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anxiety Flashcards

1
Q

Is anxiety good for us?

A

Yes, in moderate amounts.

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2
Q

Do we perform better when we are a little anxious?

A

Yes.

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3
Q

Anxiety is a …. oriented mood state.

A

“future”

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4
Q

Sudden overwhelming reaction

A

panic

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5
Q

Immediate alarm reaction to danger

A

fear

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6
Q

Can fear be good for us?

A

yes.

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7
Q

Do fear and anxiety differ psychologically and physiologically?

A

Yes.

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8
Q

How is fear different to anxiety?

A

It is an immediate emotional reaction to current danger characterised by strong escapist action tendencies, and often a surge in the sympathetic branch of the autonomic nervous system.

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9
Q

What is the difference between a cued and a uncued panic attack?

A

Cued - you know you are afraid of high places or of driving over long bridges (panic attacks specific to this cue)
Uncued - don’t know when next panic attack will occur

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10
Q

Panic attacks involve surges in muscle tension and finger temperature lasting…

A

3 minutes.

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11
Q

Panic involves which brain systems and neurotransmitters?

A

Depleted GABA
Noradrenergic system
Seretonergic system

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12
Q

What does CRF stand for and what is it’s role in anxiety?

A

Corticotropin-releasing factor - central to the expression of anxiety (and depression) and groups of genes that increase the likelihood that this system will be turned on.

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13
Q

What does CRF activate?

A

the HPA (Hypothalamic-pituitary-adrenocortical) axis

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14
Q

Which areas of the brain does the CRF system impact?

A

The amygdala and hippocampus

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15
Q

What is the area of the brain most associated with anxiety?

A

The Limbic System.

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16
Q

What does the limbic system d?

A

Acts as a mediator between the brain stem and the cortex.

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17
Q

What is the BIS activated by?

A

Signals from the brainstem of unexpected events, such as major changes in body functioning that might signal danger. It can also receive signals from the cortex to the septal-hippocampal system.

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18
Q

What happens when the BIS is activated?

A

We freeze, experience anxiety, and apprehensively evaluate the situation to confirm that danger is present.

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19
Q

Is the BIS circuit the same as or distinct rom the circuit involved in panic?

A

it is distinct!

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20
Q

What is the FFS activated by?

A

deficiencies in serotonin.

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21
Q

What activity is associated with greatly increased risk for developing anxiety disorders as an adult, particularly panic disorder and generalised anxiety disorder?

A

teenage smoking.

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22
Q

What may contribute to a sense of uncontrolability?

A

Upbringing and other disruptive or traumatic environmental factors.

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23
Q

What is a feature among patients with panic?

A

tendency to respond fearfully to anxiety symptoms (anxiety sensitivity)

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24
Q

What is anxiety sensitivity?

A

A tendency to respond fearfully to anxiety problems. It is a personality trait.

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25
Q

How is panic a conditioned fear response considered to be a “false alarm”?

A

A strong fear response initially occurs during extreme stress or maybe resulting from a dangerous situation. Cues (conditioned stimuli - both internal and external) provoke the fear response and an assumption of danger, even if the danger is not actually present.

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26
Q

Are you always aware of these cues?

A

Not necessarily. Most likely because these cues may travel from the eyes directly to the amygdala in the emotional brain without going through the cortex (the source of awareness)

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27
Q

If you have panic attacks, is it probable other family members do too?

A

Yes.

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28
Q

What is the triple vulnerability theory?

A

Generalised biological vulnerability (uptight or highly strung), generalised psychological vulnerability (believing the world is dangerous), specific psychological vulnerability (learn from early experience that certain things are dangerous) .

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29
Q

Do panic and anxiety have the same likely genetic component?

A

No, panic is a response to stress that runs in families but may have separate genetic components.

30
Q

Does anxiety increase the likelihood of panic at least?

A

Yes.

31
Q

What percentage of patients diagnosed with either anxiety or depressive disorder had at least one additional anxiety or depressive disorder at time of assessment?

A

55% (around half).

32
Q

What is the rate of comorbidity of anxiety and depressive disorders across a lifetime?

A

76%.

33
Q

What is the most common additional diagnosis for all anxiety disorders?

A

Major Depression (50% lifetime prevalence)

34
Q

What are the risks underlying anxiety disorders and depression mediated by?

A

Partially by latent variable underlying both disorders, partially by disorder-specific effects.

35
Q

Does having an additional diagnosis of depression or alcohol or drug abuse make it more or less likely that you will recover from an anxiety disorder?

A

You are less likely to recover and more likely to relapse if you do recover.

36
Q

Common physical disorder comorbidity

A

thyroid disease, respiratory disease, gastointestinal disease, arthritis, migraine headaches, allergic reactions.

37
Q

When do anxiety disorders develop when co-occurring with physical disorders?

