Anxiety Disorders - Chapter 5 Content

Question 1

Define anxiety.

Answer 1

It is a state of mood characterized by marked negative affect and bodily symptoms of tension in which a person anticipates danger and misfortune. It is the adaptive, automatic response to stress and threat.

Question 2

What is fear?

Answer 2

It is an immediate emotional alarm in reaction to present danger or life-threatening emergencies.

Question 3

Describe what panic is and it’s relationship with panic attacks.

Answer 3

Panic is the sudden overwhelming fright or terror whereas a panic attack is an abrupt experience of intense fear that cause also have physical symptoms like dizziness or heart palpitations.

Question 4

What are some of the diagnostic criteria of symptoms for a panic attack from the DSM-5?

Answer 4

Sweating, trembling, feelings of choking, chest pain, nausea, chills, numbness, fear of going crazy, fear of dying (somatic and psychological symptoms)

Question 5

What are the 2 types of panic attacks?

Answer 5

There are expected attacks where you are in a situation that can present strong fear and a potential attack, and then there are unexpected where the person has no idea when or where the next attack will occur.

Question 6

What can we use to measure some physiological symptoms of a panic attack?

Answer 6

Use electromyography to measure your heart’s beats per minute.

Question 7

What is the biological explanation for anxiety?

Answer 7

There is not one single gene that causes anxiety, but it is shown to be inherited. We can also look at neurotransmitter levels and the limbic system (mediator between brain stem and cerebral cortex) and how that connects with fear.

Question 8

What is the BIS when referring to the limbic system?

Answer 8

It is the Behavioural Inhibition System, and it’s a brain circuit in the limbic system that responds to threat signals by inhibiting activity and causing anxiety. Also connected with the brain’s Fight or Flight System (FFS).

Question 9

What are some psychological contributions to anxiety?

Answer 9

Our childhood experiences tend to show up a lot in the way that our parents made us understand the sense of control in our environment. This can also become a conditioned process.

Question 10

What is the triple vulnerability theory?

Answer 10

1. Generalized biological vulnerability (being uptight)
2. generalized psychological vulnerability (thinking the world is dangerous)
3. specific psychological vulnerability (being taught that some situations are dangerous)

Question 11

Define comorbidity.

Answer 11

The co-occurrence of two or more disorders in a single individual

Question 12

How prevalent is suicide amount people with panic disorders?

Answer 12

It is around 20% which is very alarming since this disorder is quite common and even if the patient didn’t have depression too, the rates were still too high.

Question 13

What is GAD?

Answer 13

It is a generalized anxiety disorder and this is anxiety disorder characterized by intense, uncontrolled, unfocused, chronic and continuous worry that is distressing and accompanied by physical symptoms.

Question 14

What is the criteria for GAD listed by the DSM-5?

Answer 14

a. Excessive work and anxiety, for more days than not for 6 months.
b. finding it difficult to control the worry
c. 3 or more symptoms (somatic and psychological symptoms)
d. the symptoms are causing clinically significant distress
e. not caused by another physiological effect like medication or medical condition
f. not explained by another mental disorder

Question 15

What are some causes of GAD?

Answer 15

This disorder is shown to run in families so potential genetic components. They can show less responsiveness on physiological levels such as heart rate. Cognitive avoidance, poor problem orientation, positive beliefs about worry and intolerance of uncertainty.

Question 16

What is anxiety sensitivity?

Answer 16

It is the tendency to become distressed in response to arousal-related sensations, arising from beliefs that these sensations have harmful consequences.

Question 17

What are the found treatments for GAD?

Answer 17

Medication: Benzodiazepines (lots of negative), mostly use antidepressants
Therapy: CBT, confronting threatening thoughts head-on, meditation and mindfulness-based treatments (finding feels of acceptance)

Question 18

Define Panic disorder.

Answer 18

It is a recurrent unexpected panic attack accompanied by concern about future attacks/ and or lifestyle changes to avoid future attacks. This is closely related to agoraphobia, avoidance of uncomfortable situations that might be hard to escape from

Question 19

What are the criteria for panic disorder according to the DSM-5?

Answer 19

a. recurrent unexpected panic attacks
b. at least 1 attack followed by persistent worry or change in behaviour is the following month.
c. not caused by another physiological effect like medication or medical condition
d. not explained by another mental disorder

Need to be concerned about subsequent attacks or having a maladaptive behavioural

Question 20

What are the DSM-5 criteria for agoraphobia?

Answer 20

a. Fear for two or more situations listed (slide 20)
b. avoiding certain situations that might be difficult to escape from if needed
c. these situations always provoke fear
d. actively avoided, need someone with you, create intense fear
e. fear is out of proportion
f. clinically significant
e. not caused by another physiological effect like medication or medical condition
f. not explained by another mental disorder

Question 21

What are some of the treatments used for panic disorder and agoraphobia?

Answer 21

Medications: SSRI’s
Treatment: Panic control treatment (gradual exposure to feared semantic situations to modify perceptions about them)

Question 22

How can anxiety be produced in humans?

Answer 22

Can be produced by dangers that are real or imagined, and external or internal (physical sensations)

Question 23

What is the flight, fight, or freeze response?

Answer 23

It is an adaptive, automatic function that activates the body by increasing blood flow, breathing quickens, faster heart rate, etc. It is mainly responsible for the amygdala, it reacts when we see potential danger.

Question 24

Contrast anxiety and fear.

Answer 24

Contrast: A is a negative mood state where F is an immediate short-lived reaction, A is more focused on the symptoms of physical tension and F has the flight, fight, freeze response, A is future and F is present

Question 25

When can anxiety be a helpful emotion?

Answer 25

It can be helpful when it alerts us of real danger, prepare us to take action, and help to escape and this is only when anxiety is being produced in moderate amounts.

Question 26

What are the 3 D’s of anxiety disorders?

Answer 26

Dysfunction: pervasive and persistent symptoms of anxiety/fear
Deviance: excess avoidance and escapist tendencies
Distress/Impairment: clinically significant distress

Question 27

What are the 4 characteristics of the cognitive model for GAD?

Answer 27

1. intolerance of uncertainty (a sense that they cannot cope)
2. positive belief about worry (believing that they worrying is helpful)
3. poor problem orientation (identifying problems that are un or solvable)
4. cognitive avoidance (one worry to the next)

Question 28

List some of the helpful skills developed in CBT.

Answer 28

• challenging belief about the function of worry
• building up confidence in the ability to cope
• problem-solving
• reducing avoidance to allow new learning (gradual exposure)
• relation, stress management

Question 29

How can a panic disorder be maintained?

Answer 29

Dramatisicing the interpretation of bodily sensations, over fixate on monitoring of bodily sensations, avoidance and safety behaviour