Ch. 6 - Panic, Anxiety, Obsessions, and Their Disorders Flashcards
What are the commonly shared behavioral components of Anxiety Disorders?
1) avoidance (internal or external)
2) safety behaviors (rituals or trinkets for example)
what is avoidance?
maintaining fear through negative reinforcement (avoidance removes the discomfort —-> more avoidance)
What are safety behaviors?
having, for example, rituals or trinkets that usually become engrained with routine
What are safety behaviors?
behaviors that make an individual feel safe and have less discomfort
having, for example, rituals or trinkets that usually become engrained with routine
Treatments for Anxiety Disorders
1) behavioral therapy, specifically, exposure therapy
2) cognitive behavioral therapy
3) medication (anxiolytics and antidepressants)
What is Cognitive Behavioral Therapy?
involves cognitive restructuring + exposure
What do Anxiolytics do?
offer immediate relief
What do antidepressants do?
offer long-term, therapeutic effects
What is a Phobia?
A strong and persistent fear recognized as excessive or unreasonable
What triggers a phobia?
a specific object or situation
Avoidance of a trigger (phobias) is a ___________ characteristic.
Cardinal: Individuals will do everything in their power to escape certain situations or objects that are part of their phobia
5 Phobia Subtypes Identified in the DSM-5
1) Animal (includes insects)
2) natural environment
3) blood-injection-injury
4) situational
5) other
-choking, vomiting, “space”
What are the psychological causes of phobias?
1) Classical conditioning (learned fear)
- direct or observational
2) Operant conditioning (maintained fear or avoidance)
- positive reinforcement (relief; reassurance-seeking)
- negative reinforcement (avoidance —-> removal of distress)
3) Evolutionary preparedness (animal and natural environment are most common phobias)
Phobias come about in a ___________ process.
gradual
The most effective treatment for a phobia is __________ _________.
exposure therapy
For many types of fears, exposure therapy can be done in a __________, __________ session (______ ________).
single, long; few hours
cognitive restructuring has not added much to ________ ____________.
phobia treatment
__________ alone is ineffective alone to treat phobias and _______-__________ meds may interfere with exposure therapy.
medication; anxiety-meds
What is Social Anxiety (Social Phobia)?
A persistent fear of exposure to scrutiny and potential evaluation of others in one or more social situations (6 months or longer)
What are the subtypes of social anxiety?
1) performance (e.g. public speaking)
2) nonperformance (e.g. meeting new people)
What is a biological causal factor of social anxiety?
1) Temperament - behavioral inhibition
___________ ___________ has been found to predict Social Anxiety Disorder in middle childhood.
Behavioral inhibition
What is Panic Disorder? How is it characterized?
A reoccurrence of unexpected (“out of the blue”) panic attacks
Characterized by persistent worry (1+ month) about having more attacks and/or maladaptive change in behavior to avoid attacks
What is Generalized Anxiety Disorder?
Chronic or excessive worry about multiple events and activities
The DSM-5 says it has to occur more days than not for at least ____ months. Persistent worry must be accompanied by at least ___ of ___ symptoms, most of the time (in children, only ___ is required).
6; 3; 6; 1
6 Symptoms of Generalized Anxiety Disorder
1) Edginess or restlessness
2) Tiring easily; more fatigued than usual
3) Impaired concentration or feeling as though the mind goes blank
4) Irritability (which may or may not be observable to others)
5) Increased muscle aches or soreness
6) Difficulty sleeping (due to trouble falling asleep or staying asleep, restlessness at night, or unsatisfying sleep.
What is worry?
A mental behavior that is likely a form of cognitive avoidance
3 Examples of cognitive avoidance?
-superstitious avoidance (feared outcomes less likely)
-avoidance of deeper emotional topics (distraction)
-coping and preparation (usually results in procrastination)
What are the paradoxical effects of thought supression?
boosting the worrying thoughts by trying not to think about them, causing you to think about not thinking about it and therefore thinking about it
In the US…
The lifetime risk for SAD, GAD, and PD: __________ __________ groups is less than ___-__________ __________.
ethnic minority groups; non-hispanic whites
Once a disorder develops, it is more equally distributed across ______/__________.
race/ ethinicity
Expression and rates of anxiety are expressed differently across ___________.
cultures (taijin kyofusho [social anxiety in japan])
Yoruba culture of Nigeria [generalized anxiety] is characterized by ________, ________, and _________ __________.
