Anxiety Flashcards
What distinguishes fear from anxiety?
Fear is a state of immediate alarm in response to a serious, known threat to one’s well-being
Anxiety is a state alarm in response to a vague sense of threat or danger
Both have the same physiological features - increase in respiration, perspiration, muscle tension, etc.
Anxiety is a big looming sense that something is off
* I feel anxious, why? While fear has a known threat or response
* Anxiety has a chronic state of muscle tension
* Respiration - hyperventilation will cause lightheadedness, headaches, etc.
Perspiration - lots of sweat
What are psychological contributions to anxiety?
Anxious behavior starts starts in childhood
- feeling of no control over environment
- overprotective and over intrusive parents
personality traits
- anxiety sensitivity
conditioning develops
If you bubble wrap your kids, then they won’t learn how to fall and judge fear
Anxiety sensitivity - you don’t like the sensations of anxiety and really react to it
Condition response - you are conditioned to a fear response
What is comorbidity? What is anxiety comorbid with?
Comorbidity is the occurrence of two or more disorders in a single person
3/4 of those with anxiety disorder meet criteria for another disorder
- 60% meet criteria for major depression
- Other disorders commonly comorbid with anxiety: Substance abuse, Personality disorders (avoidant, dependent, histrionic), medical disorders e.g. coronary heart disease
Major depression and anxiety disorders most commonly comorbid
Additional disposes of depression alcohol, drug abuse make recovering from anxiety difficult
Super anxious people will go in and out of depression
Feelings of anxiety might led to substance abuse
* Temporary solution that becomes the new problem
Cannabis induces anxiety in the long term
How is anxiety related to suicide?
20% of panic disorder patients attempt suicide
Comparable to people with depression
Suicidal ideation common
Suicide attempts common
-more likely by those who inflict self-harm
Panic, fear, and anxiety make people want to escape
What are features that characterize generalized anxiety disorder (GAD)?
-Uncontrollable, unproductive worrying about everyday events
-Feeling impending catastrophe even after successes
-Inability to stop the worry-anxiety cycle
Women are likely to get it in their life
* More worries/more responsibilities - role strain
○ Raising children
* Biological differences
○ Carrying children, etc.
* Childhood abuse
Assault
24/7 worry that is not productive
Endless stream of what-ifs
A feeling of looming danger
Anxiety brain becomes a catastrophic brain - you become anxieties so fast about not bad things
It lurks in the background
Where does Generalized Anxiety Disorder (GAD) happen?
The disorder is common in Western society
-Affects ~3% of the population in any given year and ~6% at some time during their lives
Usually first appears in childhood or adolescence
women are diagnosed more often than men by a 2:1 ratio
around one-quarter of those with GAD are currently in treatment
Its coming to come early - temperamental disposition, separation anxiety
2:1 ration f:m
3/4 are not getting treatment
* SSRIs
* CBT
Don’t ever cure it, but get it on the run, give them skills and chip away from unhelpful patterns
What the three new explanations for the cognitive perspective of GAD?
Metacognitive theory:
Developed by Wells; suggests that the most problematic assumption in GAD are the individual’s worry about worrying (mete-worry)
If you’re super anxious you get wrapped up in your own thoughts
So worried about something you’re not worried about something that’s important
Intolerance of uncertainty theory:
Developed by Degas; certain individuals believe that any possibility of a negative event occurring means that the event is likely to occur
* They cannot tolerate uncertainty
* They tend to castrophize it it
Avoidance Theory:
Developed by Borkovec; holds that worrying serves a “positive” function for those with GAD by reducing unusually high levels of bodily arousal
* Very avoident
* They deal with it by not showing up
* Or show up and then leave
All of these theories have received considerable research support
What do Psychological methods and behavioral methods focus on for treating GAD?
Psychological methods aim to:
Increase sense of control over thoughts and worries
more accurate view of likelihood and dangerousness of perceived threats
decrease muscle tension
Make more accurate world, so you don’t see danger around every corner
Increase your ability to deal with anxiety
Behavioral methods focus on:
Breathing retraining
muscle relaxation training
reduce behaviors associated with worry (e.g. checking or reassurance-seeking)
Front line treatment is psychological methods
What is Panic Disorder (PD)?
Sensation of dying or of losing control, panic attacks
In many cases, PD is accompanied by:
Agoraphobia: fear and avoidance of situations: unsafe and inescapable
How do phobias differ from “normal” experiences of fear?
Its more intense and persistent fear
greater desire to avoid the feared object or situation
distress that interferes with functioning
When you fear them, you see them everywhere
It starts to create problems
There is distress and impairment
What causes specific phobia?
Traumatic experiences/traumatic conditioning
Vicarious experience
panic attack
social and cultural factors
most reported specific phobias occur in women
Not just an evolutionary preparedness but prior learning; difficult previous experience
Observation
Direct, personal experience
What are neurological factors in social phobia?
the Amygdala is strongly activated when afraid and when shown faces with negative expressions
the Hippocampus and the cortical areas near the amygdala do not function normally
the Right hemisphere also appears to play a part
Dopamine, serotonin, and norepinephrine may function abnormally
the heritability of social phobia is 37% on average
-Children with shy temperament or behavioral inhibition
What is Separation Anxiety Disorder?
Child’s unrealistic and persistent worry something will happen to parents or other people important to child
Afraid to go to school; has nightmares
35% can extend into adulthood if not treated in childhood
Also adult and adolescence versions
What is the onset, course, and outcome of Separation Anxiety Disorder in children?
SAD has the earliest onset of anxiety disorders (7-8 years of age) and youngest age of referral
Progresses from mild to severe
Associated with major stress, such as moving to a ne neighborhood or entering a new school
SAD persists into adulthood for 1/3 of affected youngsters; adults may experience
- relationship difficulties
- other anxiety disorders and mental health problems
functional impairment in social and personal life
What are Social Phobias?
Severe, persistent and unreasonable fears of social or performance situations in which embarrassment may occur
- may be narrow - talking, performing, eating or writing in public
- may be broad - general fear of functioning poorly in front of others
- in both forms people rate themselves as performing less adequately than they actually do
