2. anxiety

Question 1

Achenbach’s model relating to anxiety disorder

Answer 1

3 groupings of disorders (internalising, neither, externalising)

• said that anxiety disorder is under internalising disorder.
• also said that anxiety and depression work together and are almost the same thing
• shared key features of depression and anxiety in children (eg: irritability)

Question 2

McNaughton & Corr’s model of anxiety disorder (flight, freeze, fight approach)

Answer 2

also known as traditional ‘basic animal’ model –> how animals cope and response to threat to environment

what do you do? fight, flight or freeze?

Question 3

what is the freeze approach?

Answer 3

response/behaviour to something that is not expected

eg: when you were asked by someone to marry him… you’ll freeze

Question 4

what is the approach-avoidance conflict?

Answer 4

you feel equally motivated to approach and avoid a threat.

eg: you’re at a party, you wanna go and talk to someone but you are both really wanna do it but also too terrified. so you’re stuck in both.

Question 5

under McNaughton & Corr’s model of anxiety disorder, what is phobia classified as?

Answer 5

avoidance behaviour from the avoidable stuff

eg: you have snake phobia, you just avoid the high-snake-risk places

Question 6

what is avoidance behaviour? what anxiety disorders are classified as avoidance behaviour in McNaughton & Corr’s model

Answer 6

goal: individual try to avoid and escape something that is either AVOIDABLE (phobia - snack) or UNAVOIDABLE (panic - you might not know what might trigger the panic attack but it is unavoidable)

Question 7

what is fear?

Answer 7

feelings that occur when source of harm is IMMEDIATE

Question 8

what is anxiety?

Answer 8

feelings that occur when source of harm is UNCERTAIN or UNKNOWN or DISTANT (space wise / time wise)

Question 9

different between fear and anxiety

Answer 9

fear is towards IMMEDIATE harm, anxiety is towards UNCERTAINTY, DISTANT

Question 10

why people used think fear and anxiety are the same thing???

Answer 10

fear and anxiety roots from amygdala.

Question 11

what is the role of BNST in processing harm?

Answer 11

BNST encodes the nature of uncertainty of threat

this lead to the changed belief that fear and anxiety are processed in the same brain area

Question 12

where does conscious processing associated with threat or harm take place?

Answer 12

in the brain, most subjective experience is processed at the cortical medial wall (middle line of your brain)

Question 13

what is the tripartite model of anxiety and depression?

Answer 13

• picture venn diagram shape
• anxiety and depression share a feature (negative affect)
• anxiety has unique feature: physiological arousal
• depression has unique feature: absence of positive affect

Question 14

what characterises depression in tripartite model?

Answer 14

• anhedonia
• worthlessness
• rumination (past oriented)
• suicide ideation (but then again, the strongest predictor of suicide in depression is anxiety

Question 15

what is the main key in negative affect (overlapping feature) in anxiety and depression

Answer 15

repetitive negative thought.

also, even though rumination is unique to depression and worry is unique to anxiety, both might fall under repetitive negative thought.

Question 16

what characterises anxiety in tripartite model?

Answer 16

• muscle tension
• sweating
• worry (future oriented)
• dry mouth

Question 17

explain the generic aetiology of AD

Answer 17

• pre existing vulnerability
• childhood experiences (adverse events)
• trajectory 1: incident happens (at first transient / short living)
• trajectory 2: it keeps happening, u cant get over it –> onset of ad
• trajectory 3: gets worse, secondary complications –> hopelessness and helplessness –> possible depression development

Question 18

generic treatment

Answer 18

there is common tendency to think that pharmacotherapy and psychotherapy is the same. but actually found that psycho my be in favour more (although only slightly more effective)

but then again depends on the person - if the person is responsive to psycho then yes effective but if not then pharma might be more effective

Question 19

what is the most typical psychotherapy?

Answer 19

cbt

Question 20

what is the most typical pharmacotherapy?

Answer 20

ssri

Question 21

best treatment for AD?

Answer 21

combination of psycho and pharma

Question 22

specific phobia diagnosis

Answer 22

• SP is an avoidance behaviour of the avoidable
• fear is out of proportion to actual threat
• individual recognise the excessive and unreasonable response
• 6 months (arbitrary)
• can be unusual or particular things (typically predictable)

Question 23

epidemiology: specific phobia

Answer 23

• prevalence 3-15%

- animals (most common) > heights > closed spaces > flying > blood > water > storms

Question 24

what is the little albert aetiology of AD??

Answer 24

classical (associative) conditioning for specific phobias

Question 25

what is the social learning aetiology of AD???

Answer 25

people watching anther person get shocked in computer screen by a flash of blue square.

learnt indirectly that blue square is harmful

Question 26

how can the overrepresentation of memory (or flashbulb memory) drive the development of specific phobia?

Answer 26

you over represent a single event or experience with a specific thing which then drives the development of phobia.

Question 27

what is a treatment of specific phobia

Answer 27

exposure therapy (in vivo, imaginary, virtual reality, gradual vs flooding)

Question 28

what is an in vivo therapy

Answer 28

exposure in real life

Question 29

what is the issue with exposure therapy?

Answer 29

people tend to quit therapy

Question 30

what is panic disorder

Answer 30

not just the experience of panic attack (panic attacks by itself are NECESSARY but are NOT sufficient for the disorder)

Question 31

panic disorder diagnosis

Answer 31

• recurrent UNEXPECTED panic attacks
• critical: person has concern and worry of having more panic attacks hence change their functioning and behaviour to prevent
• worry or fear of having another panic attacks has to last at least 1 month

Question 32

epidemiology of panic disorder

Answer 32

13.2% lifetime prevalence of panic attacks

however only 1.7% of these people actually have panic disorder. women > men. low income fam more common

Question 33

panic disorder aetiology

Answer 33

cognitive theories

anxiety sensitivity theory

Question 34

what is the cognitive theory concept in panic disorder aetiology

Answer 34

catastrophic misinterpretations of somatic experiences.

eg: you’re sitting on a crowded tram, heart racing sweating etc, then you just imagine the worst is happening

Question 35

what is the anxiety sensitivity theory concept in panic disorder aetiology

Answer 35

individual has increased sensitivity to physiological experiences

Question 36

what are rebuttals to cognitive theory concept in panic attacks

Answer 36

nocturnal panic attacks happen (when you are sleeping)

cognition does not seem necessary in panic incidents

Question 37

what are rebuttals to anxiety sensitivity theory concept in panic attacks

Answer 37

it is unclear whether AS is actually separable from panic. are you terrified of the actual panic event or are you just overly sensitive to the possibilities??

threshold for detection is low