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Psych Block 2 > Anxiety ( I and II) > Flashcards

Anxiety ( I and II) Flashcards

1
Q

What is the lifetime prevalence of anxiety disorders in the U.S.?

A

28% lifetime prevalence

  • More common in females
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2
Q

Anxiety disorders reflect what sort of exaggerated responses?

A

Anxiety disorders reflect an exaggerated response in:

  • Fear
  • Anxiety
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3
Q

What are fear and anxiety evolutionarily designed to do?

A

Anxiety and fear are a part of the emotional response system designed to:

  • Detect threat/danger
  • Motivate protection/defense
  • Facilitate protection/defense
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4
Q

What are the characteristics of anxiety disorders?

A
  • Pervasive and persistent symptoms of anxiety and fear
  • Involve excessive avoidance and escape
  • Cause clinically significant distress and impairment
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5
Q

What are ways anxiety can become disordered?

A

Anxiety becomes disordered when it interferes with/causes:

  • poor concentration at work
  • avoidance of social situations
  • avoidance of public places
  • difficulty sleeping
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6
Q

Define fear.

A

A defensive response that motivates protection from an imminent threat
- Immediate and short lived response

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7
Q

Define anxiety.

A

A preparatory response that motivates avoidance of impending threat
- Diffuse, long-lasting response

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8
Q

What are the physical responses of anxiety/fear?

A
  • Muscle tension
  • Increased heart rate
  • Sweating
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9
Q

What are the behavioral responses to fear/anxiety?

A
  • Avoidance

- Escape

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10
Q

What are the cognitive responses to fear/anxiety?

A
  • Cognitive constriction with a threatening situation
    • Attention narrowing
    • Thoughts focused on situation
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11
Q

How is the fear response different from anxiety?

A
  • Fear is more acute/short lived
  • Greater heart rate increase
  • More sweating
  • Behavioral avoidance/escape is more difficult to control
  • Cognitive constriction is impairing
  • Fear is elicited by imminent threat
    • Anxiety elicited by unpredictable/uncontrollable situations
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12
Q

What is the common theme amongst all anxiety disorders?

A
  • Unpredictability and uncontrollability leads to exaggerated anxiety
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13
Q

Explain the genetic/heritable component of exaggerated anxiety.

A

Heritability of exaggerated anxiety likely reflects the degree to which areas of the brain respond to threat cues in the environment

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14
Q

What biological factors contribute to anxiety?

A
  • Inheritance
  • Depleted levels of GABA
  • Limbic/amygdala and septal hippocampal systems
  • Corticotropin releasing factor (CRF)
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15
Q

How does the learning/developmental environment effect anxiety?

A

An unpredictable environment early on in development leads to increased levels of anxiety (learning to be constantly prepared for danger)

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16
Q

Why do anxiety disorders persist?

A
  • Anxiety disorders are disorders of avoidance

- Better you avoid,, the less likely you are to improve

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17
Q

Define psychological vulnerability.

A

A specific learning event where specific cues for anxiety are learned

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18
Q

How can psychological vulnerability occur (3)?

A

1) Direct conditioning
2) Vicarious conditioning (observational learning)
3) Instructional conditioning

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19
Q

What is Mowrer’s anxiety/fear interaction?

A

1) Aversive experience with a stimulus
2) Avoidance of feared stimulus
- Negative reinforcement

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20
Q

What are the main categories of anxiety disorders (4)?

A

1) Panic disorder with and without agoraphobia
2) Generalized anxiety disorder
3) Specific phobias
4) Social phobia

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21
Q

What is panic disorder/attack?

A

Abrupt experience of intense fear or discomfort in the absence of actual danger

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22
Q

What are the physical responses to panic attacks?

i.e. What is the criteria for a panic attack?

A 
-Feeling of imminent doom and urge to escape.  
At least 4 of the below: 
Heart palpitations	        
Nausea/Stomach distress
Sweating			
Choking sensation
Trembling			
Dizzy/lightheaded
Short of breath		
Derealization
Chest pain/tightness	
Hot flashes/Chills
Tingling sensations	
Fear of dying*
Fear of losing control
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23
Q

What are the subtypes of panic attacks (2)?

A

1) Situationally bound (cued)
- Situationally predisposed
2) Unexpected (uncued)

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24
Q

What is a cued panic attack?

