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Psychological disorder > Anxiety (COMPLETE) > Flashcards

Anxiety (COMPLETE) Flashcards

1
Q

What is anxiety?

A

An intense fear of events/ situations that are avoided or endured with dread

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1
Q

What’s the difference between fear and anxiety?

A

Fear:
Motivated by imminent threats
Arousal via sympathetic nervous system
Brief emotional reaction
Adaptive
Specific triggers

Anxiety:
Usually motivated by future threats
arousal via sympathetic nervous system
sustained affective state
adaptive
diffuse

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2
Q

What’s the sympathetic nervous system

A

Directs the body rapid involuntary response to dangerous or stressful situations

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3
Q

What’s the prevalence/epidemiology of anxiety?

A

Lifetime prevalence in US is 28.8%

Highly co-morbid

Woman experience higher rates of anxiety; 2:1 ratio

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4
Q

Comment on anxiety’s co-morbidity

A

50% of ppl with one anxiety disorder have the criteria for another anxiety disorder

66 meet criteria for another- 60% high comorbidity with depression

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5
Q

What’s the genetic aetiology of anxiety

A

20-40 percent heritability

even higher in panic disorder-50%

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6
Q

What’s the environmental aetiology of anxiety

A

Childhood trauma exposure increases risk

Cultural context influences prevalence
GAD much less prevalent in easter compared to western countries

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7
Q

What’s a cultural specific anxiety disorder

A

kayak angst
disorientation and fear of drowning among Inuit seal hunters

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8
Q

What’s the common criteria for anxiety disorders

A

Impairment in functioning

not better explained by a medical condition/drugs

Symptoms persist for 6 months (except panic which is 1)

Symptoms cannot be explained by another disorder

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9
Q

What are the anxiety disorders

A

Agoraphobia
Generalised anxiety disorder
specific phobia
social anxiety disorder
panic disorder

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10
Q

What are some examples of specific phobias?

A

Arachnophobia- fear of spiders

Trypanophobia- fear of needles

Cynophobia - fear of dogs

Acrophobia- fear of dogs

Claustrophobia- fear of small spaces

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11
Q

What’s the DSM 5 criteria for specific phobias

A
  1. Marked and disproportionate fear consistently triggers by specific objects/situations
  2. object is avoided or endured with intense anxiety
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12
Q

What’s the prevalence specific phobia

A

7-13% lifetime prevalece

Median age of onset is 8 years old and may be linked to specific experiences, ie. a dog bite

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13
Q

What’s the DSM 5 criteria for social anxiety disorder?

A
  1. Marked and disproportionate fear consistently triggered by exposure to potential social scrutiny
  2. Exposure to trigger leads
    to intense anxiety about being evaluated negatively
  3. Triggering situations are
    avoided or else endured with intense anxiety
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14
Q

What’s the difference between specific phobia and social anxiety disorder

A

Social anxiety is much ore serious because social situations are present in all daily life

Avoidance is the worst issue cut ruins their life

They’re always thinking of ways in which social situations will go wrong

They often begin in adolescence unlike SP which begins at usually 8

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15
Q

What’s a panic attack

A

Unexpected and uncontrollable episodes of terror, apprehension, sense of dread that are accompanied by physical changes, ie. breathlessness, palpitations, nausea and dizziness

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16
Q

What are panic disorder attacks often accompanied with?

A

Derealisations
depersonalisation

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17
Q

What’s the prevalence of panic attacks

A

Relatively common -25% of ppl have experienced a panic attack

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18
Q

What’s the DSM 5 criteria for panic disorder?

A

Recurrent unexpected panic attacks- if its triggered by something then specific phobia is more of an accurate diagnosis

At least one month of concern/worry about experiencing more attacks/fearing of the consequences of an attack or maladaptive behaviour changes

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19
Q

Panic disorders are a mis-firing of our fear system

A

Shortness of breath, sweating and faintness might cause someone to believe that they’re going through a medical emergence, ie. having a heart attack

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20
Q

What’s agoraphobia

A

Fear/anxiety act being in a large crowd and it would be embarrassing/difficult to escape if anxiety symptoms occurred,ie. public transport/shopping centres

These situations are either avoided/ require a companion or are suffered through with intense anxiety

Used to be a special case pf panic disorder but made its own cuz less than half had panic attacks

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21
Q

What’s the DSM 5 criteria for generalised anxiety disorder

A

Excessive anxiety/ worry at least 50% of days about a number of events

finds it hard to control the worry

Associated with at least 3 of the following:
Restlessness
Easily fatigued
difficulty concentrating/mind going black
Irritability
Muscle tension
sleep disturbance

NO SPECIFIC TARGET- MUCH MORE DIFFUSED

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22
Q

What’s the overview of GAD

A

Tends to eb chronic
50% reported perseverance

GAD highly comorbid with other anxiety and psychiatric disorders
80% meet the criteria for other anxiety disorders

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23
Q

What are the causes of anxiety disorder?

A

Learning
Emotional responses
Fear conditioning
Instrumental conditioning
Mowrers 2 factor model
Fear generalisation

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24
Q

Learning and anxiety disorders

A

Learning involves a change in behaviour that result from regularities in the environment
Associative learning- pavlovian theory

25
Q

Emotional responses and anxiety

A

Emotional responses are learned too
Example: Little Albert

26
Q

What was the little Albert experiment

A

Baby had no problem with animals

Then the neutral stimulus was paired with noise

The animal was now a conditioned stimulus that motivates a conditioned response, ie fear

27
Q

What did the Little Albert experiment teach us

A

Fear conditioning is an extremely important and adaptive fiction

Kids must acquire lots of fears as this is key to survival in a world that changes much faster than we evolve.

