Anxiety Disorders Flashcards
Mood and Anxiety Disorders:
Similarities
Mood and anxiety disorders are not fully separate categories. Both (1) center on disruptions of emergency or negative emotional states that under normal circumstances serve important adaptive functions, (2) share physiological and neurobiological features, (3) frequently co-occur in clinical cases, and (4) often respond to similar somatic treatments.
Anxiety: Definition
The apprehensive anticipation of danger or misfortune accompanied by a feeing of dysphoria and/or somatic symptoms of tension. The focus of the anticipated danger may be internal or external
Three components to Anxiety
(1) Subjective: reports of tension, apprehension, sense of impending danger and expectations of inability to cope
(2) Behavioral: responses of avoidance of situation at hand, impaired speech and motor functioning, and impaired performance on complex tasks
(3) Physiological: increased muscle tension, increased heart rate, blood pressure, rapid breathing, nausea, diarrhea, and frequent urination
“What Ifs”
“What Ifs” are posed through hypothetical-deductive reasoning and come with a cost.
Future What Ifs: dread, trepidation, apprehension
Past: guilt, self condemnation, feelings of failure and loss
Under conditions of uncontrollable/unpredictable stress, Anxiety:
(1) Anxiety is the first response to a stressful situation and (2) is replaced by depression if it is concluded by a clinician that the situation is uncontrollable.
Emotions and Moods
Emotions/moods are (1) primitive classification tools that have evolved because they have proven useful for survival. (2) Neither emotional responses nor emotional emotional expression are under voluntary control, and (3) are tired together fairly rigidly with their stimulus triggers. (4) They correspond to Freud’s ID.
Emotional Classification System
Our higher cognitive functions are integrated with, and built upon, our primitive emotional classification system. It is therefore possible for us to have strong emotional responses to REPRESENTATIONS of The Distant Past and the Imagined Future (hypotheses).
These cognitive functions permit us to transcend the present and free ourselves from being controlled solely by cues in the immediate environment. This provides greater flexibility in behavior and a sense of self-determination and choice (or perhaps the illusion of choice)
We can ANTICIPATE, IMAGINE, and REMEMBER environments that make us feel bad or good, and THEORIZE about why we feel the way we do.
Role of Schemata
Due to the emotional classification system, we can ANTICIPATE, IMAGINE, and REMEMBER environments that make us feel bad or good, and THEORIZE about why we feel the way we do.
Schemata are internal causal models of the world, which human beings use to try to maximize pleasure and minimize un-pleasure by: (1) selective environments (i.e., that better fit existing skills), (2) shaping environments (i.e., to better fit with existing skills), and (3) changing themselves (i.e., learning new skills)
(This is one definition of intelligence, i.e., self government)
Feedback: Key Points
(1) Feedback systems are the backbone of successful adaptation
(2) All biological and psychological systems rely on feedback for effective self regulation and stability
(3) Almost all forms of psychopathology involved compromised feedback operations of some sort (i.e., faulty error detection and/or error correction)
Neurosis
Until recently, the categories of Anxiety Disorder, Somatoform Disorder and Dissociative Disorder were lumped into this single diagnostic category: Neurosis
The term Neurosis was coined in the 19th century by William Cullen, who viewed neurosis as a biologic disorder. This was replaced in the 20th century by Freud’s Psychogenic view, which viewed Anxiety as a danger signal that repressed memories threatened to break into consciousness
Anxiety Disorders:
DSM IV to DSM 5 Changes
(1) Many of the disorders that were previously listed in the Anxiety Disorders chapter in DSM IV have been moved to separate chapters titled Obsessive-Compulsive and Related Disorders and Trauma and Stressor Related Disorders
Agoraphobia
Agoraphobia is now a separate, codable diagnosis rather than a dx that occurs solely within the context of Panic Disorder (i.e., Panic Disorder with Agoraphobia)
Basics of Anxiety Disorders in DSM IV
(a) Panic Attacks:
(1) unexpected (uncued), (2) situationally bound (cued), and (3) situationally predisposed
(b) Agoraphobia
Panic Attacks in DSM IV
Sudden onset of a discrete period of intense apprehension, fearfulness, or terror and sometimes a sense of potential doom
Criteria: 4 or more appear abruptly within 10 mins: palpitations, sweating, trembling, shortness of breath, choking, chest pain, nausea, dizziness, derealization, depersonalization, fear of going crazy, fear of dying, parathesias, chills or hot flashes
“Situationally predisposed panic attacks” are no longer included in DSM 5. There are now only (1) unexpected panic (uncured) attacks and (2) situationally bound (cued) panic attacks
Agoraphobia
Anxiety about, or avoidance of, places or situations: (1) from which escape might be difficult (or embarrassing) in the event of a panic attack or panic-like symptoms, or (2) in which help might not be available in the event of a panic attack or panic-like symptoms.
Endorsement of fears from two or more agoraphobia situations required in order to distinguish from Specific Phobia.
No requirement that the individual recognize that the fear is unreasonable- fear just as to be out of proportion
Duration of at least 6 months
Agoraphobia is now a separate, codable diagnosis rather than a dx that occurs solely within the context of Panic Disorder (i.e., in DSM IV there is Panic Disorder with Agoraphobia or Agoraphobia Without History of Panic Disorder)