A

They more often occur BEFORE the physical disabilities, suggesting an anxiety disorder may contribute to the physical disorder.

38
Q

What are common panic disorder physical disability co-occurrances?

A

Cardio, respiratory, gastrointestinal, vestibular (inner ear) disorders, even thought majority of patients would not meet criteria for panic disorder.

39
Q

What is the prevalence of suicide attempts among panic disorder?

A

20% of people with panic disorder attempt suicide.

40
Q

Do those with panic disorder and major depression have a similar rate of suicide attempts?

A

Yes, 20%.

41
Q

Having any anxiety or related disorder uniquely increases the chances of having thoughts about suicide or making suicidal attempts, but the relationship is strongest with…

A

panic disorder and PTSD.

42
Q

Anxiety disorders

A

Panic Disorder, Agoraphobia, Specific phobia, social anxiety disorder, generalised anxiety disorder

43
Q

OCD and related disorders

A

Obsesive-Compulsive Disorder, body dysmorphic disorder, trichotillomania (hair pulling), excoriation disorder (skin pulling), hoarding disorder

44
Q

trauma and stress related disorders

A

PTSD, Acute Stress Disorder, Reactive Attachment Disorder, Adjustment Disorder

45
Q

How common (M/F) over 12 months?

A

PTSD (4.6/8.3) Social Phobia (3.8/5.7), Agoraphobia (2.1, 3.5), Generalised Anxiety Disorder (2/3.5), Panic Disorder (2.3/2.8), OCD (1.6/2.2).

46
Q

Any anxiety disorder prevalence?

A

Men: 11%, Women: 18%

47
Q

Comorbidity and substance use disorders. Exception or the rule?

A

The rule.

48
Q

Specific phobia types (ANEBIS)

A

Animal, Natural environment, Blood injection, Situational

49
Q

Social anxiety disorders aren’t just about regular social situations, but also…

A

performative activities (eg. presentations).

50
Q

timeframe for PTSD

A

symptoms present 1+ month after trauma

51
Q

timeframe for Acute Stress Disorder

A

symptoms present WITHIN first month after trauma

52
Q

Non-OCD symptoms? (not any more)

A

compulsively acquire or hoard items.

53
Q

What treatment is most popular for anxiety disorders?

A

CBT.

54
Q

What are the benefits of CBT?

A

Increasing positive coping skills, increase social support, is generally effective.

55
Q

What kind of course does GAD tend to follow?

A

Chronic.

56
Q

What age group is GAD most and least common in?

A

over 45 (most common) and ages 15-24 (least common)

57
Q

What is one aspect of physiological expression that is unique to GAD?

A

Muscle tension.

58
Q

What does the term “autonomic restrictors” refer to?

A

People with GAD have a comparatively low cardiac vagal tone, leading to autonomic inflexibility because the heart is less responsive to certain tasks.

59
Q

Do people with GAD respond as strongly to stressors as those with panic disorder?

A

No, not as strong. Infact, they show less responsiveness on most physiological measures, such as heart rate, blood pressure, skin conductance and respiration rate.

60
Q

Which part of the brain shows intense cognitive processing in those with GAD?

A

The frontal lobes in the left hemisphere. It is this kind of worry (those without images generated by the right hemisphere) that may lead them to be autonomic restroctors.

61
Q

Ultimately, what are activities in the frontal lobes telling us about GAD?

A

That they are avoiding images associated with threat.

62
Q

Intense worry for someone with GAD may act as…

A

…avoidance does for people with phobias. It avoids confronting the fears, so adaptation never occurs, which is one major deficit in the way people with GAD regulate their intense anxiety.

63
Q

Theraputic benefit of benzos?

A

Relatively modest.

64
Q

Antidepressants or benzos for GAD?

A

Antidepressants.

65
Q

Which treatments are most beneficial in the long term?

A

Psychological treatments.

66
Q

How does CBT combat GAD?

A

Getting people to confront anxiety-provoking imagery while also teaching them how to relax.

67
Q

What new treatments work for GAD?

A

Meditation and mindfulness to accept anxiety.

68
Q

Are psychological treatments effective for children?

A

Yes!

69
Q

TO meet criteria for …. disorder, a person must experience an unexpected panic attack AND develop substantial anxiety over the possibility of having another attack r about implications of the attack or its consequences.

A

PANIC.

70
Q

Do all people with agoraphobia avoid panic-inducing circumstances?

A

No. Some people sit through them with intense dread, hence why the DSM5 recognises this in criteria.

71
Q

How many with agoraphobia sit through the attacks?

A

50%, but rarely presenting.

72
Q

Some also develop interoceptive avoidance. What is that?

A

Avoidance of situations that might produce the physiological arousal that somehow resembles the beginnings of a panic attack (such as excercise).

anxiety (1 decks)

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