Chapter 5 Anxiety, Trauma- and Stress-Related, and Obsessive-Compulsive and Related Disorders Flashcards
1
Q
Anxiety
A
- a negative mood state characterized by bodily symptoms of physical tension and by apprehension about the future
- In humans it can be a subjective sense of unease, a set of behaviors (looking worried and anxious or fidgeting), or a physiological response originating in the brain and reflected in elevated heart rate and muscle tension
- Difficult to study in humans- research has been done with animals
- Is also closely related to depression
- Is good for us, at least in moderate amounts
- We perform better when we are a little anxious
- Social, physical, and intellectual performances are driven and enhanced by anxiety - Howard Liddell (1949)
- Anxiety- “shadow of intelligence”
- Human ability to plan in some detail for the future was connected to that gnawing feeling that things could go wrong and we had better be prepared for them.
- Anxiety is a future-oriented mood state - Too much of a good thing can be harmful, and few sensations are more harmful than severe anxiety that is out of control.
- Severe anxiety usually doesn’t go away- that is, even if we “know” there is nothing to be afraid of, we remain anxious.
- John Madden
- The retired sports announcer and former professional football coach, who suffers from claustrophobia
- Cannot travel by air - future-oriented mood state, characterized by apprehension because we cannot predict or control upcoming events.
2
Q
Fear
A
- Immediate alarm reaction to danger
- Can be good for us
- Protects us by activating a massive response from the autonomic nervous system (increased heart rate and blood pressure), which, along with our subjective sense of terror, motivates us to escape (flee) or, possibly, to attack (fight)
- Emergency reaction- flight or fight response
- an immediate emotional reaction to current danger characterized by strong escapist action tendencies and a surge in the sympathetic branch of the autonomic nervous system
3
Q
Panic
A
- sudden overwhelming reaction
- conditioning and cognitive explanations
- Strong fear during extreme stress or as a result of dangerous situation in the environment (a true alarm) -> becomes associated with a variety of external and internal cues
- External cues- places or situations
- Internal cues- increases in heart rate or respiration
- May not be aware of the cues or triggers of severe fear -unconscious
- These cues or triggers may travel from the eyes directly to the amygdala in the emotional brain without going through the cortex, the source of awareness
4
Q
Panic attack
A
an abrupt experience of intense fear or acute discomfort, accompanied by physical symptoms that usually include heart palpitations, chest pain, shortness of breath, and, possibly, dizziness
5
Q
Expected (cued) panic attack
A
- have a panic attack in these situations but not anywhere
- Specific phobias or social phobia
6
Q
Unexpected (uncued) panic attacks
A
- if you don’t have a clue when or where the next attack will occur
- Panic disorder
7
Q
Behavioral inhibition system (BIS)
A
- is activated by signals from th brain stem of unexpected events
- Danger signals might be threatening descend from the cortex to the septal-hippocampal system
- From amygdala
- Is activated by signals that arise from the brain stem or descend from the cortex -> freeze, experience anxiety, apprehensively evaluate the situation to confirm that danger is present
- Is distinct from the circuit involved in panic
- Brain circuit in the limbic system that responds to threat signals by inhibiting activity and causing anxiety.
8
Q
Fight/flight system (FFS)
A
- originates in the brain stem and travels through several midbrain structures, including the amygdala, the ventro medial nucleus of the hypothalamus, and the central gray matter
- Produces an immediate alarm-and-escape response that looks very much like panic in humans
- Is activated partly by deficiencies in serotonin
9
Q
A theory of the development of anxiety- triple vulnerability theory
A
- Generalized biological vulnerability: tendency to be uptight or high-strung might be inherited
- Generalized psychological vulnerability: grow up believing the world is dangerous and out of control and you might not be able to cope when things go wrong based on your early experiences
- Specific psychological vulnerability: you learn from early experience, that some situations or objects are fraught with danger
10
Q
Anxiety disorders
A
generalized anxiety disorder, panic disorder, agoraphobia, specific phobia, social anxiety disorder, separation anxiety disorder and selective mutism
11
Q
Generalized anxiety disorder (GAD)
A
- worry indiscriminately about everything
- Worrying is unproductive
- Can’t seem to decide what to do about an upcoming problem or situation
- Can’t stop worrying, even if you know it is doing you no good and probably making everyone else around you miserable
12
Q
Panic disorder (PD)
A
individuals experience severe, unexpected panic attacks; they may think they’re dying or otherwise losing control
13
Q
Agoraphobia
A
- Fear and avoidance of situations in which a person feels unsafe or unable to escape to get home or to a hospital in the event of a developing panic symptoms or other physical symptoms, such as loss of bladder control
- They never know when these symptoms might occur- unable to leave the house
- Anxiety about being in places or situations from which escape might be difficult.
