Anx Dis's Flashcards
Anxiety is __________oriented whereas fear is________
Future; present
Prevalence of anx disorders are
14% in Aus annually
Some of the comorbid risks associated with anx disorders are
Greater suicidality, unemployment, marital discord, greater medical costs, increased cardiovascular costs
The DSM anx disorders are
specific phobia generalised anxiety panic disorder agoraphobia social anxiety disorder
Which is INCORRECT of anx dis’d;
1. Interfere with important areas of function i.e. social, occupational etc., OR cause severe
distress
2. Not due to drug or medical condition
3. Symptoms persist for 12+ months OR 1+mth for panic disorder
4. Fears and anxieties distinct from another anx disorder
3 - 6+ months not, 12
Specific phobia - person recognises that the fear is irrational. (T/F)
True
Phobias often cluster, the two most common phobias are;
claustrophobia, acrophobia (heights).
Prepared learning refers to___________
Suggestion that we have an evolutionary advantage where the fear circuit is primed to automatically fear things that threaten life i.e. sharks vs flower
Social anxiety disorder involves person fearing;
a) being in room with many people
b) having fear of not being able to get out of crowded room
c) being negatively evaluated by others
d) none of the above
C - being negatively evaluated by others
Social anxiety disorder was classified as________ in the DSM-IV but was changed due to_________
Social phobia; social anx is MORE persistent + severe, interferes with function more than phobias do. ALTHOUGH can be both general or specific
Social anxiety is often associated with ___________ disorders. Otherwise, their coping strategies may include
MDD + alcohol abuse;
aggression, withdrawal, submission, hostility
Social anxiety clients often work in jobs below their competency because they cannot learn any new skills
T/F
False - do it bc they dont want to be criticised
Which is INCORRECT about social anxiety dis’d;
a) difficult to extinguish bc person actively avoids social settings
b) Person has unrealistically negative beliefs about the consequences of their behaviour
c) attend more to external cues than internal (social) cues
d) 30% of cases meet avoidant PD criteria, with symptom onset around adolescence
C - social anx dis’d clients focus more on the INTERNAL cues and get caught up in their own worry about negative evaluation rather than external conversation cues
Which is INCORRECT regarding panic disorder?
a) panic attacks are unrelated to specific situations
b) panic attacks involve a sudden apprehension and fear of impending doom
c) Panic attacks peak within 10 minutes
d) panic attacks involve 3 months of worrying about having another attack
D - wrong, because need to have worry about 1 month worry about having another attack
INCORRECT regarding panic disorder;
a) The lifetime prevalence of having a panic attack is 40%
b) attacks should be recurrent and consistent over the lifespan
c) panic disorders have onset in adolescence
d) none of the above
D - all true
Neurobiological aetiology of panic disorder -
hyperactive locus coereleus = increased norepinepherine which is important for fear response + activation of sympathetic NS
interoceptive conditioning refers to ___________in panic disorder
when person gets classically conditioned to fear all somatic responses i.e. racing HR from running, person links with last panic attack, leads to actually experiencing one. Those with PD more sensitive than gen pop to somatic changes
Agoraphobia is different from social anxiety disorder because_________
involves anxiety about not being able to escape from X situation = homebound
Why was Agoraphobia shifted from being listed under panic disorder?
Because the ICD-10 has long listed it as an independent disorder + more than HALF of those with agoraphobia did not experience panic attacks, but DID show worry about other anx symptoms
Agoraphobia requires fear of being unable to escape in ___________ settings
2+
Suggested aetiology of panic disorder is
experience, genetics. Fear of the feared outcome, stops people from entering social environments
Worry refers to
the cognitive tendency to chew on a problem and be unable to let go of it. Most likely when person cant make a decision. Becomes pathological went cant stop
The core feature of GAD is
persistent, uncontrollable worrying
GAD differes from most other anx disorders because______
a) constant worrying, whereas others involve acute periods of anxiety.
b) are the group MOST common with MDD,
c) do NOT SHOW altered physiological arousal bc always on edge
Which is INCORRECT regarding GAD?
a) adults require feeling anxious >50% of day about a number of events
b) children only require >1 symptoms for GAD diagnosis, whereas adults require 3+
c) typical onset during young adulthood
d) associated with marital dissatisfaction and fewer freindships
C - onset in ADOLESCENCE although patients say they have felt this way entire life
Describe the expected aetiology of GAD
Anx is a constant coping mechanism distracting person from more distressing trauma. Worry does not involve images + physiological changes that accompany
emotions = self-talk about worry reduces emotionality/physiol arousal
Which type of childhood abuse/neglect is most associated with GAD
Maternal matreatment - 4x more likely
Women show more biological reactivity to stress__________(T/F)
True
Anxiety disorders _____________by culture, but what is feared _________.
