Anxiety

Question 1

Panic disorder

Answer 1

Repeated unexpected attacks of anxiety

Question 2

Phobias (Specific & Social)

Answer 2

Marked fear and avoidance of a situation or object

Question 3

Obsessive-compulsive disorder

Answer 3

Distressing thoughts or images with “putting right” actions

Question 4

Posttraumatic Stress Disorder

Answer 4

Unwanted, distressing memories of traumatic event

Question 5

Generalized Anxiety Disorder

Answer 5

Excessive worry about several different things

Question 6

How common are anxiety disorders?

Answer 6

10%-18% prevalence in 12 month period

Question 7

What proportion of anxiety disorders warrant treatment?

Answer 7

2/3

Question 8

Gender in anxiety?

Answer 8

Higher in women

Question 9

Anxiety is often comorbid with?

Answer 9

Depression and substance abuse

Question 10

Is anxiety heritable?

Answer 10

Yes, runs in families but obviously multifactorial aetiology

Question 11

What is the anxiety disorder persistence?

Answer 11

33% to 70% recovery over 12 years depending on disorder type

Question 12

Cost to society of anxiety disorders?

Answer 12

Around 7% of GDP

Question 13

Is paranoid thought disorder a type of anxiety?

Answer 13

No

Question 14

Medications for ADs?

Answer 14

Benzodiazepines (only for short-term distress, dependency problem so not used chronically)

Anti-depressants (especially SSRIs and SNRIs)

SSRIs/SNRIs: only often work in the short term, many people relapse.

Question 15

Psychological treatment for AD?

Answer 15

CBT and cognitive therapy

Question 16

How many sessions comprise CBT?

Answer 16

Brief 8-16 sessions

Question 17

What is CBT based on?

Answer 17

Cognitive model of emotional disorders

Question 18

What are the aims of CBT?

Answer 18

Aims to change problematic beliefs and related behaviours (rather than original causes).

Widen the gap between thought and behavior/ response

Prevents mental escalation, event don’t inevitably lead to emotion, therefore interpretation is key and can be modified.

Question 19

Panic disorder is often accompanied by…

Answer 19

Marked bodily sensations

Question 20

What is the cognitive theory of panic disorder?

Answer 20

Cognitive Theory of Panic Disorder (Clark, 1986): Persistent panic attacks result from catastrophic misinterpretation of benign body sensations

Misinterpretation involves believing the sensations indicate an immediate physical or mental disaster

Question 21

What sensations are misinterpreted in panic disorder

Answer 21

Sensations that are misinterpreted are mainly those involved in normal anxiety responses

Question 22

What leads to maintenance of panic disorder?

Answer 22

Selective attention to bodily cues and safety behaviours (i.e stopping and calming down, individual believes that the worst only doesn’t happen when they do the safety behaviour).

Question 23

Cognitive therapy for panic disorder

Answer 23

Identify catastrophic interpretations of bodily sensation

Generate alternative, non-catastrophic interpretations of bodily sensations

Test out validity of catastrophic and non-catastrophic interpretations by discussion & behavioural experiments

Question 24

Behavioural experiments for panic disorder?

Answer 24

Induce feared sensations to show their true cause

Reading word pairs (breathless-suffocate etc.)

Focus attention on body

Drop safety behaviours in presence of feared sensation to discover they are not dangerous

Question 25

What is social anxiety?

Answer 25

Marked fear & avoidance of social or performance situations (meeting strangers, talking to a group, eating or drinking while being observed, using public toilets, public speaking, etc.)

Question 26

Why does social anxiety persist?

Answer 26

Shift to internal focus of attention Use of internal information to infer how one appears to others (create distorted images and feelings) Safety behaviours (shutting down and not speaking)

Question 27

What happens in CBT for social anxiety?

Answer 27

Experiential exercise to demonstrate adverse effects of self-focused attention and safety behaviours Video (and still) feedback to correct negative self-images Attention training to promote external focus Behavioural experiments to test patients’ fearful predictions in social situations while dropping safety behaviours and/or enacting feared outcomes. Surveys to discover other people’s view of feared outcomes. Memory re-scripting to reduce social trauma

Question 28

What treatment is NOT used in CBT for social anxiety?

Answer 28

Training in self focussed attention

Question 29

Which describes the effect of a routine psychological debriefing given immediately after a traumatic event ?

Answer 29

Retards natural recovery

Question 30

Phobias are

Answer 30

Resistant to drug treatment

Question 31

Are phobias reduced by informing patient of their phobia?

Answer 31

No

Question 32

What are treatments for anxiety?

Answer 32

Antidepressants Benzodiazepines CBT Exposure therapy