14
Q
Nocturnal Panic
A
- Panic attacks occur more often between 1:30 A.M. and 3:30 A.M. than any other time.
- In some cases, people are afraid to go to sleep at night.
- Occur during delta wave or slow wave sleep, which typically occurs several hourse after we fall asleep and is the deepest stage of sleep.
- People with panic disorder often begin to panic when they start sinking into delta sleep, and then they awaken amid an attack.
- Most of these individuals think they are dying
- The change in stages of sleep to slow wave sleep produces physical sensations of “letting go” that are frightening to an individual with panic disorder
15
Q
Isolated sleep paralysis
A
- Occurs during the transitional state between sleep and walking, when a person is either falling asleep or waking up, but mostly when waking up
- The individual is unable to move and experiences a surge of terror that resembles a panic attack; occasionally, there are also vivid hallucinations
- REM sleep is spilling over into the waking cycle
16
Q
Panic control treatment (PCT)
A
- exposing patients with panic disorder to the cluster of interoceptive (physical) sensations that remind them of their panic attacks
- Create “mini” panic attacks
- Cognitive-behavioral treatment for panic attacks, involving gradual exposure to feared somatic sensations and modification of perceptions and attitudes about them.
17
Q
Specific phobia
A
- an irrational fear of a specific object or situation that markedly interferes with an individual’s ability to function.
- a nuisance-sometimes an extremely inconvenient nuisance- but people can adapt to life with a phobia by simply working around it somehow.
18
Q
Four major subtypes of specific phobia
A
- blood-injection-injury type
- situational type
- natural environment type
- animal type.
19
Q
Blood-injection-injury phobias
A
- Always differ in their physiological reaction from people with other types of phobia.
- Runs in families more strongly than any phobic disorder we know
- Inherit a strong vasovagal response to blood, injury, or the possibility of an injection- cause a drop in blood pressure and a tendency to faint
- The average age of onset for this phobia is approximately 9 years.
20
Q
Situational phobias
A
- fear of public transportation or enclosed places
- Claustrophobia: a fear of small enclosed places
- As well as panic disorder and agoraphobia, tends to emerge from mid-teens to mid-20s
- The extent to which PD, agoraphobia, and situational phobias run in families is also similar, with approximately 30% of first-degree relations having the same or a similar phobia
- The main difference between situational phobia and panic disorder- people with situational phobia never experience panic attacks outside the context of their phobic object or situation.
- Can relax when they don’t have to confront their phobic situation
21
Q
Natural environment phobias
A
- sometimes very young people develop fears of situations or events occurring in nature
- If you fear one situation or event, such as deep water, you are likely to fear another, such as storms.
- Many of these situations have some danger associated with them and, therefore, mild to moderate fear can be adaptive.
- Something in our genes makes us sensitive to these situations if any sign of danger is present. - Have a peak age of onset of about 7 years.
- They have to be persistent (lasting at least six months) and to interfere substantially with the person’s functioning, leading to avoidance
22
Q
Animal phobias
A
- fears of animals and insects
- Common but become phobic only if severe interference with functioning occurs
- The age of onset, peaks around 7 years
- Unreasonable, enduring fear of animals or insects that usually develops early in life.
23
Q
Separation Anxiety Disorder
A
- Excessive enduring fear in some children that harm will come to them or their parents while they are apart.
- Is characterized by children’s unrealistic and persistent worry that something will happen to their parents or other important people in their life or that something will to the children themselves that will separate them from their parents
24
Q
Social anxiety disorder (SAD) or Social phobia
A
- Extreme, enduring, irrational fear and avoidance of social or performance situations.
25
Q
Selective Mutism
A
- A rare childhood disorder characterized by a lack of speech in one or more settings in which speaking is socially expected.
- Driven by social anxiety
26
Q
Posttraumatic Stress Disorder (PTSD)
A
Enduring, distressing emotional disorder that follows exposure to a severe helplessness or fear inducing threat. The victim re-experiences the trauma, avoids stimuli associated with it, and develops a numbing of responsiveness and an increased vigilance and arousal.
