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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
Learning and anxiety disorders
Learning involves a change in behaviour that result from regularities in the environment Associative learning- pavlovian theory
25
Emotional responses and anxiety
Emotional responses are learned too Example: Little Albert
26
What was the little Albert experiment
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
What did the Little Albert experiment teach us
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
Do all fear associations need to be learned through direct experience?
No they can be learnt though: 1. Modelling 2. Verbal instruction.
29
What is extinction
A process where an association between a conditioned stimulus and noise diminishes
30
Why does an irrational fear stay alive if the bad thing never actually happens?
Mowrer two- factor model 1. Pavlovian conditioning: gets the fear started 2. Instrumental conditioning: keeps the fear alive
31
Whats instrumental conditioning?
Behaviours are strengthened by consequences ,ie. reinforcement
32
What is positive reinforcement?
parents buy you a holiday if you get a 1:1 degree
33
What's negative reinforcement??
Parents kick you out if you fail Avoidance is a special case of negative reinforcement ,ie. if you do it 'right' nothing happens
34
Application of Mowrers Two factor Model
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
Qualificiations to Mowrers two factor model
Its simplistic Why do some ppl have the same experiences, ie a dog bite but never develop specific phobia
36
How s fear measured in a lab setting
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
What was the finding in fear conditioning and extinction in anxious patients
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
What is fear generalisation
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
What is stimulus generalisation?
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
How can fear generalisation be shown on a scale
Curvilinear gradient
41
The amygdala's role in anxiety
Fear acquisition fear storage Fear expression
42
the medial prefrontal cortex and anxiety
extinguishes fear Regulates emotions on demand Regulates the amygdala
43
The brain and generalised anxiety disorder
Neuroimaging looks more similar to depression
44
What are other general risk factors of anxiety disorders?
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
What are specific risk factors for social anxiety disorder?
Two factor theory Catastrophising Negative self- evaluation Monitoring performance, ie. was that a fake laugh
46
What are specific risk factors for panic disorder?
Stress triggers noripinephrine release It increases activity of the sympathetic nervous system
47
NE and panic disorders
Locus coeruleus produces it Drugs that increase noripenephrine cause panic attacks Drugs that decrease it decrease the risk of panic attacks
48
Other specific risk factors for panic disorder
Physiological Factors = predisposition for panic attacks Two-Factor Theory = learned catastrophic interpretation of the attacks + engaging in avoidance behaviours
49
How do panic attacks arise?
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
What are the specific risk factors for agoraphobia
triggers are exteroceptive- places rather than introceptive- bodily states
51
What are the specific risk factors for generalised anxiety disorder?
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
What's the psychological treatment for anxiety disorders?
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
What about CBT and generalised anxiety disorder
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
Efficacy of CBT for anxiety
Effective for all anxiety disorders, but best for PTSD and OCD
55
What are the pharmacological treatments for anxiety disorders
Anxiolytics Benzodiazepines Antidepressants
56
What are anxiolytics?
Any drug that reduces anxiety
57
What are benzodiazepines
VAlium/xanax effective over placebo but are addictive and have sedative side effects, ie. drowsiness/memory loss
58
What are antidepressants
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
Finding of pharmacological treatments and anxiety disorder.
Relapse can happen if you stop taking it Combined CBT and medication is the best

Psychological disorder (20 decks)

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