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

Anxiety ( I and II) Flashcards

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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
Q

What is an uncued panic attack?

A

Panic attack occurs unexpectedly

  • Usually a specific cue, but may not recognize it
  • ie; Attacks only occur when alone in house
26
Q

What are the essential features of panic disorder (2)?

A

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
Q

What is the yearly prevalence of panic disorder?

A

11%

28
Q

What is the sex ratio of panic disorder?

A

2:1 (female)

29
Q

What is the median age of onset for panic disorder?

A

20-24 (varies)

30
Q

What is anxiety sensitivity?

A

The fear of interoceptive symptoms of fear and anxiety

31
Q

What are the physical components of anxiety sensitivity?

A
  • Heart rate increases, sweating, dizziness, etc.
    • Themselves are believed to be dangerous and evoke panic attacks

[Cognitive anxiety sensitivity & Social anxiety sensitivity]

32
Q

What is agoraphobia?

A

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
Q

What are example situations during which agoraphobia may occur?

A
  • Being outside the home alone
  • Crowds, malls, supermarkets
  • Arenas, theaters
  • Buses/public transportation
  • Driving or being a passenger in a car
34
Q

Define panic disorder WITHOUT agoraphobia.

A

Anxiety is about possibility of having more panic attacks

- Not necessarily whether escape is difficult, more so just about panic attacks

35
Q

Define panic disorder WITH agoraphobia.

A

Anxiety about having more panic attacks, and worry about having panic attack in situation where escape is difficult and/or embarrassing

36
Q

How is panic disorder pharmacologically managed?

A

Target serotonergic, noradrenergic, and GABA systems
- SSRIs (e.g., Prozac and Paxil) are preferred drugs

[Relapse rates are generally high following medication discontinuation]

37
Q

What psychological and combined treatments are used for panic disorder?

A

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
Q

What is generalized anxiety disorder?

A
  • 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
Q

What is the yearly/lifetime prevalence of general anxiety disorder?

A 
1-year = 2.9%
Lifetime = 9%
40
Q

What is the sex prevalence of general anxiety disorder?

A

Females outnumber males approximately 2:1

41
Q

What is the age of onset of general anxiety disorder?

A
  • Beginning in early adulthood and firmly in place by 30’s to middle age
  • Prevalent among the elderly
42
Q

How is general anxiety disorder diagnosed?

A
  • 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
Q

What is the role of worry in general anxiety disorder?

A

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
Q

What are the causes of general anxiety disorder?

A 
Biological vulnerability
Generalized psychological vulnerability
Specific psychological vulnerability
   - Cognitive processes
   - Physiological responses
      -“Autonomic restriction”
      - Chronic muscle tension
45
Q

How is general anxiety disorder treated?

A

CBT:

  • Exposure to Worry Images & Uncertainty
  • Relaxation Training
  • Acceptance-based interventions
46
Q

What are the defining features of specific phobias?

A
  • 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
Q

What is the general and sex prevalence of specific phobias?

A
  • 2:1 females

- 7-9% of the general population in given year

48
Q

What are the broad types of specific phobias (5)?

A
  • Animal type
  • Natural environment type
  • Blood-Injury-Injection type *
  • Situational Type
  • Other Type
    • Choking, vomiting, illness, space, etc.
49
Q

What are the various causes of specific phobias (4)?

A

1) Direct Experience
2) False Alarm
3) Vicarious Observation
4) Information

50
Q

How are specific phobias treated (5)?

A

1) Systematic Desensitization
2) Exposure/Flooding
3) Habituation and extinction
4) Tolerance of distress
5) “Inhibitory learning”

51
Q

What is social phobia?

A

Intense, extreme fear of one or more social situations due to fears of being embarrassed, humiliated, or rejected

52
Q

What are the essential components of social phobia?

A
  • 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
Q

What is the general and sex prevalence of social phobia?

A

Most prevalent anxiety disorder:

  • 7% of the general population in one year
  • females > males (slightly)
  • Adolescent onset (~15)
54
Q

What causes social phobias (4)?

A

1) Biological vulnerability
2) False alarm
3) Severe negative social event (True Alarm)
4) Modeling

55
Q

How are social phobias treated?

A
  • Exposure combined with cognitive procedures
  • Anti-depressants (mostly SSRIs, e.g., Paxil)

*High relapse rates

56
Q

What is the most effective treatment for anxiety disorders?

A

CBT

57
Q

What are the pros of CBT?

A
  • Generally effective
  • No side-effects
  • Low relapse after treatment – many continue to improve
58
Q

What are the disadvantages of CBT?

A
  • Slower than medication

- Requires hard work, time, access to services

Psych Block 2 (22 decks)

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