Chapter 5- Anxiety, OCD, Trauma, & Stress

Question 1

Fear

Answer 1

Emotional response to danger or a perceived threat

Question 2

Anxiety

Answer 2

Apprehension, tension, or dread

Question 3

Panic attacks

Answer 3

Short, intense periods of acute anxiety. 28% of adults have experienced. Isolated

Question 4

Panic disorder

Answer 4

Problematic panic attacks that are unprovoked. Comorbid with GAD, depression and alcohol abuse. 3-5% develop panic disorder, usually between late adolescence and adulthood

Question 5

Biological theory of panic disorder

Answer 5

• Heritability of 43-48%
  
  • Unknown specific genes
  • Dysregulated fight-or-flight
    
    • Poor regulation of key neurotransmitters
    • Increased activation of limbic system

Question 6

Biological theory of panic disorder

Answer 6

• Interoceptive awareness
  
  • Heightened awareness of bodily cues
• Anxiety sensitivity
  
  • Negative attribution bias of bodily symptoms
• Integrated

Question 7

Treatment for panic disorder

Answer 7

• Medication
  
  • SSRI’s
  • Serotonin-norepinephrine reuptake inhibitors
  • Tricyclic antidepressants
  • Benzo’s
• CBT
  
  • Strategies to identify and change thought patterns
    
    • Relaxation techniques
    • Thought identification
    • Desensitization
  • Sometime CBT is as effective as medication
    
    • Implications for relapse

Question 8

Separation anxiety

Answer 8

• Fear of separation
• Avoidance of situations where separation may occur
• Developmentally inappropriate

Question 9

Biological theories of separation anxiety

Answer 9

• Genetic influences
  
  • Family history of anxiety/depression
  • Heritability of 70%
• Behavioural inhibition
  
  • Shy, fearful, cautious tendencies
  • Risk factor across anxiety disorders

Question 10

Psychological and sociocultural theories of separation anxiety

Answer 10

• Parenting influences
  
  • Control
  • Communication
  • Social modelling
  • Parental traits
• Environmental influences
  
  • Situational conditions
  • Traumatic events

Question 11

Treatments for separation anxiety

Answer 11

• Medications
  
  • Antidepressants
  • Anti anxiety meds
• CBT
  
  • Coping strategies
  • Desensitization

Question 12

Selective mutism

Answer 12

1. Failure to speak in social situations
2. Links between mutism and anxiety
3. Stats in early childhood
4. Age of onset 2.7-4.6 years
5. Relatively rare

Question 13

GAD

Answer 13

• Non-specific
• Uncontrollable
• Pervasive across situations
• Comorbid with depression
• 7.7% in women
• 4.6% in men
• Increasing globally

Question 14

Emotional and cognitive theories of Gad

Answer 14

• Negativity bias
• Highly reactive
• Hard to regulate
• Cognitive factors
  
  • Problematic assumptions
  • Bias towards threat detection
  • Hyper vigilance
    
    • Coping mechanism?

Question 15

Biological theories of GAD

Answer 15

• Activity in limbic system
  
  • Amygdala reactivity
  • Decreased connectivity between amygdala and prefrontal cortex
  • Possible GABA deficiencies
• Genetics
  
  • Trait anxiety
  • Relatively heritable
  • Increases risk for developing GAD

Question 16

Treatments for GAD

Answer 16

• Medications
  
  • Antidepressants
  • Anti anxiety meds
• CBT
  
  • Coping strategies
  • Desensitization

Question 17

Social anxiety disorder

Answer 17

• Most common anxiety disorder
  
  • 12% lifetime prevalence in US
  • 1-7% internationally
• Features
  
  • Avoidance of public situations
  • Conscious of performance and evaluations of other

Question 18

Biological theories of social anxiety disorder

Answer 18

Trait anxiety

Question 19

Cognitive theories of social anxiety disorder

Answer 19

• High standards
• Negative bias
• Hyper vigilance
• Self-critical

Question 20

Treatment for social anxiety disorder

Answer 20

• Medications
  
  • SSRIs
  • SNRIs
  • Benzo’s
• CBT
  
  • Exposure therapy
  • Challenging negative thought patterns

Question 21

Phobias

Answer 21

• Irrational fear of objects and situations
• Typically develop during childhood
  
  • Can persist across lifespan
• Common disorder
  
  • 8% of US populations

Question 22

Categories of phobias

Answer 22

• Animal
• Natural environment
• Situational
• Blood/injection/injury
• Other

Question 23

Behavioural theories of phobias

Answer 23

• Behavioural
  
  • Two factor theory
    
    • Classical conditioning
      
      • leads to fear
    • Operant conditioning
      
      • Maintains the fear
  • Avoidance
    
    • reinforcement of fear

Question 24

Genetic theories of phobias

Answer 24

Genetic risk

Question 25

Treatment of phobias

Answer 25

• Exposure therapy
• Desensitization
• Blood/injection/injury
  
  • Applied tension technique
    
    • Increase blood pressure and heart rate
    • Desensitization

Question 26

Obsessions

Answer 26

Persistent thoughts, images, ideas or urges

Question 27

Compulsions

Answer 27

Repetitive behaviours or mental acts to reduce anxiety or distress

Question 28

Types of OCD

Answer 28

• Hoarding
• Trichotillomania
• Excoriation
• Body dysmorphic disorder

Question 29

Biological theories of OCD

Answer 29

• Genetic risk
• Dysfunction between frontal cortex, basal ganglia, thalamus, anterior cingulate cortex
  
  • Differences in structure and activity levels of associated ideas

Question 30

Cognitive theories of OCD

Answer 30

• Negative & intrusive thought patterns
• Depressive & anxious tendencies can promote negative thought patterns
• Rigidity in thought processes
• Thought to develop through operant conditioning

Question 31

Treatment of OCD

Answer 31

• Medicine
  
  • SSRI’s
• CBT
  
  • Exposure and response prevention
    
    • Repeated exposure to triggering events
    • Coaching to not engage with compulsions
    • Better than meds

Question 32

Trichotillomania

Question 33

Excoriation

Question 34

Interoceptive awareness

Question 35

Separation anxiety disorder

Question 36

Prolonged greif disorder

Question 37

Locus coeruleus