Chapter 5: Anxiety, Trauma- and Stressor-Related Disorders Flashcards
Anxiety
future oriented negative mood/state that is focused on apprehension about the future; focused on somatic and autonomic tension (muscles, heart beat, etc)
Fear
an immediate alarm response to a specific stimulus, focused on sympathetic nervous system
Yerkes-Dodson Law
medium anxiety/fear (arousal in general) allow for the optimal performance, but that medium is different for different people
Panic
an overwhelming fear response that is unreasonable considering the stimulus/situation
Panic Attack
an intense sense of discomfort accompanied by a physiological response; usually lasts under 15 minutes, and includes depersonalisation and derealisation; important indicator about anxiety across one’s lifespan
Expected vs Unexpected
unexpected panic attacks are unprompted, while expected ones have a known stimulus that triggers them
CFS
corticotropin releasing factor system; activates the HTPAC, and is most associated with anxiety; can activate a large network and serves as the mediator between the brainstem and the cortex
BIS
behavioural inhibition system; activated by signals from the brainstem regarding unexpected events, and works with the amygdala; danger signals can also travel down and to the BIS from the cortex; causes freezing or anxiousness if danger can be confirmed
Grey and Graeff’s FFS
fight or flight system; originates in the brain stem, goes to the amygdala, and hypothalamus before reaching the central grey matter; when stimulated in animals it creates this exact response; serotonin deficiencies could potentially activate this system
Anxiety Sensitivity
the general tendency to fear interoceptive sensations or respond fearfully to anxiety systems
Top-down and Bottom Up Processing for Anxiety
the limbic system is overly responsive to new information, and the cortex’s down regulation of this overstimulation isn’t working
Fear vs Anxiety
fear usually arises from a true alarm, or a potential alarm and a mislabelling, and therefore bypasses anxiety in that aspect; also, images can travel straight to the amygdala, and while that wouldn’t cause someone who is anxious to feel more anxious, it would heighten fear
Triple Vulnerability Theory of Anxiety
- Generalised biological vulnerability (having specific, related genes, your parents having the condition, being more likely to gamble because of your brain chemistry, etc.
- Generalised psychological vulnerability (a generalised belief that the world is a bad place, uncontrollable, unsafe, etc)
- Specific psychological vulnerability (heard parents say this, religious upbringing, etc)
Process-Based Therapy
for therapy to be the most effective, it must target the underlying process of change rather than the DSM-5’s list of signs
Unified vs Singular Protocols
addresses the issues of the disorder and are equally as effective, but singular focuses on one disorder in particular while unified focuses on more than one (related) disorders
GAD
generalised anxiety disorder; characterised by more than 6 months of excessive worrying about upcoming (daily) events and little to no control over this process; must have 3+ symptoms
1. age of onset ~31, but most claim to have had it all of their lives
2. chronic, waxes and wanes
3. more common in women
4. anxiety sensitivity (gbv)
5. autonomic inflexibility/autonomic restrictor: heart doesn’t “race” from what it should
6. mental images help because the cognitions (worries) are often without clear images of the actual event and realistic outcome
7. CBT or Zoloft (SSRI)
Panic Disorder
experiencing severe, unexpected panic attack(s), accompanied by the anxiety of having another panic attack; don’t have to have avoidance behaviour, but 6+ months
1. median age of onset is 20-24
2. more women
3. 4.7% for prevalence
4. most happen between 1:30-3:30 AM
5. strongly related to psych factor of “internal stimulus is generally dangerous”
6. SSRI, Benzos, and SNRI; if using the drugs, relapse is highly likely
7. Gradual Exposure and PCT (panic control treatment) seem to work better
8. Interoceptive avoidance or external cue avoidance
Agoraphobia
avoidance and fear of situations where a person feels as though they can’t escape to their house or the hospital in the event of a medical emergency (can include panic attacks) +6 months
1. 2/5 situations that a person avoids (closed rooms, open rooms, public areas like malls, transportation, etc)
2. agora = marketplace
3. women mostly
4. strongly related to cultural and social factors
5. interoceptive avoidance or external cue avoidance
Specific Phobia (4)
fear of a specific object or situation that interferes with daily ability to function; must go to considerable lengths to avoid the stimuli that is not in proportion to the danger that it poses, must be specific and 6+ months
1. Blood Injection Injury ** special because genetic influence
2. Situational
3. Animal
4. Natural
5. Other
6. age of onset ~7, very early
7. mostly female
8. exposure-based therapy = increasing cognitions and decreasing immediate alarm response
9. fear hierarchy
SAD
social anxiety disorder; severe suffering caused by social/performance situations; 6+ months
1. performance only is a subset
2. age of onset 13
3. sex ratio is nearly 1:1
4. prevalence is highly socially related
5. Shinkeshitsu!
6. amygdala is activated more so than others
7. behavioural inhibition is a sign anxiety will naturally be higher
8. maintenance behaviours are the main problem
9. SSRIs, CBT, and DCS with mixed results
Behavioural Inhibiton
the tendency to withdraw from new stimuli and to be afraid of them
