Chapter 6 Flashcards
Anxiety def
Apprehension over an anticipated problem
Fear def
A reaction to immediate danger
Both ____ and ____ involve physiological arousal
- Both anxiety and fear involve physiological arousal
- Anxiety – moderate arousal (e.g., restless energy, tension)
- Fear – higher arousal (e.g., overpowering urge to run)
Anxiety
- Anxiety increases preparedness
- “U-shaped” curve
- Absence of anxiety interferes with performance
- Moderate levels of anxiety improve performance
- High levels of anxiety are detrimental to performance
What does anxiety increase?
preparedness
Fear
- Fear triggers “fight or flight” response
- In the right circumstance, fear saves lives
- Fear system seems to misfire in some anxiety disorders
describe anxiety on a graph:
- “U-shaped” curve (really looks more bell curve)
- Absence of anxiety interferes with performance
- Moderate levels of anxiety improve performance
- High levels of anxiety are detrimental to performance
Anxiety Disorders
- DSM-5 Anxiety Disorders
- Specific phobias
- Social anxiety disorder
- Panic disorder
- Agoraphobia
- Generalized anxiety disorder
- Most common psychological disorders
- 28% of people report anxiety symptoms
- 10th leading cause of disability worldwide in 2015
*DSM-5 Anxiety Disorders
- DSM-5 Anxiety Disorders
- Specific phobias
- Social anxiety disorder
- Panic disorder
- Agoraphobia
- Generalized anxiety disorder
what is the most common psychological disorders
anxiety disorders (Specific phobias Social anxiety disorder Panic disorder Agoraphobia Generalized anxiety disorder)
10th leading cause of disability worldwide in 2015
Anxiety Disorders
DSM-5 Criteria: Panic Disorder
- Recurrent unexpected panic attacks
- At least 1 month of concern about the possibility of more attacks occurring or the consequences of an attack, or maladaptive behavioral changes because of the attacks
Criteria for Anxiety Disorders: DSM-5 criteria for each disorder:
- Symptoms interfere with important areas of functioning or cause marked distress (clinically significant)
- Symptoms are not caused by a drug or a medical condition
- Symptoms persist for at least 6 months or at least 1 month for panic disorder
- The fears and anxieties are distinct from the symptoms of another anxiety disorder
Panic disorder: how many month(s)
1
how to distinguish panic disorder (from other anxiety disorders)
panic disorder is for at least 1 month, the others are for at least 6 months
Specific Phobias
- Disproportionate fear caused by a specific object or situation
- Great lengths taken to avoid feared object or situation
- Most specific phobias cluster around a few feared objects and situations
- High comorbidity among specific phobias
DSM-5 Criteria: Specific Phobia
- Marked and disproportionate fear consistently triggered by specific objects or situations
- The object or situation is avoided or else endured with intense anxiety
Social Anxiety Disorder
-has overlap with…
- Persistent, unrealistically intense fear of social situations that might involve being scrutinized by or exposed to unfamiliar people
- *Fear of negative evaluation or scrutiny leads to avoidance of social situations
- Common fears include: public speaking, meeting new people, talking to people in authority
- 33% also diagnosed with Avoidant Personality Disorder
- Overlap in genetic vulnerability for both disorders
Common fears of Social Anxiety Disorder
Common fears include: public speaking, meeting new people, talking to people in authority
DSM-5 Criteria: Social Anxiety Disorder
- Marked and disproportionate fear consistently triggered by exposure to potential social scrutiny
- Exposure to the trigger leads to intense anxiety about being evaluated negatively
- Trigger situations are avoided or else endured with intense anxiety
Panic attacks
*Sudden attack of intense apprehension, terror, and feelings of impending doom
*Accompanied by at least four other symptoms:
Physical symptoms can include:
-Shortness of breath, heart palpitations, nausea, upset stomach, chest pain, feelings of choking and smothering, dizziness, lightheadedness, faintness, sweating, chills, heat sensations, numbness or tingling sensations, and trembling
*Depersonalization - feeling of being outside one’s body
*Derealization - feeling of the world not being real
*Fears of going crazy, losing control, or dying
- Symptoms come on rapidly and peak in intensity within 10 minutes
- Many people interpret symptoms as having a heart attack
- Misfiring of the fear system
- Physiological response similar to what most experience when faced with immediate threat
how do people describe panic attacks
Many people interpret symptoms as having a heart attack
panic attacks vs panic disorder
Panic attacks triggered by specific situations (e.g., phobia) should not be considered in diagnosing panic disorder
-panic disorder def: recurrent and unexpected panic attacks (except those caused by phobias)
panic disorder
- Recurrent panic attacks unrelated to specific situations
- Worry about having more panic attacks
- Panic attacks triggered by specific situations (e.g., phobia) should not be considered in diagnosing panic disorder
- 25% of the general population of people will experience a single panic attack
- -Not the same as panic disorder
DSM-5 Criteria: Panic Disorder
Recurrent unexpected panic attacks
At least 1 month of concern about the possibility of more attacks occurring or the consequences of an attack, or maladaptive behavioral changes because of the attacks
Agoraphobia
-how many people with agoraphobia will experience panic attacks
*Anxiety about situations in which it would be embarrassing or difficult to escape if anxiety symptoms occurred
E.g., crowds, stores, malls, churches, trains, bridges, tunnels, etc.
