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507 midterm > Anxiety and OCD > Flashcards

Anxiety and OCD Flashcards

1
Q

What is anxiety?

A

Unpleasant emotional state characterized by physical arousal, feelings of tension, apprehension and worry.
Book: the central nervous system’s physiological and emotional response to a vague sense of threat or danger.

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2
Q

Yerkes-Dodson curve

A

There is an ideal level of anxiety/stress that can motivate to action and actually be helpful

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3
Q

What is the difference between fear and anxiety?

A

Fear: the central nervous system’s reaction to present danger
Anxiety: anticipatory, generalized

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4
Q

State v. trait anxiety

A

State anxiety: in response to a stimulus

Trait anxiety: related to worldview, more pervasive, not situationally specific.

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5
Q

When does anxiety become abnormal?

A

When it interferes with everyday functioning.

  • irrational
  • uncontrollable
  • disruptive
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6
Q

Cognitive components of anxiety

A

difficulty concentrating, anxious/negative thoughts

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7
Q

Behavioral components of anxiety

A

Avoidance maintains anxiety through negative reinforcement.

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8
Q

Physical components of anxiety

A
  • increased heart rate, breathing
  • sweaty
  • nausea
  • tension (trapezius, facial muscles)
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9
Q

What is the most common of all mental disorders, and what percentage of people experience it?

A

Anxiety- 29% of all adults in lifetime

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10
Q

Generalized Anxiety Disorder

A

“free floating anxiety”
DSM criteria:
-chronic and persistent state of worry for at least 6 mo.
-difficulty controlling worry
- at least 3 of these: restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance

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11
Q

Cognitive components of GAD

A

Excessive worry, difficulty concentrating

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12
Q

Behavioral components of GAD

A

Misguided attempts to control

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13
Q

Physical components of GAD

A

Muscle tension, sleep disturbance

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14
Q

What percentage of the population suffers from GAD, and what other demographic info do we know?

A

3-4% of the population
Typically first appears in childhood or adolescence
Females 2x more than males
Rate almost twice as high among people with low incomes
Most likely to be faced by people who are faced with ongoing dangerous societal conditions (those living in crime-ridden neighborhoods or poverty, for example)
non Hispanic white American are more likely than African, Hispanic, or Asian Americans to develop an anxiety disorder

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15
Q

How does psychodynamic theory explain GAD?

A

Caused by inadequacies in the early parent-child relationship. Extreme punishment for id impulses teaches the child that impulses are dangerous, which causes higher anxiety. Overprotective parents cause children to lack adequate defense mechanisms to cope with anxiety. GAD becomes a defense mechanism to protect against a specific, difficult anxiety/fear

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16
Q

How does GAD develop as a defense mechanism, according to psychodynamic theory?

A

GAD develops as a defense mechanism to protect against a specific anxiety or fear.

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17
Q

What is the behavioral and cognitive etiology of GAD?

A
  • repeated exposure to feared situations
  • maladaptive cognitions: focus attention on threatening stimuli
  • irrational assumptions
  • intolerance of uncertainty
  • worry as an avoidance strategy
  • reinforcement of worry and other behaviors due to “prevention” of negative occurrences.
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18
Q

How does worry work as an avoidance strategy in GAD?

A

Worry is negatively reinforced by reduced emotional processing and negative arousal.

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19
Q

How does mindfulness work?

A
  • focus attention where you want
  • nonjudgmentally
  • notice when mind wanders and redirect
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20
Q

What is the biological etiology of GAD?

A

Heritability estimate of .32
Problems in anxiety feedback loop: GABA- failure to inhibit arousal due to malfunction in feedback or reduced receptors.
Role of other neurotransmitters: serotonin and norepinephrine

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21
Q

Panic attack

A

Sudden episode of anxiety that rapidly escalates in intensity. Symptoms include pounding heart, rapid breathing, sweating, choking sensation, dizziness, feeling like going to die or going crazy

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22
Q

Panic disorder

A

Anxiety disorder in which the person experiences frequent and unexpected panic attacks, worry about additional attacks, and material change in behavior to avoid attacks.