Koro in China is characterized by having a fear of genitals changing due to __________ __________ or _________ ________
worry, dreams, bodily complaints
malicious spirits or contaminated food
What is Obsessive-Compulsive Disorder (OCD)?
The occurrence of both obsessive thoughts and compulsive behaviors performed in an attempt to neutralize such thoughts (time-consuming; >1 hr a day)
What is an obsession?
It is persistent and recurrent intrusive thoughts, images, or impulses that are experienced as disturbing, inappropriate, and uncontrollable
What are compulsions?
They involve overt repetitive behaviors that are performed as lengthy rituals
5 Common Obsessions
1) Contamination fears (disease, germs, etc)
2) Fears of harming oneself or others
3) Need for symmetry
4) Sexuality, unwanted sexual images/thought
5) Religion (scrupulosity)
6 Common Compulsions
1) Cleaning (contrast with germ phobia)
2) Checking things
3) Repeating
4) Ordering/ arranging
5) Counting
6) Phrases/ sayings
The Lifetime prevalence rate for OCD: ___- ___%
2-3%
Most (____%) of treatment-seeking individuals with OCD have both obsessions and compulsions.
90%
Little to no _________ differences, unlike other anxiety-related disorders.
gender
Typical onset for OCD is _______ __________ or _______ ___________. _________ onset leads to greater severity and heritability estimate.
late adolescence or early adulthood; Childhood
OCD is typically _______, with relief from treatment.
Chronic
OCD is frequently comorbid with _________ and __________ depressive disorders, _____ disorders, and ______.
anxiety disorders; depressive disorders; tic disorders ; adhd
3 Cognitive causal factors for OCD include…
1) non-acceptance of thoughts
2) increased sense of moral responsibility for thoughts
3) attempts to suppress thoughts actually cause increases in thoughts
Biological causal factors of OCD may play a ____________ factor in OCD than for anxiety disorders.
greater
OCD sometimes associated with ____ (especially in childhood)
tics
_____% of 1st degree relatives of people with Tourette’s syndrome (very rare) had diagnosable OCD
23%
Evidence of abnormalities in brain structures such as the ________ __________, which have a role in voluntary motor movement, habits, cognition, emotion.
basal ganglia
The orbitofrontal cortex…
filters out and manages primitive urges
Behavioral treatment for OCD includes…
exposure and response prevention
For patients that stick with behavioral treatment, about ___-___% show a reduction in symptoms (ranging from moderate to great improvement)
50-70%
Full remission of OCD is ______.
rare
For OCD, patients are prescribed medications primarily affecting the NT ______________.
serotonin
What is body dysmorphic disorder (BDD)?
-being obsessed with perceived or imagined flaw in appearance
-having a firm belief of disfigurement/ugliness
-causes clinically significant distress and/or impairment
These “flaws” are not _________ or only seen as _______ to other people
observable; slight
4 Examples of repetitive behaviors or mental acts in response to appearance concerns in BDD include…
1) reassurance-seeking from others
2)excessive mirror checking
3) skin picking
4) self-others comparision
With BDD, one may focus on _____ body parts.
any
BDD could be better explained by criteria that fits an _______ __________ if the concerns are about weight/ fat/ eating behaviors.
eating disorder
General population point prevalence is __-__%
1-2%
BDD affects men and women about _________. Types of body obsessions tend to be ___________ though.
equally; different
BDD typically begins in _______________.
Adolescence
Comorbidity rates of BDD with SAD, depression, and OCD tend to be _______.
high
BDD vs OCD
For both, there are __________ behaviors, such as reassurance seeking and repetitive checking.
repetitive
BDD vs OCD
BDD is more _______ of obsessive beliefs than OCD
convinced
BDD vs OCD
There is a potential overlap in _________ ________ and ___________ ___________.
causal factors; treatment approaches
BDD vs Anorexia Nervosa
Both involve excessive concern with _________ appearance, ________ dissatisfaction, ___________ perception
physical; body; distorted
BDD typically/ originally normal appearance when meetin diagnostic criteria; little satisfaction after making attempts to mask flaws
!!!!!
AN: underweight for diagnosis –> satisfied with emaciation and attempts to maintain
!!!!!!!
What is Hoarding Disorder?
-acquiring and failing to discard limited value possessions and the disorganizations in living space interferes with everyday life
________ ________ has a poorer prognosis for treatment than OCD.
Hoarding disorder
What is Trichotillomania?
-compulsive hair pulling
-urge to pul out hair from any body location
- preceded by tension and followed by pleasure/ releif
- must cause clinically significant distress
-much less is known about this disorder!!!!!!!
