Chapter 5 - Anxiety Disorders Flashcards
Anxiety
Future-oriented mood state characterized by marked negative effect
- includes somatic symptoms of tension
- exhibited through behaviours, feelings and thoughts
Fear
Present-oriented mood state characterized by marked negative effect
- involves abrupt activation of the sympathetic nervous system
- Fight or flight response
Anxiety Disorders
- Characterised by pervasive and persistent symptoms of anxiety and fear.
- Involve excessive tendency to avoid/escape
- Anxiety symptoms and avoidance cause clinically significant stress and impairment
Panic Attack
Abrupt experience of intense fear or discomfort and the presence of 4+ symptoms, reaching peak w/in 10 min.
Symptoms of a Panic Attack
- Palpitations
- Sweating
- Trembling/sweating
- Shortness of breath/feeling smothered
- Feelings of choking
- Chest pain
- Dizzy, lightheaded
- Chills/hot flashes
- Nausea
- Derealisation
- Fear of dying
What are the subtypes of panic attacks? (DSM-IV)
Situationally bound
Unexpected
Situationally predisposed
What is the diathesis-stress model for anxiety disorders?
- Inherited vulnerability for anxiety and pain
- Stress and life circumstances activate the vulnerability
What are the biological contributions to anxiety disorders?
- GABA, noradrenergic and serotonergic systems
- Corticotropin releasing factor (CRF) and HPA axis
- Limbic and septal-hippocampal systems
- Behavioural inhibition system (BIS)
- Fight-flight system
What was Freud’s perspective on anxiety?
- Saw it as a psychic reaction to danger
- Involved the reactivation of an infantile fear situation
What is the behaviouristic perspective on anxiety?
- anxiety and fear result from direct classical and operant conditioning and modelling
What is the psychological perspective on anxiety?
- Caused by early experiences with uncontrollability and unpredictability
What is the social perspective on anxiety?
- Biological and psychological vulnerabilities are triggered by stressful life events
- Many stressors are familial and interpersonal
What is the integrated perspective on anxiety?
- Diathesis-stress model: Biological vulnerability interacts with psychological, experiential and social variables to produce an anxiety disorder
What is the most common secondary comorbid diagnosis with anxiety?
Major depression
What does the high rate of comorbidity in anxiety suggest?
- common factors across the different anxiety disorders
- relation between anxiety and depression
What are the types of Anxiety Disorders? (DSM 5)
- Generalized anxiety disorder
- Specific phobias
- Panic disorder with or without agoraphobia
- Social phobia
- Separation anxiety disorder
What are the diagnostic criteria for Panic Disorder?
- At least one unexpected panic attack AND
2. Anxiety/worry/fear about having another attack and its implications. Last for more than a month
What percentage of the population has had panic disorder?
3.5% w/ 2/3’s being women
At what age does Panic Disorder typically manifest?
Between 25-29 years of age
What medical treatment options are used for PD?
- Meds that target serotonergic, noradrenergic and GABA systems
- SSRI’s= preferred drug
What psychological/combined treatments are most effective?
Best long term outcome is through CBT
What is a Specific Phobia?
- Extreme/irrational fear of specific object/situation
- Exposure leads to anxiety response
- Recognizes fear is irrational
- Avoidance or intense distress
- Interferes with daily function
- Last 6+ months
How are Specific Phobias represented across the general population?
- 11% meet the criteria for SP
- More women than men
- Tends to be chronic, starts between 15-20 years of age
What are the subtypes of Specific Phobias?
- Blood/injury/injection
- Situational
- Natural environment
- Animal
- Illness
- Other
What are some potential contributing factors to Specific Phobias?
- Biological vulnerability
- Direct conditioning
- Observational learning
- Equipotentiality vs. nonassociative models
- Disgust sensitivity
