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PSYC340 > Chapter 4 - Anxiety Disorders > Flashcards

Chapter 4 - Anxiety Disorders Flashcards

1
Q

Fear

A

Activated quickly and to specific threats
Activation of fight/flight response
Strong urge to escape
There are lots of different responses possible

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2
Q

Anxiety

A

Activated diffusively, can be continuous, ongoing
Future oriented
Tension, chronic over-arousal, prepared for fight-or-flight response
Avoidance = negative reinforcement

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3
Q

What are the 2 major components of anxiety (and a third?)

A

Physiological (heightened level of arousal and physiological activation)
Cognitive (subjective perception of the anxious arousal and the associated cognitive processes; worry and rumination)
*Behavioural: avoidance and safety behaviours

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4
Q

Difference between worry and rumination

A

Rumination = thinking about the same thing over and over again
Worry = thoughts passing
Both can keep the anxiety alive

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5
Q

Describe the Yerkes-Dodson Law

A

A medium level of arousal is best for the best performance
Not enough arousal is detrimental, and so is too much
(arousal being the anxiety level)

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6
Q

Neuroticism

A

People who are stressed, low emotional stability, control freaks, irritable, anxious (linked with anxiety disorders)

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7
Q

Which is the + common psychological disorder?

A

Anxiety disorders

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8
Q

Gender gap in anxiety disorder

A

9% of men vs 16% women

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9
Q

Lifetime and one-year prevalence of anxiety disorders

A 
Lifetime = 16.6%
One-year = 10.6%
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10
Q

Changes in the DSM-5 concerning anxiety disorders

A

PTSD now a stress disorder

OCD now under “OC and related disorders”

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11
Q

Separation anxiety

A

the anxiety that results from having contact or the possibility of losing contact with attachment figures
(usually prevalent among children, but also in adults)

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12
Q

Adult separation anxiety

A

Adults who cannot stand to be alone and preoccupied with losing contact with loved ones (can be more prevalent than we think)

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13
Q

Phobic disorders

A

Persistent and disproportionate fear of some specific object or situation that presents little to no danger

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14
Q

Meaning of the term phobia

A

Implies that the person suffers intense distress and social and occupational impairment because of the anxiety - people with phobias are insightful about it

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15
Q

5 phobia subtypes

A 
Agoraphobia
Fears of heights or water
Threat fears (blood/needles, storms/thunder, etc)
Fears of being observed
Speaking fears
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16
Q

Specific phobias duration

A

Long-lasting (mean of 20yrs)

only 8% receive treatment

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17
Q

Algophobia

A

Pain

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18
Q

Monophobia

A

Being alone

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19
Q

Mysophobia

A

Contamination

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20
Q

Nyctophobia

A

Darkness

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21
Q

Pyrophobia

A

Fire

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22
Q

Dextrophobia

A

Objects on right side of the body

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23
Q

Lininophobia

A

String

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24
Q

Eophobia

A

Dawn

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25
Q

Hellenologophobia

A

Scientific or greek terms

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26
Q

Nomophobia

A

Remaining out of touch with technology

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27
Q

Pa-leng (China)

A

Fear of the cold; fear that the loss of body heat may be life-threatening

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28
Q

Age of onset of phobias

A

Vary widely

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29
Q

Causal theories for specific phobias

A 
Deep-seated psychodynamic conflicts (anxiety = defense mechanism)
Fear conditioning
Cognitive diathesis (predisposed to looking out for negative stimuli)
Evolutionary origins (biological perparedness)
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30
Q

Phobias according to psychoanalytic theory

A

Are a defense mechanism against the anxiety produced by repressed Id impulses
Anxiety is displaced from the feared Id impulse and moved to an object or situation that has some symbolic connection to it
The objects/situations become the phobic stimuli
Avoiding them = avoiding dealing with internal conflicts

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31
Q

What is psychoanalytic theory focusing on when treating phobias

A

The content of it; supposed to be symbolic

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32
Q

Phobias in behavioural model

A

result from fear conditioning (US + NS = CS)

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33
Q

Vicarious conditioning

A

Seeing someone’s phobia - getting that phobia

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34
Q

Factors influencing fear conditioning before, during and after

A

Before: genetic/temperamental factors, prior experiences (can immunize or weaken)
During: controllability - perceived
After: inflation effect

35
Q

Prepared stimuli

A

Some fears can be innate (ex: being afraid of snakes when you live in the country where you will be exposed to some)

36
Q

2 brain areas associated with negative emotional responses activated in phobias, PTSD, and SAD