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23
Q

Panic attack specifier

A

Panic attacks can occur in the context of any disorder; panic attacks in conjunction with another disorder associated with increased symptom severity, higher rates of comorbidity and suicide, poorer tx response

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24
Q

Demographics of panic disorder

A

2:1 higher in women
1.7% of population in given year
Age of onset likely related to cognitive development (20’s)
Attacks can occur during sleep

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25
Q

How does panic disorder develop?

A

Genetic vulnerability: tendency to run in families, abnormal panic circuit
Sensitive to signs of a panic attack- high “anxiety sensitivity,” misinterpret physical signs of panic attacks as dangerous and catastrophic
Vicious cycle: panic attack -> worry over another -> sensitivity to panic symptoms -> any “panic like” symptoms -> panic attack

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26
Q

CBT treatment focus for panic disorder

A
  • Psychoeducation about panic
  • interoceptive exposure
  • coping skills (relaxation techniques, resiliency training)
  • cognitive re-appraisal
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27
Q

What is a phobia?

A

A strong, irrational fear of something

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28
Q

When does a fear become pathological?

A

When there is dysfunction, distress, danger, or it is deviant.

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29
Q

How do phobias develop?

A

Classical conditioning (Little Albert), observational learning

30
Q

Stimulus generalization

A

When fear of one stimulus is generalized to a fear of broader stimuli

31
Q

Mowrer’s 2 factor theory

A

Classical conditioning is responsible for the conditioning of anxiety, and operant conditioning maintains anxiety as escape and avoidance negatively reinforce it.

32
Q

Modeling

A

Phobias can develop by seeing someone else’s fear (child is more likely to have a phobia her parent does)

33
Q

What is a specific phobia?

A

Strong or persistent fear that is excessive or unreasonable. The phobic stimulus almost always provokes an anxiety response, and is either avoided or endured with great anxiety. It interferes with functioning.

34
Q

Types of specific phobias

A
  • situational type (flying)
  • natural environment type
  • blood-injection-injury type
  • animal type
  • other type
35
Q

How does CBT treat specific phobia?

A

Exposure: systematic desensitization, flooding, modeling

36
Q

Agoraphobia symptoms

A

Must have 2 or more:

  • using public transportation
  • being in open spaces
  • being in enclosed spaces
  • standing in line
  • being in a crowd
  • being outside of home alone
37
Q

How do people with agoraphobia tend to handle the feared situations, and why do they fear them?

A

Because escape seems difficult or help would be unavailable if needed. Handled through avoidance, or endured with great distress, or with a companion.

38
Q

What is social anxiety disorder?

A

Extreme and irrational fear of being embarrassed, judged, or scrutinized by others in social or public situations. (There is a version with a “performance only” specifier)

39
Q

Which is the most common anxiety disorder?

A

Social Anxiety (3.7% of population)

40
Q

How does CBT treat SAD?

A

Exposure to social situations

Social skills training: role play, rehearse, reinforce effective behaviors that are not avoidant

41
Q

What is OCD?

A

Person’s life dominated by repetitive thoughts (obsessions) and behaviors (compulsions)

42
Q

Obsessions

A

repeated, intrusive, uncontrollable thoughts or images that cause great anxiety or distress.

43
Q

Compulsions

A

Repetitive behavior a person feels driven to perform. If they resist performing the compulsion, extreme anxiety results; completion of behavior lessens anxiety.

44
Q

What are the OCD specifiers?

A
  • good or fair insight
  • poor insight
  • absent insight/delusional beliefs
45
Q

Demographic info for OCD

A

1-2% of population
Females slightly higher
Late teens is average onset; rarely is onset after age 35

46
Q

Genetic/biological factors in OCD

A

Heritability is >50%
A certain brain circuit is hyperactive in people with OCD, making it difficult for them to turn off or dismiss their various impulses, needs, and related thoughts.

47
Q

Neurological factors in OCD

A

Inadequate serotonin

48
Q

Behavioral factors in OCD

A

Conditioning

49
Q

Cognitive factors in OCD

A

Different evaluation of normal, intrusive thoughts-attempt to suppress

  • overestimate likelihood of negative events
  • dysfunctional assumptions, such as that having a thought is equal to performing the action, and the belief that one can and should control thoughts.
50
Q

How does CBT treat OCD?

