Anxiety Disorders Flashcards
Anxiety
Apprehension over an anticipated problem, moderate arousal (restless energy)
Fear
A reaction to immediate danger, higher arousal (overpowering urge to run)
… seems to misfire in some anxiety disorders
Fear
describe the the “U-Shaped” Curve that shows how anxiety increases preparedness
Absence of anxiety interferes with performance
Moderate levels of anxiety improve performance
High levels of anxiety are detrimental to performance
Name all 5 DSM-5 Anxiety Disorders
Specific phobias
Social anxiety disorder Panic disorder
Agoraphobia
Generalized anxiety disorder
Define: 1) Specific phobia 2 )Social anxiety disorder 3) Panic disorder 4) Agoraphobia 5) Generalized anxiety disorder
1) Fear of objects or situations that is out of proportion to any real danger
2) Fear of unfamiliar people or social scrutiny
3) Anxiety about recurrent panic attacks
4) Anxiety about being in places where escaping or getting help would be difficult if anxiety symptoms occurred
5) Uncontrollable worry
4 DSM-5 Criteria for Anxiety Disorders
-Symptoms interfere with important areas of functioning or
cause marked distress
- Symptoms are not caused by a drug or a medical condition
- Symptoms persist for at least 6 months or at least 1 month for panic disorder
- The fears and anxieties are distinct from the symptoms of another anxiety disorder
DSM-5 Criteria for specific Phobias
- Disproportionate fear caused by a specific object or situation \+Awareness that fear is excessive \+Great lengths taken to avoid feared object or situation - Most specific phobias cluster around a few feared objects and situations -High comorbidity among specific phobias
Which is the specific phobia and when does it start
1) Snakes, insects
2) Storms, heights, weather
3) Blood, injection, injury
4) Public transportation, tunnels, bridges, elevators, flying, driving, closed spaces
1) Animal
Generally begins during childhood
2) Natural Environment
Generally begins during childhood
3)Blood, injury, injections, or other invasive medical procedures
Runs in families; profile of heart rate slowing and possible fainting when facing feared stimulus
4) Situational
Tends to begin in either childhood or in mid-20s
5) Other
Choking, contracting an illness, etc. Children’s fears of loud sounds, clowns, etc.
DSM-5 Criteria for Social Anxiety
- Persistent, unrealistically intense fear of social situations that might involve being scrutinized by or exposed to unfamiliar people
+ Fear of negative
evaluation or scrutiny
leads to avoidance of
social situations - Common fears include: public speaking, meeting new people, talking to people in authority
- 33% also diagnosed with Avoidant Personality Disorder
+ Overlap in genetic
vulnerability for both
disorders - Marked and disproportionate fear consistently triggered by exposure to potential social scrutiny
- Exposure to the trigger leads to intense anxiety about being evaluated negatively
- Trigger situations are avoided or else endured with intense anxiety
DSM-5 Criteria for Panic Attacks
What are Physical Symptoms
- Sudden attack of intense apprehension, terror, and feelings of impending doom
- Accompanied by at least four other symptoms:
+Physical symptoms can include:
Shortness of breath, heart palpitations, nausea, upset, stomach, chest pain, feelings of choking and smothering,dizziness, lightheadedness, faintness, sweating, chills, heat sensations, numbness or tingling sensations, and trembling
- Depersonalization - (feeling of being outside one’s body)
- Derealization (feeling of the world not being real)
- Fears of going crazy, losing control, or dying
- Symptoms come on rapidly and peak in intensity within 10 minutes
-Many people interpret symptoms as having a heart attack
- Misfiring of the fear system
+Physiological
response similar to what
most experience when
faced with immediate
threat
- Depersonalization
feeling of being outside one’s body
- Derealization
feeling of the world not being real
DSM-5 Criteria for Panic Disorder
- Recurrent panic attacks unrelated to specific situations
- Worry about having more panic attacks
- Panic attacks triggered by specific situations (e.g., phobia) should not be considered in diagnosing panic disorder
- 25% of people will experience a single panic attack !
+ Not the same as
panic disorder - Recurrent unexpected panic attacks
- At least 1 month of concern about the possibility of more attacks occurring or the consequences of an attack, or maladaptive behavioral changes because of the attacks
DSM-5 Criteria for Agrophobia
- Anxiety about situations in which it would be embarrassing or difficult to escape if anxiety symptoms occurred \+E.g., crowds, stores, malls, churches, trains, bridges, tunnels, etc.
- Causes significant impairment \+Unable to leave house or leaves house with great distress - About half of people with agoraphobia experience panic attacks
- Disproportionate and marked fear or anxiety about at least 2 situations where it would be difficult to escape or receive help in the event of incapacitation, embarrassing symptoms, or panic- like symptoms
- These situations consistently provoke fear or anxiety
- These situations are avoided, require the presence of a
companion, or are endured with intense fear or anxiety
DSM-5 Criteria for Generalized Anxiety Disorder (GAD)
- Excessive, uncontrollable, and long-lasting worry about minor thingsWorry
Cognitive tendency to chew on a problem and to be unable to let go of itCommon worries: - Relationships, health, finances, daily hassles
- Also includes: difficulty concentrating, tiring easily, restlessness,
irritability, and muscle tension - Typically begins in adolescence
- Excessive anxiety and worry at least 50% of days about a number of events or activities (e.g., family, health, finances, work, and school)
- The person finds it hard to control the worry
- The anxiety and worry are associated with at least three (or
one in children) of the following:
+Restlessness or feeling keyed up or on edge
+ Easily fatigued.
+ Difficulty concentrating or mind going blank
+ Irritability.
+ Muscle tension
+Sleep disturbance
Worry
Cognitive tendency to chew on a problem and to be unable
to let go of it
Name Factors that Increase General Risk for Anxiety Disorder
- Behavioral conditioning
- Genetic vulnerability
- Disturbances in the activity in the fear circuit of the brain
- Decreased functioning of gamma-aminobutyric acid (GABA) and serotonin; increased
norepinephrine activity - Increased cortisol awakening response -
- (CAR) Behavioral inhibition
- Neuroticism
- Cognitive factors, including sustained negative beliefs, perceived lack of control, over-attention to cues of threat, and intolerance of uncertainty
Describe disturbances in activity in the brain for people at risk of an anxiety disorder, What happens with GABA, Serotonin, Norepinephrin, Cortisol
- Disturbances in the activity in the fear circuit of the brain
- Decreased functioning of gamma-aminobutyric acid (GABA) and serotonin; increased
norepinephrine activity - Increased cortisol awakening response -
- (CAR) Behavioral inhibition
Fear Conditioning: Describe Mowrer’s Two-Factor Model
Classical Conditioning
-A person learns to fear a neutral stimulus (CS) that is paired with an intrinsically aversive stimulus (UCS)
Operant Conditioning
-A person gains relief by avoiding the CS
- Avoidance maintained though negative reinforcement