Anxiety disorders DO NOT VARY by culture, but what is feared DOES VARY
Somatic symptoms are usually what first get reported_________ (T/F)
True, psych symptoms not immediately reported.
Risk factors for anx disorders are________
genetics; high epinepherine, HIGH GABA + 5-HT,
Behavioural inhibition, neuroticism, disturbances in the fear circuit
perceived lack of control, negative beliefs, attention to threatening cues
Mowrer’s two factor model of anx development says that
1) people have a classically conditioned response to feared stimulus OR can learn through modelling, // verbal instruction of others
2) future avoidance of stimulus REINFORCES (operant conditioning) maladaptive behaviour
Mowrer’s 2-factor model explains which disorders?
Specific phobia + social anxiety disorder
those with anx disorders have slower EXTINCTION rates of classically conditioned responses compared to controls + faster rate of ACQUISITION of fear
T/F
True
Is there much difference in genetic heritability among the anx disorders?
panic disorder - 50%; social anx, agoraphobia, GAD - 20-40%
The fear circuit involves ________structures
Amygdala, hippocampus, MEDIAL PFC
The amygdala’s function is to__________
assign emotional significance to stimuli, is OVERactive in anx disorders, important for ACQUIRING fear
Medial PFC important for _________
regulating amygdala, is engaged when extinguishing fear. anx disorders have LESS activation + connectivity
= poorer regulating emotions when there is a non/threatening stimuli
behavioural inhibition in infants represents__________ and can be detected as early as________. A less significant predictor of anx dis’d is neuroticism, referring to_________
tendency to cry/ be agitated when faced
with new environments; 4 months;
tendency to experience frequent or intense negative affect.
A common belief among ALL anx disorders is ___________
Sustained negative beliefs about future that DO NOT FADE over time, may not cease over time because patient continues to engage in safety behaviours = reinforce negative cognitions
Percieved lack of control.
The MOST common treatment for all anx dis’d is___________
Exposure therapy, effective for 6+ months after therapy
a) client lists triggers
b) therapist cooperatively makes a HIERARCHY
c) work through them together
Factors affecting anx dis’s relapse______
Number of triggers
number of ENVIRONMENTS in which feared stimulus appears i.e. germs vs snakes
the neurobiological explanation of exposure therapy states that;
a) the goal of aversion therapy is erasing the fear response from the brain
b) we make new associations with feared stimulus that inhibit fear response
c) extinction of behavioural response is due to learning, not forgetting
d) both B+C
D - both B+ c
The cognitive theory of aversion therapy states that _____________
client is able to learn for themselves that they are CAPABLE of dealing with stressors without losing control.
= challenge negative beliefs about what will happen if get faced with trigger
CBT and exposure therapy has a greater combined effect than one approach individually (T/F ).
Psychological tmt is preferred over medication (T/F)
FALSE; TRUE
The 2 classes of anxiety medications are
a) Anxiolytics - (binzodiazepines) i.e. mind tranquilizers, drowsiness, memory lapses,
b) Antidepressants - (tricyclic, SSRI’s, serotonin / norepinepherine reuptake inhibitors (SNRI’s)).
The PREFERRED drug class for anxiety is _________because
Antidepressants because anxiolytics cause WITHDRAWAL + less side efx.
Trycyclic AD’s have ___________side efx, whereas SSRI/SNRI have ________
Tri- jitteriness, nausea, vomiting, weight gain, incr HR + BP
SS - overall LESS efx, but may be restlessness, insomnia, headache, sexual dysfunction
Buspirone is ________
specific drug used for GAD
