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PSYC-3700 Abnormal Behavior in Adults > Chapter 5: Anxiety, Trauma-Related, and Obsessive Compulsive Disorders > Flashcards

Chapter 5: Anxiety, Trauma-Related, and Obsessive Compulsive Disorders Flashcards

1
Q

Anxiety

A

a negative mood state characterized by

  • bodily symptoms of physical tension (HR, fidgeting, muscle tension)
  • apprehension about the future
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2
Q

Why might anziety be beneficial sometimes

A

in short, physicial and intellectual performances are driven and enhanced by anxiety, wihtout it very few of us would get anythnig done.

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3
Q

An immediate alarm reaction/feeling to dangerous or life-threatening situations

A

fear

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4
Q

Panic attack

A

an abrupt experience of intense fear or acute discomfort accompanied by physical symptoms such as Heart palpitations, chest pain, shortness of breath, and dizziness.

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5
Q

panic attacks can be ___ or ___

A

expected (CUED) or unexpected (uncued)

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6
Q

Rates of comorbidity among anxiety and related disorders such as ______ are high.

A

Depression. Anxiety disorders also co-occur with several physical conditions.

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7
Q

Having any anxiety or related disorders uniquly increases the chances of having thoughts about suicide or making suicidal attempts. What are these thoughts most strongly correlated with?

A

the relationship between suicidal ideation and suicide attempts is STRONGEST with panic disorder and PTSD

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8
Q

Main difference between anxiety and fear

A

Anxiety is a future-oriented mood state, characterized by apprehension because we cannot predict or control upcoming events

fear is Current-situation oriented. It is an immediate emotional response which is characterized by strong escapist action tendencies and often a surge in sympathetic branch of the autonomic nervous system.

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9
Q

If you know you are afraid of high places, you might have a ___ panic attack in such a situation, but not anywhere else

A

a cued panic attack; you can predict what situations MAY trigger a PA

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10
Q

If you have no clue when or where the next attack will occur, it may be considered an ____ panic attack

A

uncued/unexpected panic attack.

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11
Q

___ attacks are more common in panic disorder, and __- attacks are more common in specific phobias or social anxiety disorder.

A

UNEXPECTED attacks are more common in panic disorder, and EXPECTED attacks are more common in specific phobias or social anxiety disorder.

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12
Q

fear is an intense emotional alarm accompanied by a surge of energy in the ___ nervous system that motivates us to flee from danger.

A

fear is an intense emotional alarm accompanied by a surge of energy in the AUTONOMIC nervous system that motivates us to flee from danger.

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13
Q

Biological contributions for anxiety and panic . What two systems are involved

A

suggests that people inherit the tendency to be anxious or highly emotional. Involves the Behavioural Inhibition System and Fight and Flight System.

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14
Q

Outline the behavioural inhibition system

A

brain circuit in the limbic system activated by the brain stem in response to UNEXPECTED Events.

the limbic system projects up from the septal-hippocampus region to the frontal cortex

BIS can be activated by signals that arise from the brain stem or descend from the cortex (EX/ FUTURISTIC THINKING). Our tendency is to freeze, experience anxiety, and apprehensively evaluate the situation to confirm that danger is present.

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15
Q

Outline the fight/flight system

A

associated with panic; circuit originating in the brain stem and travelling through several structures, including amygdala.

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16
Q

depleted levels of ____ are associated with increased anxiety

A

depleted GABA

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17
Q

in addition to 5HT, GABA, and NE, what other factor may contribute to panic and anxiety?

A

CRF: corticotropin releasing factor.

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18
Q

CRF activates the ___ ____ ___ axis, which ultimately affects the ___ system; particularly the __- and ___.

A

CRF activates the HYPOTHALAMIC-PITUITARY-ADRENOCORTICAL axis, which ultimately affects the LIMBIC system; particularly the HIPPOCAMPUS and AMYGDALA.

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19
Q

Why is CRF so important in the study of biological considerations of anxiety

A

CRF can affect the dopaminergic neurotransmitter system, GABA-benzodiazepine system, and the 5HT and NEE systems.