A

Educate clients, point out how misinterpretations of unwanted thoughts, an excessive sense of responsibility and neutralizing acts have helped produce and maintain symptoms.
Exposure with response prevention:
-elicit obsessions and resist urge to act with compulsions
-tolerate resulting anxiety/distress

51
Q

Hoarding disorder

A
  • Persistent difficult discarding or parting with possessions
  • Distress associated with discarding
  • accumulation that interferes with living
  • clinically significant distress (may be personal or public health issue)
52
Q

Demo for hoarding disorder

A

2-5% of population
males > females (females more likely to present for tx)
3x more likely in older adults

53
Q

Body dysmorphic disorder

A
  • preoccupied with something wrong with face (or body part)
  • not delusional, but overvaluing
  • not a phobia (no irrational fear)
  • high rates of suicide
  • 2% of population
54
Q

Metacognitive theory in GAD

A

people with GAD hold both positive and negative beliefs about worry

55
Q

Avoidance theory in GAD

A

people with GAD have greater bodily arousal and constant worry actually reduces this arousal

56
Q

Drug treatment for GAD

A

sedative-hypnotic drugs (benzos): drugs that calm people at lower doses and help them fall asleep at higher doses. Can be problematic, so the treatment of choice is now antidepressant medication.

57
Q

Role of GABA in GAD

A

a neurotransmitter whose low activity in the brain’s fear circuit has been linked to anxiety. It carries inhibitory messages: when GABA is received at a receptor, it causes the neuron to stop firing. This finding led researchers to believe that GABA plays a key role in the reduction of normal, everyday fear reactions. Now we know that GAD is more complicated than the disturbed activity of a single neurotransmitter- there is a brain circuit responsible which includes multiple brain structures. The fear circuit is hyperactive in people with GAD.

58
Q

Systematic desensitization

A

exposure treatment that uses relaxation training and a fear hierarchy to help clients with phobias react calmly to the object or situations they dread.

59
Q

Flooding

A

an exposure treatment in which clients are exposed repeatedly and intensively to a feared object and made to see it is actually harmless.

60
Q

Modeling

A

therapist confronts the feared object while the fearful person observes.

61
Q

How is agoraphobia treated?

A

exposure therapy is used for treatment, but with the addition of support groups and home-based self-help programs.

62
Q

How effective is CBT at treating SAD?

A

at least as effective as medication (benzos or antidepressants) at reducing social fears, and people less likely to relapse than those treated with medications alone.

63
Q

What area of the brain and neurotransmitter is linked to panic?

A

locus coeruleus: a small area of the brain that seems to be active in the regulation of emotions; many of its neurons use norepinephrine. Panic reactions are linked to norepinephrine, but also to a brain circuit referred to as the “panic circuit.”

64
Q

Biological challenge tests

A

a procedure used to produce panic in participants by having them exercise vigorously or perform some other potentially panic-inducing task with a therapist

65
Q

Anxiety sensitivity

A

a tendency to focus on one’s bodily sensations, assess them illogically, and interpret them as harmful.

66
Q

Psychodynamic perspective on OCD

A

id impulses take the form of excessive thoughts and the ego defenses appear as compulsive actions. Freud traces OCD to the anal stage.

67
Q

Exposure and response prevention

A

a CBT technique used to treat OCD that exposes a client to anxiety-arousing thoughts or situations and then prevents the client from performing his or her compulsive acts.

68
Q

Drug treatment most widely used for OCD

A

antidepressant drugs, especially ones that increase serotonin activity

69
Q

trichotillomania

A

a disorder in which people repeatedly pull hair out from their scalp, eyebrows, eyelashes or other parts of the body.

70
Q

excoriation disorder

A

a disorder in which people repeatedly pick at their skin, resulting in significant sores or wounds.

71
Q

developmental perspective

A

Relationships between variables are two-directional- the impact of biological factors can often be affected by parenting, life events, newly acquired behaviors, ways of thinking- just as biology may have great influence on such variables.

72
Q

What is the difference between escape and avoidance?

A

Escape is a form of avoidance.

avoidance = things you don’t do, people or situations you don’t put yourself around, things you do/don’t do to control thoughts or emotions, etc…

escape = when confronted with people, places, situations which trigger anxiety or difficult thoughts an organism or person will get away; the act of moving away from or leaving when confronted with difficult internal experiences or environmental triggers for those experiences.

507 midterm (8 decks)

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