of knowledge and experience in interpersonal performance
- they are worse at interperosnal conversation !! Adapting to situations
56
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