A

Amygdala and insula

37
Q

Labile ANS

A

Labile ANS: peolpe who are labile, jumpy, readily aroused, importance in development of anxiety disorders
MAY be geneticall inherited

38
Q

Negative reinforcement in phobias

A

Behaviours followed by the termination of negative consequences will increase - avoidance behaviour is negatively reinforced and prevents extinction (increases phobia)

39
Q

Attentional bias in phobias

A

Scanning for the object/situation at all times, focused on the possible negative experience (increases phobia)

40
Q

Treatment for phobia - 3 types of exposure therapy

A

Exposure therapy (60-90% success)

  • in vivo (irl - high dropout rate and low acceptance)
  • systematic desnsitization (list + relax)
  • VR
  • Augmented Reality (VR+ real life)
41
Q

Psychoanalytic treatment of phobias

A

Improvement is not sign that the internal conflict has been resolved

42
Q

Treatment for blood-injection phobias

A

Tense, rather than relax, to avoid fainting

43
Q

Social Phobia (Social Anxiety Disorder)

A

Disabling fear of 1 or + discrete social situations in which a person fears that they may be exposed to the scrutiny and potential negative evaluation of others

44
Q

Symptoms of SAD

A
  • More concerned about evaluations
  • Highly aware of the image they present to others
  • High in public self-consciousness
  • Preoccupied with a need to seem perfect in front of others
  • Tend to view themselves negatively even when they perform well in social situations
  • Less certain about their positive self-views
  • See their positive attributes as being less important
45
Q

2 specifiers of SAD

A

Generalized (many situations) or non-generalized (specific)

46
Q

Generalized SAD

A

involve many situations
earlier age of onset
more severe impairment than specific phobia

47
Q

Prevalence - comorbidity of SAD

A 
12% lifetime prevalence
More females than males
Comorbid with MD, substance abuse, other AD, APD
Average age of onset is 13yo
Average duration is 20yrs
48
Q

People + at risk for SAD

A

Never married/divorced
Low SES
Lack social support
Report low quality of life, chronic physical condition

49
Q

Behavioural theory for SAD

A

Lack of social skills is the cause of the phobia
The person repeteadly commits faux pas since they never learned how to behave
Timing/placement of social responses are impaired

50
Q

Cognitive theories for SAD

A

How people’s thought processes can serve as a diathesis - how thoughts can maintain a phobia
Are + likely to: attend - stimuli, interpret ambiguous situations as threatening, believe that negative events are + likely than positive to occur

51
Q

Post-Event Processing (PEP) of negative social experiences

A

Form of rumination about previous experiences and responses to these situations, especially experiences involving other people that did not turn out well

52
Q

Taijin Kyofusho (TKS)

A

fear of doing something that will embarrass, offend, or bring shame to others
symptoms: fear of eye contact and blushing

53
Q

Treatment for SAD

A

Antidepressants
Understanding underlying causes
CBT (exposure to situations, cognitive techniques, video feedback, social skills training) - about 60% success, reduced relapse compared with meds

54
Q

Panic disorder definition

A

characterized by unexpected panic attacks that seem to come out of the blue

55
Q

Panic disorder criteria (3)

A
  1. Recurrent, unexpected panic attacks
  2. At least 1 attack followed by: persistent concern about other attacks, worry about consequences of the attack, significant behavioural change related to the attack
  3. Absence or presence of agoraphobia
56
Q

Agoraphobia

A

EITHER:

  1. anxiety about being in places/situations from which escape might be difficult or embarrassing, or where help may not be available
  2. situations are avoided, restricted or endured with distress or anxiety about having a panic attack, require the presence of a companion
57
Q

Agoraphobia

A

EITHER:

  1. anxiety about being in places/situations from which escape might be difficult or embarrassing, or where help may not be available
  2. situations are avoided, restricted or endured with distress or anxiety about having a panic attack, require the presence of a companion
58
Q

Typical agoraphobic fears

A

being outside the home alone, being in a crowd or standing in line, traveling by car, bus, or train, being on a bridge

59
Q

Prevalence of panic disorder

A

4.7% lifetime
50% have other diagnosis
80-90% report that 1st attack happened after a major negative life event
2x+ prevalent in women

60
Q

Panic Disorder among the Inuit of Northern Canada or West Greenland

A

Kayak-angst: Occurs among seal hunters that are alone at sea - involved intense fear, disorientation, and concerns about drowning

