Anxiety Disorders Flashcards
What is the safest response to anxiety?
To avoid the thing that is causing you anxiety.
What is the second safest response to anxiety?
Usually aggression; if you can’t avoid it, then you fight it.
Eliciting condition: realistic/objective threat to self
Physical vs. social threat
Eliciting condition: specific ‘prepared’ stimuli
Insects, animals, heights, enclosed places, anger
Eliciting condition: novel sitmuli
Can cause you to feel anxious, because you don’t know what to expect from this situation
What are the THREE interrelated anxiety systems?
Physical system - fight/flight
Cognitive system - perception of threat
Behavioural system - escape/avoidance tendencies
THREE words to remember about anxiety
Avoidance; maintenance; exposure
Anxiety disorder comorbidities
Anxiety disorders are highly comorbid with each other, depression, substance use
Changes in Anxiety Disorders from DSM-4 to DSM-5
In DSM-5 it is now possible to be diagnosed with Separation Anxiety Disorder as a child or adult.
Posttraumatic Stress Disorder was removed from the Anxiety chapter of DSM-4 and moved into its own chapter in DSM-5.
Same with Obsessive-Compulsive Disorder - it has its own category.
Trichotillomania is under it’s own heading.
Hoarding is now its own disorder within OCD.
DSM-5 SOCIAL ANXIETY DISORDER criteria
A. Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others (in children, the anxiety must occur in peer settings and not just during interactions with adults).
B. The individual fears that they will act in a way or show anxiety symptoms that will be negatively evaluated.
C. The social situations almost always provoke fear or anxiety.
D. The social situations are avoided or endured with intense fear or anxiety.
E. The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context.
How long does fear or anxiety have to be seen to be classified as SOCIAL ANXIETY DISORDER?
Fear, anxiety or avoidance is persistent, typically lasting for 6 months or more.
Age of onset for SOCIAL ANXIETY DISORDER?
Childhood or adolescence.
Course is chronic without treatment.
Prevalence of SOCIAL ANXIETY DISORDER in males and females?
Prevalence is 1.5-2.2. higher in women.
SOCIAL ANXIETY DISORDER comorbidites (4)
Other anxiety disorders; depression; substance use; avoidant personality disorder.
Treatment for SOCIAL ANXIETY DISORDER
Cognitive Behaviour Therapy (often in group settings, about 2/3 achieve substantial improvement).
- Psychoeducation about maintaining factors; cognitive challenging of negative thoughts; behavioural experiments; reducing safety behaviours; attention training; video feedback.
What characterises GENERALISED ANXIETY DISORDER?
Mainly characterised by excessive and uncontrollable worry about a variety of events/outcomes (the person is constantly worried about something).
Time frame for GENERALISED ANXIETY DISORDER
Occurs more days than not, for at least 6 months.
What makes GENERALISED ANXIETY DISORDER different from the other anxiety disorders?
It is the only one that doesn’t include increased heart rate, blushing, and other automatic arousal symptoms - it is instead characterised by semantic symptoms.
Gender prevalence of GENERALISED ANXIETY DISORDER
Twice as many women are diagnosed than men - 2:1
but more men seek help with this disorder
How much percent of the population meet diagnosis for GENERALISED ANXIETY DISORDER?
4%
DSM-5 GENERALISED ANXIETY DISORDER criteria
A. Excessive anxiety and worry (apprehensive expectation), occuring more days than not for at least 6 months, about a number of events or activities.
B. The individual finds it difficult to control the worry..
C. The anxiety and worry are associated with three (or more) of the following six symptoms: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance
Define SELECTIVE MUTISM
Characterised by a consistent failure to speak in social situations in which there is an expectation to speak even though the individual speaks in other situations.
Define SPECIFIC PHOBIA
Fearful or anxious about or avoidant of circumscribed objects or situations.
Define SOCIAL ANXIETY DISORDER (social phobia)
The individual is fearful or anxious about or avoidant of social interactions and situations that involve the possibility of being scrutinized.
Define PANIC DISORDER
The individual experiences recurrent unexpected panic attacks and is persistently concerned or worried about having more panic attacks or changes their behaviour in maladaptive ways because of the panic attacks.
Define AGORAPHOBIA
Individuals are fearful and anxious about two or more of the following situations: using public transportation; being in open spaces; being in enclosed places; standing in line or being in a crowd; being outside of the home alone in other situations.
Aims of Ponniah, Magiati & Hollon (2013) study
Review randomised controlled trials of psychological treatments for OCD in adults using criteria that differentiates between interventions that are efficacious and specific.
Define efficacious and specific
Two or more independent research groups have found that the treatment leads to a better outcome than another treatment.
Define efficacious
At least two independent research teams have shown the treatment to be more efficacious than its absence.
Define possibly efficacious
Supported by evidence from only one research group awaiting replication.
Based on Ponniah, Magiati and Hollon’s (2013) study, what would be the treatment of choice for a person with OCD.
Exposure and response prevention (either flooding or gradual exposure).
