Anxiety Disorder Flashcards
Maladaptive Anxiety
- unrealistic
- out of proportion
- persistent and anticipatory
- impairs functioning significantly and ongoingly
Fear
an adaptive survival mechanism whereby perceived threat or danger leads to activation of fight/flight/freeze response
Panic disorder is…
a distortion of the adaptive fear response
Diagnostic criteria for panic disorder
recurrent, sudden panic attacks + anticipatory anxiety or avoidance behaviour for at least one month
Etiology of Panic Disorder: Biological theories
- abnormal functioning of brain chemicals (norpinephrine) in locus coeruleus
- suffocation alarm (sensitive to co2 changes)
- genetic basis: family/twin studies
Etiology of Panic Disorder: Cognitive theories
- people with panic disorder have ‘anxiety sensitivity’
- pay very close attention to bodily sensations
- misinterpret these sensations in a negative direction
- engage in snowballing, catastrophic thinking
Etiology of Panic Disorder: Psychodynamic theories
- unconscious conflicts create anxiety
- Panic disorder is an expression of our unconscious mind and the conflict.
- Struggle to separate from people you are dependent on.
- Aggression- feel towards people you love and are dependent on = conflict
Treatment for panic disorder
CBT is highly effective (gives corrective info, teaches relaxation techniques, expose client to stimulus and apply techniques, apply in real life using a graded hierarchy)
- psychodynamic therapy to explore and resolve unconscious conflicts
- medication to reduce symptoms
DSM diagnostic criteria for phobias
- marked and persistent fear that is excessive or unreasonable cued by a specific object or situation
- exposure to stimulus provokes an immediate anxiety response
- phobic situation is avoided or else is endured with intense anxiety
- duration of at least 6 months
- causes significant distress or impairment in functioning (NB)
Etiology of phobias: Biological theories
- prepared conditioning (kinds of threats that would have been nb for early ancestors)
- genetic predisposition (3-4 times more likely to get if family has a phobia)
- over-activation of amygdala in response to cues of threat/danger
Etiology of phobias: cognitive theories
- over-prediction of danger
- self-defeating thoughts and irrational beliefs
- negatives: doesn’t tell us why people think this way.
Etiology of phobias: Psychodynamic theories
it’s not the thing out there that you are afraid of- it is what is inside of you that you are scared of. but we cant think of those things so we use a defence mechanism of projection to an outside thing. it feels more acceptable than a conscious connection of what is inside of you.
Etiology of phobias: Learning theory
- phobias involve classical and operant conditioning
- Classical conditioning: in a previous adverse experience, a neutral object becomes associated with fear/pain
- Phobia then maintained by operant conditioning: avoidance of feared stimulus brings relief from anxiety – this reinforces the avoidance behaviour and prevents opportunities to learn that object/situation is not dangerous
- Observational learning may also play a role
Post Traumatic Stress Disorder - four symptoms
- intrusive/re-experiencing symptoms (flashbacks)
- avoidance of traumatic reminders
- changes in mood or cognitions
- hyperarousal
Time frame for PTSD
lasts more than 1 month
Factors relating to the event itself that make some trauma survivors more vulnerable to developing PTSD
- events involving interpersonal violence increase risk
- experiences of dissociation during traumatic event increase risk for PTSD
- direct exposure creates more risk for PTSD than just witnessing an event
Factors that pre-date the event that make some trauma survivors more vulnerable to developing PTSD
- being female =twice as likely to develop PTSD
- lower socio-economic status
- history of sexual abuse
- rigid beliefs about what is positive and negative
- avoidant coping strategies
Factors after the event that make some trauma survivors more vulnerable to developing PTSD
- loss of material resources as a result of a traumatic event
- absence of social support
PTSD Treatment
- assess client’s current physical safety
- psycho-education about PTSD
- help client identify and access available support structures
- anxiety management techniques to address hyperarousal symptoms
- exposure therapy (retellings of trauma in safe enviro)
- address avoidance symptoms (gradual exposure in safe situation
Social Anxiety Disorder DSM criteria
- persistent fear of social or performance situations in the presence of unfamiliar people or possible scrutiny of others
- fear of negative evaluation
- exposure to social or performance situations evokes intense anxiety
- these situations are therefore avoided or endured with extreme distress
- 6 months
Social Anxiety Disorder- 2 types
- generalised subtype (occurs across all social situations)
2. non-generalised subtypes (only occurs in one or two types of social or performance situations)
Social Anxiety Disorder- associated features
- hypersensitivity to criticism
- low self-esteem
- difficulty being assertive
Social Anxiety Disorder- frequent social triggers
- Initiating conversation
- Taking part in small groups
- Dating
- Interacting with authority figures
- Attending parties
- Writing or performing in front of others
- Eating or drinking in public
Social Anxiety Disorder- genetic theory
- relatives of social phobics have higher rates of social phobia
- concordance rate is 24% in identical and 15% in fraternal twins
Social Anxiety Disorder- dysfunctional cognitive style theory
- overestimate likelihood of social rejection and negative consequences of rejection
- low expectancies about social competence
- low expectancies about being able to cope with feared events
Social Anxiety Disorder- behavioural inhibition to the unfamiliar theory
- tendency in early childhood to show avoidance and anxiety when exposed to unfamiliar people/situations
- could be inherited or learned
- early precursor to social phobia
Social Anxiety Disorder- conditioning theory
-a specific adverse social event leads the person to fear and avoid subsequent social situations
Social Anxiety Disorder- treatment
- CBT most effective
- relaxation training
- identifying unrealistic beliefs and developing more realistic ones
- social skills training
- systematic desensitisation (graded hierarchy)
medication for Social Anxiety Disorder
serotonin reuptake inhibitors or SSRIs
