Anxiety disorders Flashcards
Triple vulnerability model (Barlow, 2002)
Vulnerabilities increases sensitivity of the alarm trigger and involve:
- biological factors
- generalised psychological factors
- specific psychological factors
Biological factors
e.g. is the fact that individuals seem to inherit a general predisposition towards anxiety and depressive disorders
Generalised psychological factors
Include beliefs that the world is generally a dangerous place combined with broad expectations that events are beyond one’s control
specific psychological factors
Psychological factors that are specific to particular objects or situations and include factors that influence the expectation of a negative outcome when confronted with a specific object or event.
true alarms
Where fear occurs in response to direct danger. Acknowledging the capacity of the fight/flight response to prepare the body to deal with a threat more effectively
false alarms
In contrast to the true alarms, the fight/flight response occurs in situations that do not produce an immediate physical threat. It is also a hallmark of anxiety disorders
conditioning
A direct way to learn about potential dangers,
vicarious acquisition
Fear is acquired through process of modelling
informational pathway
describes the development of fear following the verbal transmission of danger-related information from others
Types of anxiety disorders
Specific phobias, Panic disorder and Agoraphobia, Social Anxiety disorder, Generalised anxiety disorder (GAD)
Diagnosis of Specific phobias
DSM-IV:
- marked and consistent fear when a specific object or situation is encountered
- fear is out of proportion to the danger posed by the object or situation
- fear causes emotional, social and/or occupational disruption
- lifetime prevalence s estimated 7-9%
- F to M ratio is 2:1
subtypes of Specific phobias
- animal
- natural environment (e.g. height, water)
- blood, injection and injury
- situational (e.g. airplanes, enclosed spaces)
epidemiology (Specific phobias)
- CH and early adolescence
- prevalence is greater among children than adults
- lifetime prevalence is estimated at 7-9%
aetiology (Specific phobias)
- evidence that phobias have a heritable component
- phobias may be acquired through classical (association) conditioning
- issues:
- phobic fears are not distributed evenly across all possible stimuli
- many with phobias do not recall an initial traumatic event
treatment - Specific phobias
- exposure therapy are most effective
- works through extinction
- also works by challenging expectations of danger leading to an increased sense of control
Diagnosis of Panic Disorder
DSM-IV
- recurring uncontrolled panic attacks as well as persistent worry about having additional attacks and their consequences
- presence of significant changes in behaviour related to panic, e.g., avoid exercise as it may increase HR
Diagnosis of Agoraphobia
DSM-IV
- marked fear or anxiety about being in places from which escape is difficult e.g. public transport, enclosed spaces
- feared situations are actively avoided or endured with intense fear
epidemiology (Panic Disorder)
- panic disorder: 3.5%
- panic disorder is somewhat common among F more than do in M
epidemiology (Agoraphobia)
- agoraphobia: 2.3%
- the proportion of F to M increase as the severity of agoraphobia increases
aetiology of Panic Disorder and Agoraphobia
- generalised biological vulnerability
- genetics
- e.g. neuroticism
- generalised psychological vulnerability
- one’s beliefs, thoughts
- e.g. anxiety sensitivity
- specific psychological vulnerability
- e.g. catastrophising physical sensations
Treatment - Panic Disorder and Agoraphobia
- meds
- CBT including graded exposure to feared situations
- psychoeducation
Diagnosis of Social Anxiety disorder
- fear of evaluation by other people
- marked fear or anxiety in social situations
- fear of negative evaluation by others
- the anxiety interferes with individual’s functioning
epidemiology (Social Anxiety disorder)
- SAD is one of the most common and earliest in onset of the disorder
- half report onset prior to 12 y.o
- lifetime prevalence is 8%
- more common among F
aetiology (Social Anxiety disorder)
- twin studies support a genetic vulnerability
- excessive parental criticism may undermine self-confidence
- criticism > is it the individual’s perception (by self)or fact of the indv (by others)?
- cognitive dysfunctions may distort the way in which people perceive how others evaluate them