*Causes significant impairment
-Unable to leave house or leaves house with great distress
*About half of people with agoraphobia experience panic attacks
DSM-5 Criteria: Agoraphobia
- Disproportionate and marked fear or anxiety about at least 2 situations where it would be difficult to escape or receive help in the event of incapacitation, embarrassing symptoms, or panic-like symptoms
- These situations consistently provoke fear or anxiety
- These situations are avoided, require the presence of a companion, or are endured with intense fear or anxiety
Generalized Anxiety Disorder (GAD)
-Def
DSM def: Uncontrollable worry
- Excessive, uncontrollable, and long-lasting worry about minor things
- Worry : Cognitive tendency to chew on a problem and to be unable to let go of it
- Common worries: Relationships, health, finances, daily hassles
- Also includes: difficulty concentrating, tiring easily, restlessness, irritability, and muscle tension
- Typically begins in adolescence
DSM-5 Criteria: Generalized Anxiety Disorder
- Excessive anxiety and worry at least 50% of days about a number of events or activities (e.g., family, health, finances, work, and school)
- The person finds it hard to control the worry
- The anxiety and worry are associated with at least three (or one in children) of the following:
- Restlessness or feeling keyed up or on edge
- Easily fatigued
- Difficulty concentrating or mind going blank
- Irritability
- Muscle tension
- Sleep disturbance
Comorbidity of anxiety disorder
- among anxiety disorders
- with other disorders… specifically
- More than 50% of those with anxiety disorder meet criteria for another anxiety disorder
- 75% of those with anxiety disorder meet criteria for another psychological disorder
- Disorders commonly comorbid with anxiety:
- 60% also have depression
- Obsessive compulsive disorder also common
- Comorbidity is associated with greater severity and poorer outcomes of the anxiety disorders
what percent of people will experience a panic attack
25% of people will experience a single panic attack
Not the same as panic disorder
Treatment of the Anxiety Disorders: Commonalities Across Psychological Treatments
- Exposure: Face the situation or object that triggers anxiety
- Virtual reality vs. in vivo (real-life) exposure are equally effective
- Mindfulness and acceptance treatments also show promise
Exposure as a treatment as Anxiety disorder
(how effective?)
(behavioral vs cognitive view)
- Exposure: Face the situation or object that triggers anxiety
- E.g., exposure hierarchy: graded exposure to a list of triggers
- Effective for 70-90% of clients
- Behavioral view: Newly learned associations inhibit fear
- Cognitive view: Corrects mistaken beliefs
Psychological Treatment of Phobias
*Exposure
-In vivo (real-life) exposure
-For phobias involving fear of animals, injections, or dental work:
Very brief treatments lasting only a couple of hours have been found to be highly effective
-Most people experience relief from phobic symptoms
Exposure as a treatment as Anxiety disorder
behavioral vs cognitive view
*Exposure: Face the situation or object that triggers anxiety
-E.g., exposure hierarchy: graded exposure to a list of triggers
Effective for 70-90% of clients
Behavioral view: Newly learned associations inhibit fear
Cognitive view: Corrects mistaken beliefs
Psychological Treatment of Phobias
*Exposure
In vivo (real-life) exposure
For phobias involving fear of animals, injections, or dental work:
Very brief treatments lasting only a couple of hours have been found to be highly effective
Most people experience relief from phobic symptoms
Social skills training
as a psychological treatment of Social Anxiety Disorder
Provides extensive modeling of behaviors
Reduces use of safety behaviors (e.g., poor eye contact)
Clarks’ cognitive therapy for social anxiety
Reduce internal focus of attention
Reduce the idea that people are looking at you
Challenge negative images of how others will react
Psychological Treatment of Agoraphobia
- CBT for agoraphobia
- Systematic exposure to feared situations
- Coached to gradually leave home and engage in community activities for short periods of time
- Enhanced by involving patient’s partner
Clarks’ cognitive therapy for social anxiety
- Reduce internal focus of attention
- Reduce the idea that people are looking at you
- Challenge negative images of how others will react
Professor thinks this is the best approach to GAD
Cognitive behavioral methods
Medications
*Anxiolytics: drugs that reduce anxiety
-Benzodiazepines (e.g., Valium, Xanax)
Can be addictive and cause severe withdrawal symptoms
Side effects: cognitive and motor difficulties
-Antidepressants (e.g., Tricyclics, SSRIs, SNRIs)
Side effects: jitteriness, weight gain, elevated heart rate
- Most people relapse once they stop taking medications
- Psychological treatments are considered the preferred treatment of most anxiety disorders
Benzodiazepines as a means to reduce anxiety
-a type of…
Benzodiazepines (e.g., Valium, Xanax)
Can be addictive and cause severe withdrawal symptoms
Side effects: cognitive and motor difficulties
-a type of Anxiolytics