Anxiety Flashcards
Panic attack definition
Abrupt surge of immense fear or discomfort, reaches peak in minutes.
Occurs from calm or anxious state.
Specifier, not a disorder itself.
Activation of autonomic nervous system “fight or flight”.
22.7% experienced at least one panic attack (Kessler et al., 2006)
Panic attack symptoms
4 + symptoms: Palpitations Increased heart rate Sweating Trembling Shortness of breath Choking feeling Chest pain Nausea Dizziness, lightheadedness Chills Parasthesia (numbness or tingling) Derealisation or depersonalisation Fear of losing control or going crazy Fear of dying
Panic disorder
3.7% population
Occurrence of panic attacks
Anticipatory anxiety concerning next one.
PD Cognitive theories
Clark and Beck
catastrophic misinterpretation of bodily sensations > anxiety about sensations > more sensations.
PD conditioning theories
Situations paired with panic attacks once or twice > panic and anxiety when encountered again
Situations (external cues) or sensations (interoceptive cues)
Interoceptive = why panic attacks can occur from calm state – physiological symptoms remind individual of panic attack.
Poor outcome/longer recovery
Longer duration before treatment Severity of ‘phobic’ avoidance Co-morbid affective disorder (e.g. depression) Alcohol and/ or substance misuse Personality disorder Incomplete remission with treatment Female Co-morbid Agoraphobia
Agoraphobia
Previously sub-type of PD (PD with or without agoraphobia).
Now classified as a disorder in itself.
Frequently co-morbid with PD.
Fear of public or crowded situations where they feel trapped as escape is difficult.
Specific phobia symptoms
Persistent and irrational fear of specific object/situation.
Exposure to stimulus provokes immediate anxiety response.
Sufferer knows fear is irrational/disproportionate.
The phobic situation is avoided or endured with anxiety or distress.
Interferes with functioning, or distress about having the phobia.
Specific phobia causes
Classical conditioning - onset simple phobias (no limit to number)
Steketee (1985) only 25% of animal phobics remembered related traumatic event.
Dysfunctional cognitions.
Most animal phobic reactions are not related to fear of being hurt by the animal. 91% afraid of panic attack, 41% afraid of pain.
Specific phobia treatments
CBT especially systematic desensitisation.
GAD symptoms
6+ months. 3+ symptoms. Sig. distress/impairment.
Hard to control anxiety/worry about number of activities/events.
Restlessness Fatigue Poor concentration Irritability Muscle tension Sleep disturbance
Not confined to features of another disorder.
Not due to substance.
Social anxiety disorder
Persistent fear of one or more social/performance situation.
Fear of embarrassment/humiliation or scrutiny by unfamiliar people.
Situations avoided or endured with distress.
Interferes with functioning or distress about having phobia.
Non-Generalised (less severe): single or many social situations.
Generalised (more severe): ‘most social situations’
2/3 at least one co-morbid diagnosis (Ruscio et al., 2008)
Anxiety disorder treatment
Pharmacological
SSRIs - first line
Benzodiazepines (tranquilisers) have addictive qualities (e.g. valium)
CBT
Addresses faulty cognitions surrounding anxiety-inducing stimulus.
Behavioural techniques e.g systemic desensitisation.
DSM Anxiety disorders list
12 disorders inc: Separation anxiety Selective mutism Specific Phobia Social anxiety Panic disorder Agoraphobia GAD
