5 Anxiety

Question 1

Is there any difference between anxiety and fear?

Answer 1

DSM differentiates:
- Anxiety is anticipating threat
- Fear is being in immediate presence of threat
But this distinction is not well supported in research

Question 2

Anxiety is activated in response to _______ ________.

Answer 2

Anxiety is activated in response to perceived threat.

Question 3

Is there any qualitative difference between normal and abnormal anxiety?

Answer 3

No. It’s a question of degree.

Question 4

Which three interrelated systems undergo change in response to threat?

Answer 4

Physical system
Cognitive system
Behavioural system

Question 5

What are the physical signals of anxiety?

Answer 5

• SNS activation –fight/flight response

- Sweating, heart rate, trembling etc.

Question 6

What are 3 cognitive signals of anxiety?

Answer 6

1. Perception of threat

2. Attentional shift and hypervigilance
3. Difficulty concentrating on other information

Question 7

What are 2 behavioural signals of anxiety?

Answer 7

1. Escape/avoidance

2. Aggression

Question 8

In what way is anxiety evolutionarily useful?

Answer 8

It helps ensure survival by preparing individual to deal with threat

Question 9

A threat appraisal generates an _________ of harm

Answer 9

A threat appraisal generates an expectancy of harm

Question 10

What’s the difference between a threatening stimulus and threatening outcome?

Answer 10

Threatening stimulus (e.g. situation) is acue that threatening outcome (e.g. harm to self) is likely.

Question 11

Threat appraisal is a product of perceived ________ and perceived _________.

Answer 11

Threat appraisal is a product of perceived probability and perceived cost.

Question 12

In what four ways can anxiety be learned?

Answer 12

1 Classical conditioning –e.g. in phobias,fear associated with phobic object

2 Instrumental conditioning –e.g. go on bus -> humiliated

3 Observational learning
– e.g. seen others bullied for specific action

4. Instruction
   –e.g. parents said sth is dangerous

Question 13

What do individual differences in trait anxiety predict?

Answer 13

1 Tendency to perceive threat in ambiguous situations

2 Intensity of anxiety

Question 14

People with high trait anxiety experience anxiety more often and more intensely

Answer 14

People with high trait anxiety experience anxiety more _____ and more ______

Question 15

The two aspects of overestimation of threat are…

Answer 15

1. Overestimation of risk

2. Overestimation of cost

Question 16

Physical fears usually involve overestimation of _______.

Social fears usually involve overestimation of _______.

Answer 16

Physical fears usually involve overestimation of risk (e.g. see spot on skin - must be cancer)

Social fears usually involve overestimation of cost (e.g. if people laugh at me, my life will be over)

Question 17

In what way can pathological anxiety represent a dysfunction?

Answer 17

Anxiety module responding to non-threatening situations. System designed to save you from danger, but being activated when no danger. Hence dysfunction.

Question 18

If someone is terrified of snakes, but lives somewhere with no snakes, would this count as a disorder?

Answer 18

No, as there is no distress and no interference with life.

Question 19

In DSM-IV & V anxiety disorders are categorised according to ______ of anxiety.

Answer 19

In DSM-IV & V anxiety disorders are categorised according to focus of anxiety.

Question 20

What is the difference in the role of avoidance in normal/abnormal anxiety?

Answer 20

In normal anxiety, avoidance saves you. In abnormal anxiety, avoidance maintains anxiety – person never sticks around to learn that their threat estimation is overblown.

Question 21

What is Separation Anxiety Disorder?

Answer 21

In DSM-IV listed among childhood disorders (only if symptoms onset before 18). Fear of being away from primary caregiver. In DSM-5 extends to adults –fear of separation from primary attachment figure.

Question 22

What are Social Phobics afraid of?

Answer 22

Negative evaluation, possibility of being embarassed, humiliated.

Question 23

What is the focus of fear in Panic Disorder?

Answer 23

The fear itself –afraid of having another panic attacks. May develop agoraphobia –avoidance of situations where panic may occur.

Question 24

What is the point of the compulsions in OCD?

Answer 24

To neutralise intrusive/unacceptable thoughts.

Question 25

What are the most frequent comorbidities with anxiety disorders?

Answer 25

Most anxieties are comorbid with each other –people tend to have more than one. Also comorbid with depression and with substance use disorder

Question 26

What are the 4 risk factors for development of anxiety disorders (according to Barlow)?

Answer 26

1. Genetically inherited neuroticism.
   High N, more likely to develop ADs and depression.
2. Low perceived control (often with overprotective parents) – also risk factor for depression
3. Trait anxiety
4. Specific psychological vulnerabilities, derived from direct experience, observation and/or instruction

Question 27

What happened to the classification of Agoraphobia in DSM-5?

Answer 27

It was uncoupled from Panic Disorder –can be severe avoidance not just of panic, but of anything (e.g. incontinence).

Question 28

How was Selective Mutism redefined in DSM-5?

Answer 28

Used to be disorder for kids who refuse to talk in specific situations (shy). Not just a childhood disorder anymore.

Question 29

How many months must symptoms of phobias be present in DSM-5?

Answer 29

More than 6 months.

Question 30

What has changed in the importance of the client’s view of their anxiety between DSM-IV and DSM-5?

Answer 30

In DSM-5, it’s no longer required that patient believes anxiety to be unrealistic. Judgement of rationality made by clinician.

Question 31

What are the 7 disorders in the DSM-V Anxiety Disorders chapter? SSSSPAG

Answer 31

1. Separation Anxiety
2. Selective Mutism
3. Specific Phobia
4. Social Anxiety Disorder (Social Phobia)
5. Panic Disorder
6. Agoraphobia
7. Generalized Anxiety Disorder

Question 32

What are the 5 Trauma- and Stressor-Related disorders? PAARD

Answer 32

1. Posttraumatic Stress Disorder
2. Acute Stress Disorder
3. Adjustment Disorders
4. Reactive Attachment Disorder
5. Disinhibited Social Engagement Disorder

Question 33

What are the 5 Obsessive-Compulsive and Related Disorders? OHTEB

Answer 33

1. Obsessive-Compulsive Disorder
2. Hoarding Disorder
3. Trichotillomania (Hair-Pulling Disorder)
4. Excoriation (Skin-Picking) Disorder
5. Body Dysmorphic Disorder

Question 34

What 4 new disorders are in the DSM-5 Obsessive-Compulsive and Related Disorders chapter?

Answer 34

1. Hoarding in DSM-IV was seen as a symptom of OCD, but now seen as different in causation and treatment.

2 & 3. Trichotillomania and excoriation migrated from impulse control disorders in DSM-IV. Alleviate distress/anxiety by pulling on hair or picking at skin.

4. Body Dysmorphic Disorder migrated from DSM-IV disorders such as hypochondria. Now anxiety or distress is important. Person believes something is seriously wrong with body –big nose, muscle dysmorphia etc.