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psyc236 > anxiety and related disorders > Flashcards

anxiety and related disorders Flashcards

1
Q

what is anxiety?

A

future-oriented mood state characterized by marked negative effects, it has somatic symptoms of tension (shaking, headaches, insomnia)

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2
Q

what is fear?

A

present-oriented mood state marked negative effect, immediate flight or fight response to danger/threat, strong alarm and escape behaviour, and sympathetic nervous system (increase HR and muscle tension)

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3
Q

what is everyday anxiety?

A

difficulty sleeping before/after a stressful event, feeling uncomfortable in awkward social situations, and worrying about exams or getting a job

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4
Q

what is an anxiety disorder?

A

recurring bad memories from previous traumatic event, irrational fear of something that does not pose a threat, avoiding social situations in fear of judgment or humiliations, and constant feelings that interfere with everyday activities

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5
Q

what is yerkes-dodson law?

A

performance optimized by moderate levels of anxiety, excessive anxiety leads to decreased capacity, intellect, and perception of performances

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6
Q

what are the types of anxiety disorders?

A

-agoraphobia
-panic disorder
-generalized anxiety disorder
-post-traumatic stress disorder
-social anxiety disorder
-obsessive compulsive disorder

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7
Q

what is the relationship between anxiety and depression?

A

-85% of patients with depression will experience significant symptoms of anxiety
-comorbid depression symptoms or MDD occur in up to 90% of patients with anxiety disorders
-increased symptom severity, chronic course, poorer outcome

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8
Q

what is the connection of neuroanatomy?

A

sensory information to thalamus to amygdala to hypothalamus to brain stem to spinal cord

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9
Q

what is the two factor theory?

A

-neural stimulus (CS) pairs with inherently negative stimulus (UCS)
-avoidance of cs lessens anxiety (negative reinforcement through operant conditioning)
-vicarious learning/modeling (seeing other people being anxious or hearing stories)
-exposure therapy: learn to not avoid something that may not be stressful/fearful (anymore or ever)

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10
Q

what are the three anxiety symptoms?

A
  1. Subjective distress
  2. Physiological response
  3. Avoidance or escape
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11
Q

what are the characteristics of anxiety disorders?

A

-maladaptive
-pervasive, persistent (most of the time for a long period of time)
-consistently cued (trigger)
-excessive avoidance/escape tendencies
-significant distress/impairment caused by symptoms and avoidance

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12
Q

what are the symptoms for panic attack (how many)?

A

4 or more symptoms that peak in 10 mins (waiting it out can resolve it)
-palpitations, pounding heart
-sweating
-trembling or shaking
-shortness of breath or smothering
-feeling of choking
-chest pain
-nausea
-feeling dizzy or faint
-numbing or tingling sensation (paresthesias)
-chills or hot flashes
-derealization, depersonalization
-fear of losing control
-fear of dying

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13
Q

what are the symptoms for panic disorder?

A
  1. unexpected panic attack
  2. one month or more of; concern about additional attacks or worry about consequences and change in behaviour related to attacks
  3. panic due to medical condition or drugs
  4. distinction from other anxiety/mental disorders
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14
Q

what are the symptoms for agoraphobia?

A
  1. fear/anxiety about two or more of the following; using public transportation, being in open spaces, being in enclosed spaces, standing in line/being in a crowd, being outside the home alone
  2. concerns about escape or obtaining help
  3. situations consistently provoke fear
  4. avoidance of agoraphobic situation
  5. disproportionate fear (social anxiety trait)
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15
Q

what are the cognitive and behavioural vulnerabilities?

A

-interoceptive awareness (appropriately aware of symptoms)
-anxiety sensitivity
-catastrophic misinterpretations (worst interpretation)
-controllability (feeling of no control over something)

-avoidance
-fewer coping skills

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16
Q

what are the symptoms for specific phobias?

A
  1. marked fear or anxiety about a phobic object or situation
  2. phobic object consistently evokes fear/anxiety
  3. phobic object is avoided or endured with extreme distress
  4. the fear or anxiety is out of proportion to the actual danger posed by the specific object or situation, and to the sociocultural context
  5. duration of 6 months or more
  6. clinically significant impairment
  7. distinction from other disorders/anxiety conditions
17
Q

what are some specifiers of specific phobias?

A

-animals
-blood-injury injections; medical procedures, injections, seeing blood
-situational; transportation, enclosed spaces
-natural environment; events in nature
-others; choking/vomiting, loud sounds, costumed characters

18
Q

what is the etiology of specific phobias?

A

-evolutionary; phobic avoidance of certain stimuli
-cognitive; overestimate danger, under-estimate coping and catastrophize
-behavioral; avoidance learning, observation learning, and classical conditioning

19
Q

what is generalized anxiety disorder?

A
  1. excessive uncontrollable anxious apprehension and worry about life events in several areas (more days than not, 6 months or more)
  2. difficulty controlling worry
  3. anxiety and worry are associated with three or more of the symptoms
20
Q

what are GAD’s symptoms?

A

-restlessness or feeling keyed up or on edge
-being easily fatigued
-difficulty concentrating or mind going blank
-irritability
-muscle tension
-sleep disturbance

21
Q

what is the biological and cognitive etiology for GAD?

A

Biological: neurotransmitters (GABA; inhibitory, decreases with anxiety and gives calming effects) and genetics

Cognitive : intolerant of uncertainty, believe worry is a helpful coping strategy, poor problem orientation, worry is a form of cognitive avoidance
-poor problem solving leads to symptom of anxiety and not a good coping strategy

22
Q

what is ocd? obsessions? compulsions?

