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PSYC 337 > Chapter 6 > Flashcards

Chapter 6 Flashcards

1
Q

Anxiety

A
  • general feeling of apprehension ab possible future danger
  • response pattern is a blend unpleasant emotions and cognitions
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2
Q

Fear

A
  • alarm reaction that occurs as result of immediate danger
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3
Q

Anxiety disorders

A
  • unrealistic, irrational fears or anxieties that cause significant distress/impairments
  • eg Specific phobia, Social anxiety disorder, Panic disorder, Agoraphobia, Generalized anxiety disorder
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4
Q

Commonalities (causes of anxiety disorders)

A
  • neuroticism
  • involves limbic system
  • neurotransmitters: GABA, norepinephrine, serotonin
  • ppl who feel out of control over emotions/environment are more vulnerable
  • sociocultural environment
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5
Q

Commonalities (effective treatment of anxiety disorders)

A
  • graduated exposure to fears is best
  • cognitive restructuring
  • medications effective for all except phobias
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6
Q

Phobia

A
  • persistent and disproportionate fear of some specific object/situation that presents little to no actual danger
  • great deal of avoidance of feared situations
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7
Q

Ablutophobia

A
  • fear of bathing
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8
Q

Achluophobia

A
  • fear of darkness
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9
Q

Acrophobia

A
  • fear of heights
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10
Q

Aerophobia

A
  • fear of flying
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11
Q

Algophobia

A
  • fear of pain
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12
Q

Agoraphobia

A
  • fear of open spaces or crowds
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13
Q

Aichmophobia

A
  • fear of needles or pointy objects
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14
Q

Amaxophobia

A
  • fear of riding in a car
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15
Q

Androphobia

A
  • fear of men
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16
Q

5 types of phobias in DSM

A
  • animal
  • natural environment (storms, heights, water)
  • blood-injection-injury
  • situational (public transit, tunnels, flying, driving)
  • other (choking, vomiting, falling down)
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17
Q

DSM-5 Criteria for Specific Phobias

A
  • marked fear/anxiety of specific situation
  • situation almost always provokes anxiety
  • avoidance
  • fear/anxiety out of proportion
  • lasting at least 6 months
  • clinically significant distress or impairment
  • not better explained by another disorder
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18
Q

Blood-injection-injury phobia

A
  • presents differently from other phobias
  • typically experience as much disgust as fear
  • drop in heart rate and blood pressure
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19
Q

Prevalence of specific phobias

A
  • 12% during lifetime
  • more common in women, 90% of animal phobias are women
  • high prevalence of comorbidity
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20
Q

Age of onset of specific phobias

A
  • animal, dental, blood-injection-injury phobias start in childhood
  • other phobias start in early adolescence or early adulthood
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21
Q

Psychoanalytic viewpoint on phobias

A
  • defense against anxiety that stems from repressed impulses from the id
  • too dangerous to “know” repressed id impulse
  • anxiety displaced to external object/situation that has some symbolic relationship to real object of anxiety (young hans scared of horses but actually his father?)
  • defense mechanism is displacement
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22
Q

Phobias as cognitive distortions

A
  • ‘possible’ becomes ‘probable’
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23
Q

Phobias as learned behavior

A
  • classical conditioning: fear response can be conditioned to previously neutral stimuli when paired with traumatic events
  • vicarious conditioning: learn from seeing fear response from someone else (ie parental modeling)
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24
Q

Prepared learning

A
  • when primates and humans are evolutionarily prepared to associate certain objects w frightening events
  • why we are more likely to have phobia of animals
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25
Q

Biological causal factors of phobias

A
  • genetic/temperamental variables affect speed and strength of conditioning of fear
  • identical twins more likely to share animal phobias than situational phobias
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26
Q

Treatments of phobias

A
  • exposure therapy is best bet!
  • participant modelling: watching someone else have contact w feared object
  • medication ineffective on its own
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27
Q

Social Anxiety Disorder

A
  • social phobia
  • disabling fear of 1 or more specific social situations
  • underlying fear of scrutiny/negative evaluation of others
  • 2 subtypes: performance (eg public speaking) and nonperformance (eg eating in publlic)
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28
Q

Prevalence of social anxiety

A
  • about 12% of population meets diagnostic criteria in lifetime
  • typically begins early adolescence/adulthood
  • more common in women
  • often present (2/3) w other anxiety disorders (anxiety disorders as causally connected network of symptoms)
  • 1/3 abuse alcohol to manage symptoms
  • lower employment rate and SES
  • very persistent (1/3 spontaneous recovery in 12 years)
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29
Q

Psychological causal factors of social anxiety

A
  • learned behavior (direct or vicarious conditioning – 56-58% can identify direct traumatic exp as origin)
  • evolutionarily based predisposition to acquire fears of social stimuli that signal dominance/aggression from others
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30
Q

Diminished sense of personal control in social anxiety

A
  • perceptions of uncontrollability and unpredictability
  • esp. when person has experienced actual social defeat
  • developed in part due to overprotective parents
31
Q