61
Q

Which region of the brain may be involved in phobic avoidance and anticipation

A

Hippocampus

62
Q

Which brain region with abnormal activity may start panic attacks

A

Amygdala

63
Q

Noradrenergic activity theory for panic disorder

A

Panic is caused by overactivity in the noradrenergic system
Stimulation of the locus ceruleus causes monkeys to have panic attacks - but drugs that block firing in this area are not effective to stop panic attacks
Yohimbine (drug stimulating the area) can cause panic attacks in humans

64
Q

Problem in GABA theory for Panic Disorder

A

GABA usually inhibits noradrenergic activity

People with PD have less GABA receptor binding sites

65
Q

Cognitive behavioural theories for Panic Disorder

A

Interoceptive conditioning (fearing fear)
Anxiety sensitivity and perceived control
Safety behaviours and maintenance of panic
Cognitive biases and maintenance of panic
Cognitive theory of panic

66
Q

Cognitive theory of panic

A

(see slide) something triggering is a perceived threat, apprehension about having a panic attack occurs, body sensations arrive, interpretation of sensations of catastrophy - is a perceived threat, circle goes on

67
Q

Anxiety sensitivity

A

being very sensitive/connected to your anxiety, constantly monitoring
risk factor for anxiety psychopathology
predicts the development of panic attacks

68
Q

Treatments for panic disorder

A

Medications (minor tranquilizers or antidepressants)
CBT: breathing techniques, progressive relaxation, cognitive techniques (target catastrophizing), exposure - 75-95% efficacy

69
Q

Generalized Anxiety Disorder

A

Chronic, excessive or unreasonable anxiety and worry about a number of events and daily activities
free-floating anxiety
difficult to control the worry
anxious apprehension

70
Q

Physical symptoms of GAD

A 
restelessness, being on edge
being easily fatigued
difficulty concentrating, mind going blank
irritability
muscle tension
sleep disturbance
71
Q

Prevalence of GAD

A 
5.7% lifetime
gradual onset
2x+ common in women
don't typically seek treatment
begins in mid-teens
high comorbidity with anxiety/mood disorders
difficult to treat
72
Q

Psychosocial factors influencing GAD

A 
Psychodynamic: defense mechanisms are not workin
uncontrollable events (hypervigilance)
Cognitive biases (attentional bias, negative interpretation)
vicious circle
73
Q

Benefits of worry according to GAD patients

A 
Superstitious avoidance of catastrophe
actual avoidance of catastrophe
avoidance of deeper emotional topics
coping and preparation
motivating device
74
Q

Worry and aversive images

A

Worry reduced the reaction to aversive images

75
Q

Biological factors for GAD

A

Mild-modest heritability (neuroticism trait)
GABA deficiency - based on the fact that benzos are effective for treating it - increase the release of GABA
GABA inhibitors increase anxiety

76
Q

Treatments of GAD

A

Anxiolytics (benzos, buspirone)
Antidepressants
CBT: worry outcome monitoring, identifying/targeting core fears, response prevention (avoidance), mindfulness
Psychodynamic: understand underlying conflicts, work through the origins of the defense

77
Q

Selective mutism

A

Failure to speak in one situation (usually school) when able to speak in other situations (usually home)

78
Q

SAD specifier in DSM-5

A

Now a “performance only” specifier can be added, but the generalized vs specific is not there anymore

79
Q

What is the “widening the bandwidth” technique to get rid of SAD?

A

doing acts that people with SAD deem inappropriate, and notice the lack of reaction in others - goal is to come to the conclusion that they can widen the scope of their actions without negative feedback

80
Q

Depersonalization and derealization in panic disorder/agoraphobia

A

Depersonalization: feeling of being outside one’s body

Derealization: feeling of the world’s not being real, fears of losing control, going crazy, dying, etc

81
Q

CBGT Cognitive-Behavioural Group Therapy

A

combination of cognitive restructuring and situational exposure typically delivered in a group of 6-8 clients

82
Q

Panic-control therapy

A

3 components
Relaxation training
Combination of Ellis and Beck type interventions (CBT)
Exposure to internal cues that trigger panic (interoceptive exposure)
Practicing behaviours that elicit panic in a safe setting to learn how to respond to them - reduces unpredictability

83
Q

Types of Mindfulness used in treatment

A

Decentering: being able to view thoughts and emotions objectively, without engaging with them (central to GAD therapy)
Lovingkindness: type of mindful meditation useful in the treatment of SAD, where people focus on being kind towards themselves and extending that kindness onto others

84
Q

DCS: d-cycloserine

A

medication that could enhance exposure-based treatment by facilitating extinction of fear
Administered close to an exposure (1-2hrs)
Caveat: if the exposure does not go well the drug could enhance the fear memory - making the phobia worse

PSYC340 (14 decks)

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