A

Obsessions; intrusive, recurring thoughts, focus is the urge and fear associated with the thought

Compulsions; repetitive behaviors or mental actions repeated to reduce anxiety associated with thoughts (cleaning/washing, checking, mental rituals, arranging, and constant reassurance)
-Includes; OCD, BDD, hoarding, trichotillomania (hair pull), excoriation (skin pull)

23
Q

what is the behavioural and cognitive etiology for OCD?

A

Cognitive;
-maladaptive metacognitive beliefs (must have control over all thoughts and are dangerous/bad)
-thought-action fusion (equating thoughts with action, thinking one’s behaviour is unacceptable)

Behavioural; early life experiences with dangerous/unacceptable thoughts and compulsions negatively reinforced (reduce urge/anxiety)

24
Q

what is body dysmorphic disorder?

A

-excessive preoccupation with an imagined or exaggerated body disfigurement (delusion)
-significant distress or impairment in social, occupational, or another important aspect of life
-difficult to control, spend hours dwelling
May also have; MDD, GAD, suicide ideation

25
Q

what are the three trauma/stress-related disorders?

A

-post-traumatic stress disorder (over one month)
-acute stress disorder (3 days to one month)
-adjustment disorder (life stressor)

26
Q

what is PTSD?

A

1 exposure, 1 intrusion, 1 avoidance, 2 alterations, 2 arousal/reactivity

27
Q

what is exposure for PTSD?

A

exposure to actual or threatened death, serious injury, or sexual violence to them or someone else
-direct experience
-witnessing the event
-learning that the events occurred to a close relative or friend (violent/accidental)
-experiencing repeated or extreme exposure to aversive details of the event

28
Q

what is intrusion for PTSD?

A

-recurrent, involuntary and intrusive distressing memories of the traumatic event
-recurrent distressing dreams related to the traumatic events
-dissociative reactions in which the individual feels/acts as if the event were recurring
-intense or prolonged psychological distress at exposure to internal/external cues
-marked physiological reactions to internal or external cues

29
Q

what is avoidance for PTSD?

A

-avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event
-avoidance of or efforts to avoid external reminders

30
Q

what is alternations of PTSD?

A

-cant remember an important aspect of the traumatic events
-persistent and exaggerated negative beliefs or expectation
-persistent distorted cognitions about the cause or consequences of the traumatic event leading to blaming themselves or others
-persistent negative emotional state
-markedly diminished interest of participation in significant activities
-feelings of detachment or estrangement from others
-persistent inability to experience positive emotions

31
Q

what is arousal/reactivity of PTSD?

A

-irritable behaviour and angry outbursts (little to no provocation) typically expressed as verbal or physical aggression toward people or objects
-reckless or self-destructive behaviour
-hyper vigilance (assessing threats around)
-exaggerated startle response
-problems with concentration
-sleep disturbance (difficulty falling or staying asleep)

32
Q

what is acute stress disorder?

A

-diagnostic criteria most identical to PTSD
-3 days after stress to 1 month post-trauma
-after one month, diagnosis is ptsd (half get diagnosed)

33
Q

what is the behavioural etiology of PTSD?

A

traumatic experience (UCS) with a traumatic reaction (UCR) true alarm.
-traumatic experiences pair with neural stimuli associated with trauma scene (stimulus generalization)
-memories dreams or visits to trauma scene (conditioned stimulus CS)
-anxiety is the conditioned response false alarm
-avoidance of trauma memories and trauma stimuli maintains anxiety symptoms through negative reinforcement

34
Q

what is the treatment for anxiety disorders?

A

Pharmacotherapy; benzodiazepines and antidepressants

Cognitive restructuring; thought record and behavioural experiments

Exposure techniques; systematic desensitization, in-vivo exposure, flooding/intense exposure, and interoceptive exposure

Problem solving; generation of solutions

Relaxation; mental, physical, breathing retraining

Other techniques; mindfulness-based strategies and virtual reality

35
Q

what is the medication treatment for GAD?

A

-anxiolytic drugs (benzodiazepines- ativan and xanax)
-antidepressants (imipramine)

36
Q

what are the OCD treatments?

A

-behavior therapy; exposure and response prevention (better than drugs)
-cognitive therapy; reduce negative appraisals of thoughts, normalize intrusive cognitions, address core OCD beliefs
-biological treatments; drugs that increase serotonin (clomipramine and SSRIs) and psychosurgery (cingulotomy- lesion to cingulate bundle in limbic system)

37
Q

what are the PTSD treatments?

A

-behaviour therapy; exposure to trauma memory extinguishes fear through habituation, virtual reality therapy for imaginal exposure, constructivist-narrative (reinterprets)
-cognitive therapy; address perceptions of self blame
-medication treatments; SSRIs reduce anxiety and panic

38
Q

what is cognitive-behaviour therapy for GAD?

A

-worry exposure; one topic at a time and focus on distressing images and physiological arousal until habituation
-stimulus control; restrict worry to specific time and setting
-address biases in thinking; sometimes worry is not inaccurate and focus on acceptance rather than avoidance
-relaxation training

39
Q

what is the treatment for GAD?

A

Panic disorder; CBT showed largest effect sizes and smallest drop out rates compared to medication and psychological treatments

Specific phobias; pharmacology not that helpful, in vivo exposure most helpful with 80-90% of people helped

Social anxiety; CBGT- group therapy allows for opportunities for exposure

psyc236 (3 decks)

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