CRF essentially can affect the whole brain and the regions primarily involved in anxiety and panic

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20
Q

the area of the brain most often associated with anxiety is the ___ system, how?

A

limbic

the more primitive brainstem regions monitors and senses changes in bodily functions and relays these potential danger signals to highly cortical processes through the limbic system.

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21
Q

BIS system is assoicated with ___, where sa FFS system is associated with ___

A

BIS system is assoicated with ANXIETY, where AS FFS system is associated with PANIC

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22
Q

the FFS system originates in the ___ ___ and travels through the amygdala, ___ nucleus of the hypothalamus, and the central gray matter.

A

the FFS system originates in the BRAIN STEM and travels through the amygdala, VENTOMEDIAL nucleus of the hypothalamus, and the central gray matter.

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23
Q

The BIS system is associated with CRF, NE, and 5HT pathways. Some authors think that the FFS is activated partly by deficiencies in ___

A

serotonin.

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24
Q

when the FFS system is stimlated in animals, this circuit that origniates in the brain stem and passes throguh ventromedial hypothalamus and central grey matter produces an immediate ___ and ___ repsonse

A

alarm and escape response.

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25
Q

examine the causes and the relationship between smoking and anxiety

A

teens who smoked 20+ cigarrettes daily were 15 times as likely to develop panic disorders, and 5x more likely to develop anxiety disorders.

  • the link between smoking and anxiety is that anxiety sensitivity, distress tolerance, and anhedonia all contribute to smoking. This could be one reason that so many people with anxiety find it very difficult to quit smoking.
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26
Q

explain the neurobiology/physiology that is associated with anxiety

A
  • brain images show that amygdala is overly repsonsive to stimulation or new information. There is ABNORMAL BOTTOM UP PROCESSING
  • at the same time, the frontal cortex/ reasoning regions of the brain are DOWN REGULATED and cannot “calm down” the hyperexcitable amygdala.
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27
Q

Psychological contributions for anxiety and panic originated with ____, who saw anxiety as a psychic reaction to danger surrounding the reactivation of an infantile fear situation.

A

Freud

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28
Q

behaviourists view anxiety as a product of ___ conditioning, ____ reinforcement or _____

A

behaviourists view anxiety as a product of CLASSICAL conditioning, NEGATIVE reinforcement or MODELLING.

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29
Q

explain how parenting styles contribute to anxiety vulnerability later in life

A
  • cultivating a sense of control is important to prevent anxiety as an adult.
  • parents who interact in a positive way with their children by responding to their needs, particularly when the child communicates need for attention, food, relief from pain etc, these parents teach their children that they have contorl over their environments and their responses have an effect on their parents and their environments.
  • parents who provide a secure home base BUT allow their children to explore their world adn develop the necessary skills to cope with unexpected occurrences enable their children to develop a healthy sense of control.
  • parents who are overprotective and overintrusice and who clear the way for their children, never letting them experience any adversity, may facilitate anxiety in older kids because these children don’t learn that they can control their environment too.
30
Q

external cues to anxiety

A

places of situations similar to the one where the initial panic attack accured

31
Q

internal cue

A

increases in Hr or resp rate that were associated with the original panic attack.

these cues are related to classical conditions. You asociate cutes with panic

32
Q

social contributions to anxiety and related disorders

A

Focus on the relation between stressful life evets as triggers for biological and psych vulnerabilities to anxiety and panic

33
Q

An integrated model of etiological risk factors that considers the complex interaction among biological, psychological, experiential, and social variables

A

triple vulnerability model

34
Q

three vulnerabilities of the TVM

A

1) generalized biological vulnerability: heritable contribution to negative affect.
2) generalized psychological vulnerability: perceptions to situations may predispose someone to anxiety. Ex/ tendency to lack self confidence, low self esteem, poor coping skills.
3) SPECIFIC psychological vulnerability: things you learn from early experience ex/ being afraid of dogs, hypochondriac?

35
Q

Explain the two factor conditioning theory behavioural model to anxiety. What two types of conditioning are used?