A

When panic attacks are clearly triggered by specific situations
(e.g., realizing a final exam is occurring with no preparation)

25
What is an uncued panic attack?
Panic attack occurs unexpectedly - Usually a specific cue, but may not recognize it - ie; Attacks only occur when alone in house
26
What are the essential features of panic disorder (2)?
1) Recurrent unexpected panic attacks 2) At least 1 month of concern about having more panic attacks, or worry about consequences of having panic attacks, or behavioral changes because of panic attacks
27
What is the yearly prevalence of panic disorder?
11%
28
What is the sex ratio of panic disorder?
2:1 (female)
29
What is the median age of onset for panic disorder?
20-24 (varies)
30
What is anxiety sensitivity?
The fear of interoceptive symptoms of fear and anxiety
31
What are the physical components of anxiety sensitivity?
- Heart rate increases, sweating, dizziness, etc. - Themselves are believed to be dangerous and evoke panic attacks [Cognitive anxiety sensitivity & Social anxiety sensitivity]
32
What is agoraphobia?
Anxiety about having panic attack or panic-like symptoms in situations from which escape is difficult or embarrassing - Ie the fear of having more panic attacks
33
What are example situations during which agoraphobia may occur?
- Being outside the home alone - Crowds, malls, supermarkets - Arenas, theaters - Buses/public transportation - Driving or being a passenger in a car
34
Define panic disorder WITHOUT agoraphobia.
Anxiety is about possibility of having more panic attacks | - Not necessarily whether escape is difficult, more so just about panic attacks
35
Define panic disorder WITH agoraphobia.
Anxiety about having more panic attacks, and worry about having panic attack in situation where escape is difficult and/or embarrassing
36
How is panic disorder pharmacologically managed?
Target serotonergic, noradrenergic, and GABA systems - SSRIs (e.g., Prozac and Paxil) are preferred drugs [Relapse rates are generally high following medication discontinuation]
37
What psychological and combined treatments are used for panic disorder?
1) Cognitive-behavioral therapies (CBT) are highly effective - Limited evidence that combined treatment produces better outcome - Medication can be quicker, but CBT tends to lead to longer period of remission of symptoms
38
What is generalized anxiety disorder?
- Excessive/uncontrollable worrying and anxious apprehension - Coupled with strong, persistent anxiety - Persists for 6 months or more - Somatic symptoms: muscle tension, “keyed up” or on edge
39
What is the yearly/lifetime prevalence of general anxiety disorder?
``` 1-year = 2.9% Lifetime = 9% ```
40
What is the sex prevalence of general anxiety disorder?
Females outnumber males approximately 2:1
41
What is the age of onset of general anxiety disorder?
- Beginning in early adulthood and firmly in place by 30’s to middle age - Prevalent among the elderly
42
How is general anxiety disorder diagnosed?
- Excessive anxiety and worry - Difficult to control the worry - Associated with 3 or more of: Restlessness/Keyed-up Fatigue Poor Concentration Irritability Muscle Tension Sleep Problems [Often comorbid with social phobia, major depressive disorder, substance use disorders]
43
What is the role of worry in general anxiety disorder?
Worry in GAD: - Not fear based - Wide range of worry topics (inability to cope/loss of control) - Worry about minor things - Possible consequences of negative events [Worry is theorized to be negatively reinforcing]
44
What are the causes of general anxiety disorder?
``` Biological vulnerability Generalized psychological vulnerability Specific psychological vulnerability - Cognitive processes - Physiological responses -“Autonomic restriction” - Chronic muscle tension ```
45
How is general anxiety disorder treated?
CBT: - Exposure to Worry Images & Uncertainty - Relaxation Training - Acceptance-based interventions
46
What are the defining features of specific phobias?
- Extreme irrational fear of a specific object or situation - Go to great lengths to avoid phobic objects, or endure with distress - Recognize that the fear and avoidance are unreasonable - Markedly interferes with one’s ability to function *Chronic course
47
What is the general and sex prevalence of specific phobias?
- 2:1 females | - 7-9% of the general population in given year
48
What are the broad types of specific phobias (5)?
- Animal type - Natural environment type - Blood-Injury-Injection type * - Situational Type - Other Type - Choking, vomiting, illness, space, etc.
49
What are the various causes of specific phobias (4)?
1) Direct Experience 2) False Alarm 3) Vicarious Observation 4) Information
50
How are specific phobias treated (5)?
1) Systematic Desensitization 2) Exposure/Flooding 3) Habituation and extinction 4) Tolerance of distress 5) “Inhibitory learning”
51
What is social phobia?
Intense, extreme fear of one or more social situations due to fears of being embarrassed, humiliated, or rejected
52
What are the essential components of social phobia?
- Situation(s) almost always cause fear - Person recognizes fear as excessive/unrealistic - Situations are avoided or endured with distress - Markedly interferes with one’s ability to function
53
What is the general and sex prevalence of social phobia?
Most prevalent anxiety disorder: - 7% of the general population in one year - females > males (slightly) - Adolescent onset (~15)
54
What causes social phobias (4)?
1) Biological vulnerability 2) False alarm 3) Severe negative social event (True Alarm) 4) Modeling
55
How are social phobias treated?
- Exposure combined with cognitive procedures - Anti-depressants (mostly SSRIs, e.g., Paxil) *High relapse rates
56
What is the most effective treatment for anxiety disorders?
CBT
57
What are the pros of CBT?
- Generally effective - No side-effects - Low relapse after treatment – many continue to improve
58
What are the disadvantages of CBT?
- Slower than medication | - Requires hard work, time, access to services

Psych Block 2 (22 decks)

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