anxiety & phobias Flashcards
anxiety vs fear
anxiety = a general feeling of apprehension about possible future dangers (no clear source of danger)
fear = an alarm reaction that occurs in response to immediate danger (clear source of danger)
- 3 components: cognitive (subjective, thoughts), behavioral (actions, what you do) & physiological
anxiety disorders
a group of disorders that share obvious symptoms of clinically significant fear or anxiety for at least 6 months
many people w 1 AD will experience at least 1 more AD and/or depression
25-29% of U.S
similarities between basic cause of different ADs
- biological: genetic contributions, personality traits (neuroticism = proneness to experience neg moods), brain structures (lambic system, parts of cortex, NTs), disordered patterns of cognition
- psychological: classical conditioning, perceptions of a lack of control
- environmental: parenting styles, social-cultural env
specific phobia
= a strong & persistent fear that that is triggered by the presence of a specific object or situation
- show an immediate fear response
- also experience anxiety if they anticipate the encounter
- usually recognize that their fear is excessive or unreasonable
- phobic behavior is reinforced bcuz every time a fear situation is avoided, anxiety decreases
blood-injection-injury phobia
- experience as much disgust as fear
- show a unique physiological response – initial acceleration then dramatic drop in heart rate & blood pressure – only show this response to blood or injury stimuli
- also experience nausea, dizziness or fainting – do not occur with other SP
applied tension technique: tense arm muscles when see object - keep blood flowing making them less likely to pass out (bc usually blood pressure goes down)
specific phobia prevalence, gender & age of onset
lifetime prevalence: 12-20%
gender: vary depending on SP but always more common in women
age: differs - some in childhood (animal, BII), some in teens/early adulthood (driving, claustrophobia)
psychoanalytic causes of SPs
phobias represent a defense against anxiety that stems from repressed impulses from the id
- it is too dangerous to ‘know’ the repressed impulse = anxiety is displaced into some external object or situation that has some symbolic relationship to the real object of the anxiety
criticized for being too speculative
learning perspective causes for SPs
explains develop of phobic behavior through classical conditioning
- fear response can be conditioned to previously neutral stimuli when they are paired w traumatic/painful events
vicarious/observational conditioning – watching a person behaving fearfully with an object can be distressing & result in fear being transmitted
role of past experiences in SPs
differences in life experiences affect whether conditioned fears or phobias develop
- e.g. years of pos exps with dogs before being bitten = not likely to develop phobia
some life exps may serve as risk factors = makes certain people more vulnerable to phobias
others may serve as protective factors for the develop of phobias
evolutionary preparedness theory for SPs
we are evolutionarily prepared to associate certain objects (e.g. snakes, water, enclosed spaces) with frightening events
- prepared learning occurs bcuz over evolution, humans who rapidly acquired fears of dangerous objects/situations = advantage
- prepared fears not inborn/innate – easily acquired or resistant to extinction
biological factors for SPs
genetics/temperament/personality traits may make someone more or less likely to acquire fears/phobias
- behaviorally inhibited (excessively timid, shy, easily distracted) toddlers = higher risk (same for social)
treatment of SPs
exposure therapy = best treatment – controlled exposure to the stimuli or situations that elicit phobic fear
participant modeling = therapist models ways of interacting with the stimulus
medications = ineffective by themselves but d-cycloserine may enhance effectiveness of small amounts of exposure therapy
social phobia / social anxiety disorder
disabling fears of one or more specific social situations (e.g. public speaking)
- fears they may be exposed scrutiny & neg evaluation = avoids or endures with great distress
2 subtypes: one center on performance situations, other is more general
prevalence, gender & age of onset of social phobia
prevalence: 12%
age: early or middle adolescence
gender: more common in women
learning perspective for social phobia
social phobia originates from simple instances of direct or vicarious classical conditioning
e.g. experiencing/witnessing a perceived social defeat/humiliation or being/witnessing the target of anger or criticism
evolutionary perspective for social phobias
social phobias evolved as a byproduct of dominance hierarchies
- aggressive encounters between members of a social group and a defeated individual who displays fear & submissive behavior
cognitive biases in social phobia
expect that other people will reject or neg evaluate them
= sense of vulnerability when around threatening people
= expect that they’ll behave in an awkward & unacceptable way resulting in rejection
= become preoccupied with bodily responses & neg self-images in social situations
vicious cycle evolves: their inward attention & awkward behavior = others react in a less friendly way = confirms expectations
cog/behavioral therapies for social phobias
cognitive restructuring = therapist attempts to help clients identify their underlying neg, automatic thoughts – then helps them change these thoughts/beliefs through logical reanalysis
exposure therapy & CBT produce comparable results, but cog reconstructing more effective
produces long-lasting improvements + low relapse rate
medication for social phobia
several categories of antidepressants – effectiveness sometimes comparable to CBT
- must be taken over a long period of time to ensure that relapse doesn’t occur
agoraphobia
most commonly feared/avoided situations include streets & crowded places
- develops as a complication of having panic attacks in 1 or more such situations
- frightened by their own bodily sensations = avoid activities that will create arousal e.g. exercise
prevalence, gender & age of onset of agoraphobia
prevalence: 4.7%
age: often late adolescence, average 23-34
gender: more common in women
prevalence, gender & age of onset of agoraphobia
prevalence: 4.7%
age: often late adolescence, average 23-34
gender: more common in women
medications for agoraphobia
anxiolytics (anti anxiety medication) – show some symptom relief
- act very quickly (30-60 mins) = useful in acute situations of intense panic/anxiety
antidepressants – don’t create physiological dependence + can alleviate any comorbid depressive symptoms – but takes 4 weeks before effective & not useful in an acute situation
relapse rates when drugs are discontinued were high
therapy for agoraphobia
exposure therapy
- quite effective – helped 60-75% of people with AP show clinically significant improvement
2 techniques developed:
- interoceptive exposure = deliberate exposure to feared internal sensations – fear of internal should be treated the same as external (prolonged exposure)
- cognitive restructuring – in recognition that catastrophic automatic thoughts may help maintain panic attacks
