AB: Fear and Anxiety Flashcards
What is the primary function of emotion?
The mobilise the organism to deal quickly enough with important (interpersonal) encounters
When does fear kick in?
Immediate danger (basic emotion)
Name three physiological responses to fear
Heartrate, blood pressure, muscle tone, breathing
Why is fear described as a two wave response?
There’s an initial response based on adrenaline which leads to physiological responses and there’s a slower response based in the cortisol that lasts minutes or hours and causes stress
What behaviour often proceeds fear?
Freeze, Flight, Fight or fright
How does anxiety differ to fear
It’s about a threat in the future (anticipatory.) It’s more complex (not in simpler organisms) and it’s to prepare for or avoid future danger.
What makes an anxiety a disorder?
- Irrational; Stimulus doesn’t justify the fear, excessively intensive or long duration.
- Distress/Impairment; fear is aversive, cause avoidance behaviours
What percentage of people suffer from an anxiety disorder, social anxiety, specific phobia, agoraphobia and panic disorder? Is there gender differences?
(Dutch figures, American are higher with 28% anxiety) anxiety disorder; 19.6 social anxiety; 9.3 specific phobia; 7.9 agoraphobia; 0.9 panic disorder; 3.8 Higher for women in all
What did mowers propose regarding specific phobia and anxiety disorders in general?
It is formed through classical conditioning and maintained through operant conditioning (reinforcement of avoidance)
What paradox does this maintenance lead to
Neurotic paradox; short term the fear lessons but in the long term the fear grows or is maintained
What was the criticism for this learning theory? (3)
Why more fears for certain stimuli (snakes over electricity)
Why sometime times fear without previous trauma?
Why sometimes no fear after traumatic experience?
What was the rebuttal for these criticisms?
- Certain stimuli: There is evolutionary preparedness/ prepared learning
- No traumatic experience: Vicarious learning/ modelling (seeing someone have a bad experience or seeing fear), information transfer (hearing scary stuff), Inflation (stacking of stimulus)
- No fear: Latent inhibition (previous positive experiences)
What is the criteria of a specific phobia
Marked fear or anxiety Always, immediate Avoidance or endured Out of proportion to actual danger (in socio-cultural context!) 6 months or more Distress / Impairment Not better explained by...
How can genes contribute to an anxiety disorder?
Genes for neuroticism, Behaviour inhibition and specific genes (eg panic disorders)
How can environment contribute to an anxiety disorder?
Positive and negative reinforcement, parent modelling, parenting styles
What behaviour in an infant can predict whether a child will by shy or outgoing
A quiet child in response to a stimulus is more likely to be outgoing and a child that is overwhelmed and excited by a stimulus (behavioural inhibition) is more likely to be shyer.
What else can a highly reactive infant (behavioural inhibition) at fourteen months predict
45% symptoms social anxiety
How did Wolpe propose in inhibiting a fear response?
Reciprocal inhibition: Inhibition by a relaxation response (when flexing muscle another is inhibited so when relaxing fear must be inhibited,)
What were the success rates?
Equivalent success rates without relaxation (didn’t work)
What is the neuroscientific explanation of exposure?
Inhibition of CS-US association (amygdala) by CS-noUS association (prefrontal cortex & hippocampus)
Explain David Clarke’s cognitive model to panic
Trigger stimulus leads to a perceived threat as well as body sensations. Perceived threat leads to apprehension or worry which leads to more body sensations. Body sensations leads to an interpretation of the sensations as catastrophic which leads to perceived threat. This leads to a cycle.
How can anxiety effect exam results?
an absence of anxiety is a problem, a little anxiety is adaptive, and a lot of anxiety is detrimental.
What anxiety disorders do not include unusually intense fear
Generalised anxiety disorder
Why may population estimates be an underestimate?
People forget symptoms occurring over a lifetime
What other risks are anxiety disorders linked to outside of cognition?
elevated risk of major medical conditions and marital discord, and more than a fourfold increase in the risk of suicide attempts
What is involved in a panic disorder?
Anxiety about recurrent panic attacks
Apart from fear what may a stimulus elicit in a phobia?
Disgust
John, Jacob and George are friends. John has acrophobia. Someone in the group has claustrophobia. Who is the most likely and why?
John because specific phobias are highly comorbid
What are the DSM criteria for social anxiety disorder?
- Marked and disproportionate fear consistently triggered by exposure to potential social scrutiny
- Exposure to the trigger leads to intense anxiety about being evaluated negatively
- Trigger situations are avoided or else endured with intense anxiety
How may manifestations of social anxiety disorder differ?
can range in severity from a few specific fears to a generalized host of fears
What manifestation is most likely to be Comorbid with depression or substance abuse?