A

Two-Factor Conditioning Theory–

1) Classical conditioning research helps explain how panic-prone people associate anxiety with certain cues in their environment (objects, people, places, etc.)
•J.B. Watson’s Little Albert experiment
•Respondent Stimulus generalization research demonstrates how a fearful event can later become a fear of similar events.

2) Operant conditioning (especially negative reinforcement) can help maintain a developed and generalized phobia.
•Negative reinforcement (Escape and Avoidance conditioning) lead to maintaining the fear
•No exposure to the feared stimuli = no chance for extinction of the fear.

36
Q

Anxiety disorders are marked by distressing, persistent ___ and ___ behaviors that reduce anxiety.

A

Anxiety disorders are marked by distressing, persistent ANXIETY and MALADAPTIVE behaviors that reduce anxiety.

37
Q

iin addition to high comorbidity between anxiety and depression, what other physicial disorders are comorbid with anxiety?

A
  • panic attacks often co-occur with thyroid conditions, respiratory disease, cardiovasular disease, Gi and vestibular ear disease.
38
Q

T/F person with panic disorder is just as likely to commit suicide as someone with clinical depression

A

true. 20% of patients with panic disorders had attempted suicide.

all anxiety disorders are associated with suicide attempts with intent to die. Suicidal ideation and attempts are common, but more common in those who inflict self-harm

39
Q

Anxiety ___ physical disorders

A

precedes.

40
Q

an anxiety characterized by intense unfocused anxiety

A

generalized anxiety disorder.

41
Q

Generalized anxiety disorder clinical description

A

-Uncontrollable, unproductive worrying about everyday events
•Feeling impending catastrophe even after successes
•INABILITY to stop the worry-anxiety cycle

42
Q

whereas panic is associated with ___ arousal, GAD is characterized by ___ ___ and ___ ____

A

whereas panic is associated with AUTONOMIC arousal, GAD is characterized byMUSCLE TENSION and MENTAL AGITATION.

43
Q

In order to meet the criteria for GAD, DSM5 specifies that excessive worrying and apprenhensive expectation must be ongoing for at least:

A

6 months. It must also be difficult to turn off or control the worry process; GAD and pathological worry must be different than normal worry.

44
Q

GAD is more common in older or younger people?

A

older adults over 45

45
Q

It seems that aspects of GAD are genetic, in particular, the trait of ___ ___ is heritable and causes the tendency to become distressed in response to arousal-related sensations

A

anxiety sensitivity is seen to be inherited.

46
Q

T/F People with GAD are less physiologically responsive than others with more panic-based anxiety disorders

A

true. People with other panic disorders get anxious and panic in response to increased heart rate. But individuals with GAD show less responsiveness on physiological measures.

47
Q

Although people with GAD are less responsive to heart rate changes, what physical measure is seen to be upregulated in people with GAD?

A

they are always tense. They have chronic muscle tension.

48
Q

4 main cognitive characteristics of GAF

A

1) intolerance to uncertainty
2) positive beliefs about worry
3) poor problem orientations: ex/ problems are to be avoided rather than see them as challenges to be met
4) cognitive avoidance: worry may serve an avoidance function. The avoidance means that they are never able to work throguh their problems and arrive at solutions.

49
Q

Drug treatments for GAD

A

typically benzodiazepine drug treatment. The effectiveness of this treatment long term has not been empirically supported.
- usually used for SHORT TERM RELIEF

  • sometimes antidepressants
50
Q

Psych treatements for GAD tend to focus on:

- what treatments are there?

A

focus on the worry process and avoidance of feelings of anxiety and negative affect, and seem to work about as well as drugs

1) CBT: pts evoke the worry process during therapy sessions and confront threatening images and thoughts head-on; pts learn to use cognitive therapy and other coping techniques to counteract and control the worry process.
2) Mindfulness-based therapies

51
Q

agoraphobia:

A

fear and avoidance of situations in which a person feels unsafe or unable to escape to get home or to a hostpial in the event of developing panic symptoms or other physical symptoms, such as loss of bladder control.

