Anxiety Disorders Flashcards by Sarah underwood

Anxiety

a negative mood state; bodily symptoms of tension
physiological, behavioral, subject sense unease
apprehensive, future oriented

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Fear

immediate alarm reaction to real/perceived danger
activates sympathetic nervous system
immediate, present-oriented

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Biological contributions to anxiety and fear

increased physiological vulnerability - polygenetic influences
Brain circuits and neurotransmitter - GABA
Limbic system

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Social contributions to anxiety and fear

interpersonal - family, friends
occupational
education

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Physiological contributions to anxiety and fear

sense of control
classical and operant conditioning
integrated w/ other factors

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Triple Vulnerability theory

integrated model
generalized biological vulnerability - heritage contribution to negative affect
generalized psychological vulnerability - beliefs and perceptions, sense that events are uncontrollable or unpredictable
Specific psychological vulnerabilities - learning/modeling

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Anxiety disorders have a

high comorbidity rates, 2 or more disorders at once

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Rates

55-76%

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suicide attempts and ideation

about 20%

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Generalized Anxiety Disorder (GAD)

%, onset, course, sex ratio

Chronic intense, uncontrollable, worrying that is distressing, unproductive, accompanied by tenseness, irritability and restlessness
3.1% year 5.7% lifetime
insidious onset, chronic course
2 to 1 (F to M)

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GAD differential diagnosis

social anxiety, OCD, PTSD, medical condition, dpressive, bipolar or psychotic disorders

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Causes GAD

free floating anxiety- historical explanation 
inherited tendency to be anxious 
increased threat sensitivity 
autonomic restrictions 
frontal lobe activation

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pharmacological treatments of GAD

risks

benzodiazapines, effective short term, risks- addiction, impairs cognitive and motor functioning
antidepressants- paxil, effexor

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Psychological treatments of GAD

same short term effectiveness compared to pharmacological

more effective as a long term

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Cognitive behavior therapy for GAD

evoke worry process during sessions

teach coping strategies

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Newer Treatment Focus of GAD

acceptance and medication with CBT

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Panic Disorder

stats, onset, median age, sex ratio

recurrent panic attacks, fear of future panic attacks, and/or lifestyle changes to avoid panic attacks
2.7% year, 4.7% lifetime
2 to 1 ratio
median age 20-24, ranges from teens to 40’s

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nocturnal panic attacks

60% w/ disorder experience it

NREM sleep; delta wave

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Differential diagnosis Panic Disorder

other specified anxiety disorders, substance/medication induced

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Agoraphobia

characterized by anxiety about being in specific places/situations in which escape may be difficult in event of panic
integrated with panic disorder in DSM 4 & 4TR
lasts 6 months or longer

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Causes of Panic Disorder

generalized biological vulnerability - alarm reaction to stress, learned alarms (heart starts pounding panic attack happens)
generalized psychological vulnerability- anxiety about future attacks, hyper vigilance

Development of Agoraphobia

cultural explanation- more socially acceptable for women to be anxious or afraid
gender differences- cultural explanation

Treatments for panic disorder

Medications - SSRI’s, SNRI’s, benzodiazapines, high rate of relapse once meds are stopped
psychological interventions- exposure based, relaxation and breathing exercises
PCT
combined treatments- psychological and pharmacological

Panic control treatment (PCT)

a CBT approach to panic attacks; involves gradual exposure to fear and modifications of perceptions

Specific Phobias

irrational and extreme fear of object or situation that substantially interferes w/ ability to function

Blood-injection-injury Phobia

needles, sight of blood, injury | onset about 7

Situational phobia

transportation, small places | onset early to mid 20's

Animal phobia onset

age 7

Natural environment phobia

heights, water | age 7

Specific Phobia stats, ratio, course, causes

12.5% lifetime 8.7% year chronic course causes: direct exposure, vicarious experience, information transmission

Treatments for specific phobias

CBT, exposure therapies, relaxation

Social Anxiety Disorder (SAD) | stats,, causes, treatments, onset

extreme and irrational fear/shyness and avoidance of social or performance situations 12.1% life, 6.8% year Onset: adolescence Causes: generalized biological vulnerability, generalized psychological vulnerability, specific psychological vulnerabilities Treatments: medications, SSRI's, beta blockers, psychological CBT and exposure

Separation Anxiety Disorder

excessive fear that harm will come to themselves or important people in their life - unrealistic and persistent - significant impairment 4. 1% in childhood, 6.6% adulthood

obsessions

unwanted recurrent and persistent thoughts, urges, impulses, or images that cause anxiety/distress

compulsion

repetitive behaviors or mental acts that the individual feels driven to perform in order to reduce anxiety/distress

OCD characteristics

presence of recurrent obsessions and/or compulsions | must be time consuming and/or cause significant distress or impairment

contamination (symptom subtype)

obsession: germs compulsion: repetitive washing, avoid touching

symmetry (symptom subtype)

obsession: exactness compulsion: order, counting, repeated rituals

forbidden thoughts/actions (symptom subtype)

obsession: fears, urges, harm compulsion: checking, repeated reassurance

Hoarding

obsession: fear of throwing away compulsion: collecting, saving things

Percentages of obsession

symmetry 26.7% forbidden thoughts/actions 21% contamination/cleaning 15.9% hoarding 15.5%

4 major categories of compulsion

checking, ordering, arranging, washing/cleaning

OCD stats, course, onset, sex ratio

1.6% to 2.3% life sex 1:1 chronic course onset childhood to 30's, 19 median age

OCD causes

specific psychological vulnerability early life experiences and learning dangerous/unacceptable thoughts thought action confusion

OCD treatment

medication psychosurgery CBT exposure and ritual prevention (ERP)

PTSD

prolonged, severe stress response and development of characteristic symptoms to exposure to traumatic events - cannot be diagnosed until 1 month after traumatic event - victim re-experiences trauma, avoids stimuli ass. with, develops increase arousal and vigilance - reckelss/self destructive behavior, emotional numbing, interpersonal problems

PTSD prevalence rates

6.8% lifetime

PTSD is most common in

combat, sexual assaults, accidents

causes of PTSD

``` intensity of trauma generalized biological vulnerability generalized psychological vulnerability social factors, social support neurobiological model- threatening cues (hear a car back fire and think its a bomb) ```

PTSD treatments

CBT, imaginable exposure, increase coping skills and social support, psychoanalytic therapy,