Those with a broader array of fears are more likely to experience comorbid depression and alcohol abuse
When does social anxiety disorder tend to emerge?
Social anxiety disorder generally begins during adolescence, when peer relationships become particularly important.
What are the DSM requirements for panic disorder?
- Recurrent unexpected panic attacks
- At least 1 month of concern or worry about the possibility of more attacks occurring or the consequences of an attack, or maladaptive be- havioral changes because of the attacks
Name and describe two changes in cognition which may occur during a panic attack
depersonalization (a feeling of being outside one’s body); derealization (a feeling of the world not being real)
Why may a person feel like they are dying, losing control or going crazy in a panic attack?
Because the symptoms are inexplicable, the person tries to make sense of the experience.
What are the DSM criteria for generalised anxiety disorder?
• Excessive anxiety and worry at least 50 percent of days about a number of events or activities
•The person finds it hard to control the worry
• The anxiety and worry are associated with at least three (or
one in children) of the following:
•restlessness or feeling keyed up or on edge
• easily fatigued
• difficulty concentrating or mind going blank • irritability
• muscle tension
• sleep disturbance
When does GAD usually develop and how long does it last?
GAD typically begins in adolescence. Once it develops, GAD is often chronic
Of these anxiety disorders which is most highly related to marital distress, why could this be?
Perhaps because of the chronicity, GAD is more strongly related to marital distress than any other anxiety disorder
Comment on the rate of cormorbidity in anxiety disorders (3)
More than half of people with one anxiety disorder meet the criteria for another anxiety disorder during their lives and three-quarters of people with an anxiety disorder meet the diagnostic criteria for at least one other psychological disorder, . More specifically, about 60 percent of people in treatment for anxiety disorders meet the diagnostic criteria for major depression.
What other disorder is often comorbid with anxiety disorders?
Obsessive compulsive disorder
Other than prevalence, what other difference is there regarding anxiety in men and women?
When present, anxiety disorders also appear related to more functional impairment for women compared with men
Give four possible reasons for these differences
Men may be less likely to report symptoms, social factors, such as gender roles (ie men encouraged to face fears.), women may experience different life circumstances (sexual assault) and men may be raised to believe they have more personal control over situations
How may culture influence anxiety disorders?
culture and envi- ronment influence what people come to fear. “If you live near a volcano you’re going to fear lava.
In other cultures may people be more likely to describe somatic rather than psychological symptoms? Why/ why not?
No, this conclusion might reflect sampling problems—that is, researchers often studied anxiety and depression in psychological clinics in the United States but in medical clinics in other cultures.
Which countries have the highest rates of anxiety
America, Europe
Give a reason why a person with an anxiety disorder might be more likely to adapt a new one than someone without
The same risk factors involved with adapting the first one
Through experimentation how has it been shown people with anxiety disorder differ in classical conditioning
in many different ways.
Most centrally, people with anxiety disorders seem to acquire fears more
readily through classical conditioning, and those fears are more persistent once conditioned
What is the heritability estimate of anxiety disorders?
.5 to .6 percent (This indicates that genes may explain about 50-60 percent of the risk for anxiety disorders in the population. )
How is anxiety linked with brain activity
Increased activity in the amygdala and other regions of the fear circuit and decreased activity in the medial prefrontal cortex (relates amygdala activity) as well as deficits in the pathways between the two areas
What has PET and SPECT shown about neurotransmitters and neuropeptides involved in anxiety?
PET and SPECT imaging studies link anxiety disorders to disruptions in serotonin levels, changes in the function of the GABA system (centrally involved in modulating activity in the amygdala and fear circuit.)
What has drug manipulation shown about neurotransmitters and neuropeptides involved in anxiety?
anxiety disorders are related to increased levels of norepinephrine and changes in the sensitivity of norepinephrine receptors (a key neurotransmitter in the activation of the sympathetic nervous system for “fight-or- flight” responses)
What has animal research shown?
an array of neurotransmitters and neuropeptides are involved in the process of fear conditioning and extinction.
What has research on the HPA system shown?
In one study of adolescents who had no lifetime history of an anxiety disorder, the size of this early morning rise, called the cortisol awakening response (CAR, morning piss), predicted the onset of anxiety disorders over the next 6 years
What anxiety disorder is behavioural inhibition in infants particularly a strong indicator for
Social anxiety
What personality trait is a good predictor of anxiety disorders?
