Anxiety and Obsessive-Compulsive and Related Disorders (Tut 501 & PB)

Question 1

Define fear

Answer 1

It is the emotional response to real or perceived imminent threat

Question 2

Define anxiety

Answer 2

It is the anticipation of a future threat

Question 3

What is an anxiety disorder

Answer 3

Fear or anxiety symptoms that impair normal day to day functioning

Are a group of disorders that are characterized by excessive maladaptive anxiety reactions or fear.

Question 4

What brain structures are involved in fear and anxiety response

Answer 4

Amygdala: brain structure associated with processing expression and memory of emotions. When fear experience 2 neural pathways activated. 1 when we encounter a possible threat the potential dangerous stimulus activates the amygdala triggering the hypothalamic pituitary adrenal HPA axis to prepare action response. The chemical prepares us to defend ourselves or flee. Stimulus also activates second slower pathway where sensory signal travel to hippocampus and prefrontal cortex to evaluate any potential danger

Hippocampus: the part of the brain involved in forming organising and sorting memory

Prefrontal cortex: region of cortex responsible for executive functioning allows management of attention behavior and emotions.

GABA: gamma aminobutyric acid an inhibitory neurotransmitter involved in inducing sleep and relaxation

Question 5

What genetic influence can affect anxiety and fear

Answer 5

Neurotransmitter are chemical that helps transmit messages in the brain

Serotonin is implicated in depressive and anxiety disorders with regards to transporter gene 5-HTTLPR

Polymorphic variation ( DNA mutation) affects length of one region of associated alleles which are gene pair responsible for each trait. short alleles are associated with reduction in serotonin activity and increase fear and anxiety related behavior.

Question 6

Expand on psychological dimension of anxiety and fear

Answer 6

Negative appraisal: interpreting events as threatening

Anxiety sensitive: trait involving fear of physiological changes within the body.

Reappraisal: minimizing negative response by looking at a situation from different perspectives.

Question 7

Define phobias

Answer 7

A strong persistent unwarranted fear of a specific object or situation.

Question 8

What 3 categories of phobias are there

Answer 8

Social anxiety disorders is an intense fear of being examined in social or performance situation.

It is usually comorbid meaning it exists simultaneously with another condition such as major depressive disorders

Specific phobias: an extreme fear of a specific object or situation. It can involve
Living creatures
Environmental conditions
Blood injections 
Situational factors

Agoraphobia: is an intense fear of either being outside of home alone traveling via public transport being in open spaces being in stores or theatres standing in line or being in a crowd. Due to escape not being readily available

Panic attack: an episode of intense fear accompanied by various physiological symptoms.

Question 9

What are some psychological pathway to phobias

Answer 9

Fear conditioning

Observational learning

Negative informational effect

Cognitive processes

Question 10

Give examples of cognitive behavioural treatment for phobias

Answer 10

Exposure therapy: gradually introducing individual to the feared situation or object until fear dissipates

Systematic desensitisation: exposure technique combined with an additional response

Cognitive restructuring: identifying and changing irrational or anxiety arousing thoughts associated with phobia

Modeling therapy: viewing another person’s successful interaction with feared objects or situation

Question 11

Define panic disorder

Answer 11

A condition involving recurrent unexpected panic attacks with apprehension over future attacks or Behavioural changes to avoid attacks

Question 12

Give the pattern of development of panic attacks

Answer 12

A physiological change occurs eg hyperventilation palpation

Catastrophic thoughts developes like I’m going to die

Thoughts result in more apprehension and fear causing more physiological stimulus

A circular pattern develop as body changes cause greater fear

The pairing of changes of internal sensations with fears cause interoceptive conditioning which occurs when internal bodily sensations of fear and anxiety have preceded Panic attack serves as signal for new panic attacks.

Question 13

What steps are involved in cognitive behavioural therapy

Answer 13

Educating client about panic disorder and fixing misconceptions regarding symptoms

Identifying and resolving catastrophic thinking

Teaching client to self induce physiological symptoms associated with panic in order to extinguish introspective conditioning that has occurred in response to bodily cues

Encourage the client to face symptoms both within session and in the outside world

Teach coping statement

Helping clients to identify the antecedents of panic

Question 14

What is generalised anxiety disorder

Answer 14

A condition characterized by persistent high levels of anxiety and excessive worry over many life circumstances

Question 15

Define schema

Answer 15

Mental framework for organising and interpreting info

Question 16

How does CBT attempt to treat GAD

Answer 16

Identity worrisome thoughts

Discriminate between worries that are helpful to problem solving

Evaluate beliefs about worry including evidence for and against distorted beliefs

Develop self control skills to monitor and challenge irrational thoughts and substitute more positive coping thought

Using muscle relaxation to deal with somatic symptoms.

Question 17

What is Obsessive compulsive disorder

Answer 17

A condition characterized by intrusive repetitive anxiety producing thoughts or a strong need to perform acts to reduce anxiety

Obsession: intrusive repetitive thought or image that causes anxiety

Themes including

• Contamination concern about dirt and germs
• Errors or uncertainty
• Unwanted impulses
• Orderliness

Compulsion: need to perform acts or mental tadjs to reduce anxiety.

Question 18

What is hoarding disorder

Answer 18

Condition involving congested living space due to accumulation of items and distress over thought of discarding them

Question 19

Define body dysmorphic disorder

Answer 19

Condition involving a preoccupation with a perceived physical defect or excessive concern over a slight physical defect

Muscle dysmophia is the belief that one’s body is too small or insufficiently muscular.

Question 20

Discuss hair pulling disorder or trichotillomania

Answer 20

Involves recurrent and compulsive hair pulling despite repeated attempts to stop behavior.

Question 21

Discuss exoriation or skin picking disorder

Answer 21

Involves repetitive and recurrent picking of the skin that results in skin lesions.

Question 22

What biological factors play in etiology of OCD

Answer 22

Orbitofrontal cortex: brain regions associated with planning and decision making

Caudate nuclei: brain region that regulate transmission of impulses warning that something is wrong

Question 23

What cognitive characteristics are common in OCD patients

Answer 23

Exaggerated estimates regarding probability of harm

Control

Intolerance of uncertainty

They display thought fusion where distressing thoughts regarding an action an event or an object become fused with action event or object.

Disconformatory bias where they search for evidence that may show they failed to perform routine correctly

Question 24

What is separation anxiety disorder

Answer 24

severe distress about leaving
home, being alone, or being
separated from a parent

Question 25

Define selective mutism

Answer 25

consistent

failure to speak in certain situations

Question 26

reactive attachment disorder

RAD

Answer 26

a trauma-related disorder
characterized by inhibited, avoidant
social behaviors and reluctance to seek
or respond to attention or nurturing

Question 27

disinhibited social engagement

disorder (DSED)

Answer 27

a trauma-related 
attachment disorder characterized 
by indiscriminate, superficial 
attachments and desperation 
for interpersonal contact