Anxiety Disorders Flashcards
Described anxiety as “the shadow of intelligence”
Howard Lidell
Anxiety Disorders
- most common psychiatric disorder
- Phobias are the most common
- 60% comorbid with major depression; also comorbid with substance abuse, personality disorders, medical conditions
- more common in women
Generalized Anxiety Disorder
-also known as “free-floating anxiety”
-worry on various domains
-characterized by muscle tension, mental agitation
-at least 6 months duration
-at least 3 symptoms
-difficult to control worry
-people with GAD are called “autonomic restrictors”
*CAUSES
-GABA deficit
-worry reinforces bc it distracts from negative emotions and images
-avoidance prevents extinction of underlying anxiety
-Metacognitive theory
People with GAD implicitly hold positive and negative beliefs about worrying
-Intolerance of Uncertainty Theory
-sense of sometimes unbearable uncertainty over the possibility of an unacceptable negative outcome
Therapy for GAD
-Relaxation training
-CBT to control worry process
-benzodiazepines (anti-anxiety drugs; most common)
-barbiturates (same but less addictive)
-Rational Emotive therapy
point out irrational assumptions and suggest more appropriate assumptions
-Acceptance and Commitment therapy
become aware of their streams of thoughts and learn to accept them as mere events of the mind
-Brain parts: prefrontal cortex, anterior cingulate cortex, amygdala
Panic Disorder
- abrupt surge of intense fear within minutes
- at least 1 month of concern about possibility of more attacks
- at least 4 symptoms
- also experience depersonalization/derealization symptoms
- adolescence-adulthood peak
- highest number of medical visits among anxiety disorders
- comorbid with MDE, bipolar, mild alcohol use
- CAUSES
- abnormal activity of norepinephrine
- high anxiety sensitivity
- classical conditioning of panic in response to bodily sensations
- lack of perceived control can trigger panic
Therapy for Panic Disorder
- benzodiazepines
- SSRI
- SNRI
- Anti-depressant drugs
- Cognitive therapy
- relaxation training
- panic control therapy (exposure to somatic sensations associated w/ panic attack in a safe setting
Specific Phobia
-disproportionate fear consistently triggered by specific objects or situations
-at least 6 months
-types:
animal, natural environment, blood-injection, situational
*CAUSES
-learned thru classical conditioning (modeling, stimulus generalization)
-active avoidance: intentionally behaves to avoid phobic stimulus
-interoceptive avoidance: avoidance of internal physical sensations
-emphasize amygdala
*DEVELOPMENT
direct experience
observation (vicarious)
unexpected panic attack
informational transmission
Therapy for Specific phobia
-desensitization covert -imagines in vivo -actual -modeling -flooding -exposed repeatedly and let them know its harmless
Social Anxiety Disorder
- specifier: performance type
- afraid of being scrutinized by others
- Blushing -hallmark physical response
- occurs after stressful humiliating event
- common in females and collectivistic orientations
- comorbid with anxiety disorders, MDE, bipolar, substance-abuse, BDD
- CAUSES
- conditioning
classical: learns o fear neutral (CS) that is paired with aversive stimulus (UCS)
operant: gains relief by avoiding the CS; avoidant response is maintained because it is reinforcing (reduce fear)
Therapy for Social Anxiety Disorder
- CBT
- role play socially phobic situations in front of one another
- exposure
- tricyclic depressants
- MAO inhibitors
- mix CBT with SSRI
Agoraphobia
- agora meaning “marketplace”
- anxiety about situations that are difficult to escape from
- at least 6 months
- active avoidance
- CAUSES
- high anxiety sensitivy
- fear-of-fear hypothesis
- strongest and most specific association with genetic factor among phobias
Therapy for Agoraphobia
- systematic exposure to feared situations
- self-guided treatment
Causes of Anxiety Disorders
*BIOLOGICAL
-no single gene can cause but a collection
-corticotropin-releasing factor (CRF)
central to expression of anxiety
directly related to GABA, serotogenic, noradregenic neurotransmitter systems
-limbic system
-behavioral inhibition system (BIS)
activated if there are unexpected events
*PSYCHOLOGICAL
-sense of controllability with unexpected situations
*SOCIAL
-work, relationship, physical injuries
*COGNITIVE
-sustained negative beliefs about the future
-perceived control
-more attention to signs of threat
Triple Vulnerability theory
-Generalized biological vulnerability
-Generalized psychological vulnerability
perception of the world is dangerous
-Specific psychological vulnerability
learn from early experience which is taught by parents
inability to cope
