anxiety I and II Flashcards
anxiety disorders reflect exaggerated responses to two emotions….
- fear
- anxiety
characteristics of anxiety disorders
- Pervasive and persistent symptoms of anxiety and fear
- Involve excessive avoidance and escape
- Cause clinically significant distress and impairment
3 systems model of anxiety and fear
- physiological (feelings)
- verbal/cognitive
- behavioral
fear and anxiety from an evolutionary standpoint
- fear - immediate response to danger
- anxiety - preparatory fear in anticipation of danger
three important differences between fear and anxiety
1) fear is acute - greater HR increase, more sweating, harder to control behavior, thoughts focused on danger
2) anxiety is a longer emotional response
3) fear is elicited by immediate threat whereas anxiety is elicited by unpredictability
behaviors attached to anxiety vs fear
fear: defense, escape
anxiety: avoidance, preventiveness
what all anxiety disorders have in common
Unpredictability and uncontrollability leads to exaggerated anxiety
biological contributions to anxiety
- Genetic transmission
- Anxiety and brain circuits (Depleted levels of GABA)
- Limbic (amygdala) and septal-hippocampal systems
- Corticotropin releasing factor (CRF)
Mowrer’s anxiety/fear interaction
1) aversive experience (dog bite)
2) avoidance of all dogs and inability to learn that some dogs don’t bite
why do anxiety disorders persist?
the better you are at avoiding, the worse you are at improving
list the anxiety disorders
Panic disorder with and without agoraphobia
Generalized anxiety disorder
Specific phobias
Social phobia
definition, subtypes, symptoms of panic attack
- panic attack: abrupt episode of fear or discomfort in absence of real danger
- DSM-5 subtypes (cued vs uncued)
- breathlessness, HR rate up, chest pain
panic disorder essential features
- Recurrent unexpected panic attacks
- 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
- avoidance of situations where panic attack has occurred
what is anxiety sensitivity
literally being anxious about anxious symptoms
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
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
agoraphobia
- panic when escape is perceived as difficult
meds for panic disorder
- 5-HT, NE, GABA targeted
- SSRIs the most effective (prozac and paxil)
- high rate of relapse when meds discontinued
generalized anxiety disorder (GAD) symptoms
- Excessive worry and anxious apprehension
- Worry must be perceived as uncontrollable
- Coupled with strong, persistent anxiety
- Persists for 6 months or more
- Somatic symptoms differ from panic (e.g., muscle tension, “keyed up” or on edge)
onset of GAD
- insidious
- begins in early adulthood and firmly in place by 30s
- highly prevalent in elderly
GAD diagnosis
- 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
GAD often comorbid with….
social phobia, MDD, substance abuse
how is GAD maintained?
- negative reinforcement by removal of negative imagery in the mind
- imagery relief has be be continuously amped up and repeated
what is Barlow’s triple vulnerability theory?
1) biological vulnerability
2) general psychological vulnerability
- uncontrollable early learning environment
- constantly prepared for danger
3) specific psychological vulnerability
- specific learning event where specific cues for anxiety are learned, direct, vicarious, and instructional conditioning