52
Q

Panic Disorder

A

anxiety about the possibility of another attack or the implications of the attack.
–Sensation of dying or of losing control
–Racing heartbeat, rapid breathing, dizziness, nausea, or sensation of heart attack or imminent death

53
Q

Agoraphobic situations provoke fear and anxiety. It is marked by fear/anxiety about two or more of the 5 situations:

A

Marked fear or anxiety about two or more of the following five situations:

  1. Using public transportation (e.g., automobiles, buses, trains, ships, planes).
  2. Being in open spaces (e.g., parking lots, marketplaces, bridges).
  3. Being in enclosed places (e.g., shops, theatres, cinemas).
  4. Standing in line or being in a crowd.
  5. Being outside of the home alone.
54
Q

anxiety is diminished for individuals with agoraphobia if they think a lcoation is :

A

safe

55
Q

Most agoraphobic avoidance behaviour is a complication of ________

A

Most agoraphobic avoidance behaviour is a complication of severe, unexpected panic attack.
- but it can become independent of panic attacks: an individual who has not had a panic attack for years may still have a strong agoraphobic tendency for location avoidance.

56
Q

A high comorbidity exists between panic disorder and drug use/dependence. Why?

A

a lot of them get dependent on the anxiety-reducing effects of etOH when they are experiencing panic-like bodily sensations.

57
Q

mean age of onset for agoraphobia and panic disorder

A

25-29 years

58
Q

what is interoceptive avoidant behavior seen in agoraphobic individuals

A

the avoidance of behaviour or situations that might resemble a panic attack/result in the physiological arousal that resembles a panic attack

ex/ refraining from exercise because that activity causes your heart rate to increase, like it does in a PA.

59
Q

in terms of cultural occurences of agoraphobia and panic disorder, which demographic has it the most? the least?

A

highest occurrence in white americans

lowest in asian americans.

60
Q

which gender is affected more by agoraphobia and panic disorder

A

women

61
Q

most likely way that men cope with agoraphobia and panic disorder

A

alcohol. because men are so impaired by alcohol abuse, clinicians may not realize they also have panic disorder

62
Q

nocturnal panic

A

panic attack happening in the slowest wave (delta sleep) between 1:30 and 3:30am.

63
Q

t/f; people may be having nightmares during nocturnal panic attacks

A

false. nocturnal PAs occur in the deepest sleep, but nightmares and dreams occur in REM sleep.

64
Q

possible cause for isolated sleep paralysis

A

REM sleep may be spilling over into the waking cycle. REM sleep induces paralysis and dreaming, but you are already waking up. This may cause you to think you are seeing things and you are unable to move.

65
Q

people struggling with agoraphobia and panic disorder tend to have a genetic vulnerability to ___

A

stress. People with PD develop anxiety over possibility of another attack.

66
Q

agoraphobia often develops after a person has unexpected panic attacks, but the severity of agoraphobia is determined by:

A

social and cultural factors. Moderated by presence and absence of safety signals.

67
Q

learned alarms

A

cues/locations that become associated with panic.

68
Q

medication treatments for agoraphobia and panic disorder

A
  • benzodiazepines
  • SSRIS
  • SNRIs
  • relapse 50-90% if medication is stopped
69
Q

Psychological treatments, particularly CBTs are effective for panic disorder. What is a specific treatment

A

Panic Control Treatment: expose pts with agoraphobia and panic disorder to the cluster of INTEROCEPTIVE sensations that remind them of their panic attacks (ex/ make them exercise or spin them on a chair to raise their heart rate and make them feel dizzy). Basic attitudes and perceptions concerning the dangerousness of the feared but objectively hamrless siruations are identified and modified.

  • many people remain “better” for a couple years after panic control treatment, but “boostes” may be required.
70
Q

relationship between psychological and drug treatments for agoraphobia and panic disorder

A

studies have shown that combined psych and drug treatment do not actually enhance the treatment of agoraphobia and panic disorder.

  • in fact, those on meds+CBT deteriorated after 2 years compared to groups with CBT alone
  • could be because benzos actually affect cognitive functioning long term use, but they do help short term. For some people, its important to get over these symptoms short term (ex/ during the panic attack), but it might be wise to not constantly use benzos

PSYC-3700 Abnormal Behavior in Adults (24 decks)

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