Cognitive biases in social anxiety

A
  • tend to expect other ppl will reject or negatively evaluate them
  • expect that they will be awkward
  • vicious cycle
  • tendency to interpret ambiguous social info as negative
32
Q

Biological causal factors of social anxiety

A
  • most important temperamental variable is behavioral inhibition
  • children high on behavioral inhibition ages 2-6 were 3x more likely to be diagnosed w social phobia
  • modest genetic contribution (12-30%)
  • larger part of variance due to nonshared environmental factors (twin studies)
33
Q

Treatments of social anxiety

A
  • CBT: prolonged and graduated exposure is very effective; cognitive restructuring (identify and change underlying negative thoughts)
  • Medications: sometimes effective, mostly antidepressants; CBT is better
34
Q

Panic Disorder

A
  • occurrence of panic attacks that often come ‘out of the blue’ (not provoked by identifiable aspects of immediate situation)
  • most symptoms are physical (at least 4 of 13 symptoms for panic attack)
  • palpitations, sweating, shaking, shortness of breath, choking, chest pain, nausea, dizzy, chills/heat, numbness, derealization, fear of losing control, fear of dying
  • at least one attack followed by 1mo+ of worry ab another and/or maladaptive change in behavior
35
Q

Agoraphobia

A
  • fear of ‘open gathering places’ (places that it would be hard to escape or where immediate help would be unavailable)
  • may involve inability to leave home
  • frequent complication of panic disorder
36
Q

Prevalence of panic disorder and agoraphobia

A
  • panic disorder with or without agoraphobia: begins 20s-40s, about 4.7% of population
  • both twice as prevalent in women vs men (more agoraphobic avoidance=higher percentage of women)
37
Q

Odds ratio

A
  • represents increase in odds of disorder associated with female vs male gender (looks like 2.1)
38
Q

Odds ratio of agoraphobia

A

2.0

39
Q

Odds ratio of specific phobia

A

2.0

40
Q

Odds ratio of panic disorder

A

1.9

41
Q

Odds ratio of generalized anxiety disorder

A

1.7

42
Q

Odds ratio of social anxiety disorder

A

1.3

43
Q

Comorbidity of panic disorder

A
  • majority have at least 1 comorbid disorder (usually GAD, social A, specific phobia, PTSD, depression, substance-use
  • increased risk for suicidal ideation
44
Q

Biological causal factors of panic disorder

A
  • moderate heritable component (30-34% of variance in liability to panic symptoms)
  • amygdala (nuclei in front of hippocampus) critically involved in fear – central area for ‘fear network’
  • theory that panic disorder likely to develop in those with abnormally sensitive fear networks
  • noradrenergic and serotonergic systems most implicated in panic attacks
  • GABA implicated in anticipatory anxiety
45
Q

Cognitive Theory of Panic

A
  • proposes that people w panic disorder are hypersensitive to bodily sensations
  • tendency to catastrophize ab meaning of bodily sensations
46
Q

Panic circle

A

(trigger stimulus –>) perceived threat – apprehension or worry – (Trigger stimulus –>) body sensations –interpretation of sensations as catastrophic – perceived threat…

47
Q

Comprehensive Learning Theory of Panic Disorder

A
  • initial panic attacks become associated w initially neutral internal (interoceptive) and external (exteroceptive) cues through conditioning
  • more intense panic attack = more robust conditioning
48
Q

Anxiety sensitivity

A
  • trait-like belief that certain bodily symptoms may have harmful consequences
  • predicts dev. of panic attacks and onset of other anx. disorders
49
Q

Behavioral and Cognitive-Behavioral Treatments for Panic Disorders and Agoraphobia

A
  • prolonged exposure effective in 60-75% of ppl with agoraphobia
  • Panic Control Treatment (PCT) targets agoraphobic avoidance and panic attacks
  • PCT is combo of cognitive and behavioral components (incl. education, cog. restructuring, breathing retraining, interoceptive exposure)
  • greater magnitude of improvement w these than meds
50
Q

Medications for panic and agoraphobia

A
  • anxiolytics from benzodiazepine category (eg Xanax or Klonopin) – act very fast but cause drowsiness
  • sometimes use antidepressants (SSRIs) – take at least 4 weeks, can alleviate comorbid depressive symptoms, can have troublesome side effects
51
Q

Generalized Anxiety Disorder

A
  • chronic, excessive, and unreasonable worry about many different aspects of life
  • future-oriented mood state of anxious apprehension
  • frequently engage in subtle avoidance like checking and procrastination
52
Q

DSM-5 Criteria for GAD

A
  • excessive anxiety and worry, more days than not for 6mo+, ab number of events or activities
  • difficult to control worry
  • associated w at least 3/6 of: restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbances
  • anxiety or symptoms cause clinically significant distress or impairment
53
Q

Prevalence of GAD

A
  • 3% of population
  • tends to be chronic
  • about 2x as common in women
  • most ppl can still function
54
Q

Comorbidity of GAD

A
  • often co-occurs w other disorders, esp. anxiety/mood
  • many people experience occasional panic attacks (might qualify for panic disorder diagnosis)
55
Q