28
Q

Do all fear associations need to be learned through direct experience?

A

No they can be learnt though:
1. Modelling
2. Verbal instruction.

29
Q

What is extinction

A

A process where an association between a conditioned stimulus and noise diminishes

30
Q

Why does an irrational fear stay alive if the bad thing never actually happens?

A

Mowrer two- factor model

  1. Pavlovian conditioning: gets the fear started
  2. Instrumental conditioning: keeps the fear alive
31
Q

Whats instrumental conditioning?

A

Behaviours are strengthened by consequences ,ie. reinforcement

32
Q

What is positive reinforcement?

A

parents buy you a holiday if you get a 1:1 degree

33
Q

What’s negative reinforcement??

A

Parents kick you out if you fail

Avoidance is a special case of negative reinforcement
,ie. if you do it ‘right’ nothing happens

34
Q

Application of Mowrers Two factor Model

A

Pavlovian conditioning: Dog snaps at a child and being near the dog makes a big fear reaction

Instrumental conditioning
The individual avoids coming near dogs/ crosses the street when they see a dog

and they never get to learn that most dogs don’t bite

35
Q

Qualificiations to Mowrers two factor model

A

Its simplistic

Why do some ppl have the same experiences, ie a dog bite but never develop specific phobia

36
Q

How s fear measured in a lab setting

A

Self report- how afraid are u from a scale of 1-10

Physiology
Heart rate/Skin conductance response

Behaviour:
Avoidance responses

Brain:
Amygdala reactibity

This is used to study individual differences in how ppl
1. Acquire and
2. Extinguish fears

37
Q

What was the finding in fear conditioning and extinction in anxious patients

A

Anxious patients tend to be more fearful of the neutral stimulus- generalise fears

Anxious patients are slower to extinguish fears

Studying fear conditioning allows us to study how treatments work and how to develop new ones

38
Q

What is fear generalisation

A

Fear-avoidance reaction is rarely isolated to the events that featured in a learning experience.

Example: Because the mouse was associated with loud noise, he generalised that fear to the rabbit and the dog

39
Q

What is stimulus generalisation?

A

The process whew neutral stimuli is distinct from but still similar to the original conditioned stimulus and then it can partially elicit a conditioned reposes

40
Q

How can fear generalisation be shown on a scale

A

Curvilinear gradient

41
Q

The amygdala’s role in anxiety

A

Fear acquisition

fear storage

Fear expression

42
Q

the medial prefrontal cortex and anxiety

A

extinguishes fear

Regulates emotions on demand
Regulates the amygdala

43
Q

The brain and generalised anxiety disorder

A

Neuroimaging looks more similar to depression

44
Q

What are other general risk factors of anxiety disorders?

A

Behaviour inhibition- becoming distressed or withdraw when faced with novel situations

Neuroticsm- tendency to experience frequent and intense negative affect

Attention to threat- paying more attention to negative cues in the environemnt

Negative bias- interpreting neutral stimuli as negative

45
Q

What are specific risk factors for social anxiety disorder?

A

Two factor theory
Catastrophising
Negative self- evaluation

Monitoring performance, ie. was that a fake laugh

46
Q

What are specific risk factors for panic disorder?

A

Stress triggers noripinephrine release

It increases activity of the sympathetic nervous system

47
Q

NE and panic disorders

A

Locus coeruleus produces it

Drugs that increase noripenephrine cause panic attacks

Drugs that decrease it decrease the risk of panic attacks

48
Q

Other specific risk factors for panic disorder

A

Physiological Factors = predisposition for panic attacks

Two-Factor Theory = learned catastrophic interpretation of the attacks + engaging in avoidance behaviours

49
Q

How do panic attacks arise?

A

from a catastrophic interpretation of physiological symptoms

Can be induced in a lab through inhalation of air enriched with CO2

In healthy ppl, if an explanation is given that theyll feel breathless, then panic is lessened

50
Q

What are the specific risk factors for agoraphobia

A

triggers are exteroceptive- places
rather than introceptive- bodily states

51
Q

What are the specific risk factors for generalised anxiety disorder?

A

Generalised distress and worry
Strong association with major depression

high intolerance of uncertainty- causes sufferers to worry mote

reinforcing properties of worry- distracts from real and intense emotions

52
Q

What’s the psychological treatment for anxiety disorders?

A

CBT

Behavioural:
Exposure to threats, ie. social situations

prevent safety behaviours,ie trying to not use eye contact

Cognitive
Challenging beliefs
Develop confidence in coping abilities

53
Q

What about CBT and generalised anxiety disorder

A

Its kind of an exception aux there’s no triggering stimulus to expose

Relaxation training

Cognitive restructuring
Reduces negative bias
reduces catastrophising

Mindfulness- being in the present

54
Q

Efficacy of CBT for anxiety

A

Effective for all anxiety disorders, but best for PTSD and OCD

55
Q

What are the pharmacological treatments for anxiety disorders

A

Anxiolytics
Benzodiazepines
Antidepressants

56
Q

What are anxiolytics?

A

Any drug that reduces anxiety

57
Q

What are benzodiazepines

A

VAlium/xanax

effective over placebo but are addictive and have sedative side effects, ie. drowsiness/memory loss

58
Q

What are antidepressants

A

SSRis, SNRIs Tricyclics

Effective over placebo and are not additive
but side effects can be very bad but less dangerous, ie. weight gain/insominia

59
Q

Finding of pharmacological treatments and anxiety disorder.

A

Relapse can happen if you stop taking it

Combined CBT and medication is the best

Psychological disorder (20 decks)

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