Neuroticism
Name four cognitive factors associated with anxiety
Sustained negative beliefs about the future (exaggerated consequences of actions), a perceived lack of control, over-attention to signs of threat and tolerance of uncertainty
How do people sustain these negative beliefs through multiple Times disastrous consequences do not occur
they engage in safety behaviors. For example, people who fear they will die from a fast heart rate stop all physical activity the minute they feel their heart race
What can cause a perceived lack of control?
Childhood experiences,
such as traumatic events, punitive and restrictive parenting, or abuse,
may promote a view that life is not controllable, about half of people with anxiety disorders report a history of childhood physical or sexual abuse
What effect did the dot probe task have on participants when rigged
When rigged so people focused more on negative stimuli it made them more anxious, when rigged to have them attend to positive stimuli it significantly relieved their anxiety levels to the point some didn’t meet the requirements for GAD anymore
Other than avoiding situations, give examples of safety behaviours in people with social anxiety disorder. What effect does this have?
avoiding eye contact, disengaging from conver- sation, and standing apart from others. Although these behaviors are used to avoid negative feedback, they create other problems. Other people tend to disapprove of these types of avoidant behaviors, which then intensifies the problem.
What cognitive factor can attribute to social anxiety disorder
Too Much Focus on Negative Self-Evaluations
What part of the fear circuit is particularly important in panic disorder
locus coeruleus
How is the locus coeruleus involved in panic disorder?
The locus coeruleus is the major source of the neurotransmitter norepinephrine in the brain. Surges in norepinephrine are a natural response to stress, and when these surges occur, they are associated with increased activity of the sympathetic nervous system
What name has been given to classical conditioning of panic attacks in response to bodily sensations?
interoceptive conditioning: a person experiences somatic signs of anxiety, which are followed by the person’s first panic attack; panic attacks then become a conditioned response to the somatic changes
What does having a panic attack in response to changes in physiological symptoms depend on?
the extent to which they are frightened by the bodily changes
What is the anxiety sensitivity index used for?
the extent to which people respond fearfully to their bodily sensations with a sub scale measuring The propensity toward catastrophic interpretations
What is the principle cognitive model of the ethology of agoraphobia?
the fear-of-fear hypothesis (Goldstein & Chambless, 1978), which suggests that agoraphobia is driven by negative thoughts about the consequences of experiencing anxiety in public.
How does GAD differ from other anxiety disorders
It doesn’t require an intense fear, much more likely to experience episodes of MDD,
What is the core feature of GAD?
Worry
Name and describe a model which may explain why some people worry more than others do
people diagnosed with GAD find it highly aversive to experience rapid shifts in emotions. According to the contrast avoidance model, to ward off sudden shifts in emotion, people with GAD find it preferable to sustain a chronic state of worry and distress
What treatments are common across all anxiety disorders?
CBT (usually very specific cognitive techniques to go with exposure therapy) and exposure therapy
What key features should be present to prevent relapse?
exposure should include as many features of the feared object as possible, exposure should be conducted in as many different contexts as possible
What happens rather than a response being “erased” with exposure therapy?
extinction involves learning new associations to stimuli related to dogs. These newly learned associations inhibit activation of the fear. Thus, extinction involves learning, not forgetting.
What is the cognitive view of exposure treatment?
exposure helps people correct their mistaken beliefs that they are unable to cope with the stimulus
What does cognitive approaches to the treatment of anxiety consist of?
challenging people’s beliefs about (1) the likelihood of negative outcomes if they face an anxiety-provoking object or situation, and (2) their ability to cope with the anxiety.
What training may help those with social anxiety?
Social skills
What are people with social anxiety told not to do when undergoing exposure therapy
Partake in safety behaviours, this makes it more effective
What does cognitive therapy for social anxiety focus on
Not to focus their attention internally
What therapy is often employed for GAD?
relaxation training to promote calmness. Relaxation techniques can involve relaxing muscle groups one by one or generating calming mental images. Broader forms of CBT have also been developed, which include strategies to help improve problem solving and to address the thought patterns that contribute to GAD.
What name is given to drugs that reduce anxiety?
anxiolytics
What two types of medication are usually used to treat anxiety? Which are preferred?
benzodiazepines (e.g., Valium and Xanax) and anti- depressants, including tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and serotonin–norepinephrine reuptake inhibitors (SNRIs). Antidepressants are preferred over benzos
What negative side effects do benzodiazepines have?
significant cognitive and motor side effects, such as memory lapses and drowsiness
What negative side effects do tricyclic antidepressants have?
jitteriness, weight gain, elevated heart rate, and high blood pressure
What are the first choice medication for depressions? What side effects do they have?
SSRIs and SNRIs; gastrointestinal distress, restlessness, insomnia, headache, and diminished sexual functioning