Psychoanalytic viewpoint and GAD

A
  • anxiety results from unconscious conflict between ego and id impulses
  • defense mechanisms do not work w GAD
  • this theory is not testable
56
Q

Perceptions of uncontrollability in ppl with GAD

A
  • may have history of experiencing important events in their lives as unpredictable or uncontrollable
  • may be more likely to have history of trauma in childhood
  • less tolerance for uncertainty!
57
Q

Sense of mastery

A
  • parent responsiveness to child needs influences dev. of sense of mastery
  • history of control over important aspects of environment also significant variable
58
Q

Reinforcing properties of worry (GAD)

A
  • think benefits of worrying are: superstitious avoidance of catastrophe, avoidance of deeper emotional topics, coping and preparation
59
Q

Negative consequences of worry

A
  • greater sense of danger and anxiety
  • more negative and intrusive thoughts
  • cognitive bias for threatening information (likely due to prominent danger schemas)
60
Q

Biological causal factors of GAD

A
  • heritability: approx 30%
  • neuroticism is part of genetic predisposition
  • GABA (inhibits anxiety) is functionally deficient
  • corticotropin-releasing hormone (CRH) plays role
61
Q

Treatment of GAD (Cognitive-Behavioral)

A
  • combination of behavioral techniques
  • often exposure-based techniques
  • magnitude of changes with CBT comparable to those w benzodiazepines
  • benzodiazepines do not have much effect of worry/psyc symptoms, can lead to dependence
  • buspirone works better w less side effects (after 2-4w)
62
Q

Thought reaction record

A
  • part of CBT treatment of anxiety
  • The Situation, Your Thoughts, What You Did, What You Could Have Done Differently
  • think of alternate ways to interpret things that might reduce anxiety
63
Q

Obsessive-Compulsive Disorder

A
  • formerly anxiety disorder in DSM, now own group
  • occurrence of obsessive thoughts and compulsive behaviors in attempt to neutralize such thoughts
  • obsessions: persistent, recurrent intrusive thoughts, images, impulses, etc
  • compulsions: overt repetitive behaviors (rituals)
  • learned behavior!
64
Q

DSM5 criteria for OCD

A
  • presence of obsessions (tries to ignore or suppress), compulsions, or both
  • obsessions or compulsions for more than 1h/day OR cause clinically significant distress/impairment
  • not attributable to or better explained by smt else
65
Q

Prevalence of OCD

A
  • 2-3% meet criteria in lifetime
  • over 90% of those seeking treatment have both obsessions and compulsions
  • little-no gender differences in adults
  • usually gradual onset, becomes chronic
66
Q

Comorbidity and OCD

A
  • most frequent w other anxiety disorders (social phobia, panic disorder, GAD, PTSD)
  • 25-50% of ppl w OCD experience major depression in lifetime
67
Q

Mowrer’s Two-Process Theory of avoidance learning

A
  • neutral stimulus becomes associated w frightening thoughts/experiences through classical cond.
  • stimuli come to elicit anxiety – compulsive behavior reduces anxiety
68
Q

Cognitive Biases and Distortions in OCD

A
  • attentional bias toward relevant disturbing material
  • difficulty blocking out negative/irrelevant input of distracting info
  • low confidence in memory ability may contribute to repeating ritualistic behaviors
69
Q

Biological Causal Factors of OCD

A
  • moderately high concordance rate in mz twins
  • increased metabolic activity in orbital frontal cortex, cingulate gyrus/cortex, and basal ganglia
  • serotonin is strongly implicated
70
Q

Treatment of OCD

A
  • CBT: exposure and response prevention
  • medications that affect serotonin system are best (clomipramine and fluoxetine)
  • high relapse rates when meds discontinued
  • combination treatment better for kids + teens
71
Q

Body Dysmorphic Disorder

A
  • preoccupation w certain aspects of body (perceived or imagined flaws)
  • causes clinically significant impairment or distress
  • most have compulsive checking behavior
  • avoidance of usual activities (social functioning and work)
  • 94% of ppl w BDD felt depressed at some point bc of it
  • SSRIs can often help (higher doses than OCD)
  • exposure and response prevention work well!
72
Q

Prevalence of BDD

A
  • 2% of people meet diagnostic criteria (20% of those seeking rhinoplasty!)
  • equal in men and women
  • onset usually in adolescence
  • often also have depression diagnosis
73
Q

Hoarding Disorder

A
  • acquire and fail to discard many possessions that seem useless or of very limited value
  • significantly more disabled than those w OCD without hoarding symptoms
  • 3-5% of adults (10-40% w OCD)
  • diff. brain activation patterns than OCD w/o hoarding
  • OCD meds not effective for hoarding
  • behavior therapy also less effective
74
Q

Trichotillomania

A
  • compulsive hair pulling, resulting in noticeable hair loss
  • usually preceded by increasing sense of tension, pulling hair out brings relief
  • onset post-puberty is more severe course
  • research still in early stages

PSYC 337 (15 decks)

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