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Psych 354 > Chapter 6 - anxiety > Flashcards

Chapter 6 - anxiety Flashcards

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1
Q

Approximately ___% of adults have anxiety disorders (including phobia disorders) over the last year ?

A

18%

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2
Q

Yerkes-Dodson Law:
- what does it look like?
- 2 axes?
- 3 different categories/zones?

A
  • normal/bell curve
  • X: arousal level, Y: performance
  • Yellow:
    → not aroused enough
  • Green:
    → optimal arousal & performance
  • Red:
    → too much arousal, decreased performance
    → where you’re concerned about an anxiety disorder
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3
Q

3 elements of anxiety? ex?

A
  • thoughts
    → “They don’t really want to hang out with me”
  • feelings
    → Sad / Lonely
  • behaviors
    → avoidance
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4
Q

Common features / symptoms of anxiety disorders?

A
  • Situations that almost always provoke fear or anxiety
  • Out of proportion with stressor or event
  • Excessive or unreasonable
  • Persistent
  • Avoid situations or suffer
  • Impairment with life
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5
Q

Most common form of mental disorder?

A

Anxiety disorders!
(in terms of 1 year prevalence rates)

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6
Q

Most common type of anxiety disorder?

A

specific phobia

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7
Q

___% of those with MDD meet criteria for one or more anxiety disorder

A

60%

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8
Q

People who develop anxiety disorders are much more likely to have experienced ____?

A

a stressful life event
(danger, insecurity, family discord)

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9
Q

What is the typical order of onset for a patient with comorbid anxiety and MDD?

A
  • Usually anxiety comes first
  • Anxiety disorder is more likely to onset earlier than depression
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10
Q

4 reasons for comorbidity between depression and anxiety?

A
  • Common causes
    → Stressful life events (trauma, break ups, moving, starting college, etc)
  • Impacted by the same cognitive biases
  • Same biological vulnerabilities
    → (ex. Serotonin reuptake issues)
  • Overlap in diagnostic criteria
    → Issues with concentration, falling asleep, etc
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11
Q

Common comorbidity:
People with anxiety are 3x more likely to have _______ disorder than people without anxiety?

A

alcohol use disorder

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12
Q

What are the 6 different anxiety disorders we talked about?

A
  • Specific phobia
  • Social anxiety disorder
  • OCD
  • Panic disorder
  • GAD
  • Agoraphobia
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13
Q

Typical age of onset for each anxiety disorder (which are youngest to oldest) ?

A
  • Specific phobia → childhood
  • Social anxiety disorder → adolescence (10-20)
  • OCD → adolescence to early adulthood
  • Panic disorder → late adolescence - mid 30s
  • GAD → late adolescence - mid 30s
  • Agoraphobia → adulthood
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14
Q

Course & outcomes for anxiety disorders? worse outcomes associated with…?

A
  • usually chronic conditions
  • long term outcome is mixed and somewhat unpredictable
  • most people continue to have problems for many years
  • worse outcomes associated with younger age of onset & lack of treatment
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15
Q

Demographic predictors:
- what’s the gender difference? - what disorder is there no gender difference for?

A
  • Women 2-3x more likely than men for most anxiety disorders
  • no gender difference for OCD
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16
Q

Demographic predictors:
- which racial group is more likely to have an anxiety disorder?

A

Non-hispanic white americans&raquo_space; black or hispanic americans

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17
Q

Only about ___% of people who quality for a diagnosis of an anxiety disorder ever seek treatment

A

25%

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18
Q

OCD DSM diagnostic criteria:

A
  • Obsessions and/OR compulsions
  • Time consuming or causes distress or impairment
    → Distracting
    → Avoiding
    → Cognitive performance
  • Symptoms not due to substances or medical condition
  • Not better explained by symptoms of another mental disorder
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19
Q

OCD Obsessions: DSM def?

A
  • Thoughts, urges, or images that are…
    → Recurrent and persistent
    → Intrusive and unwanted (not voluntary)
    → Cause anxiety and distress
    2. Individual attempts to ignore or suppress or neutralize them with some other thought or action
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20
Q

5 most common types of obsessions:

A
  1. Contamination
  2. Repeated doubts
  3. Order/arranging
  4. Violent/aggressive
  5. Sexual obsessions
21
Q

How are OCD obsessions different from normal intrusive thoughts?

A
  • more frequent
  • last longer
  • more discomfort
  • more difficulty dismissing
  • more likely to interpret them as meaningful
22
Q

OCD Compulsions DSM def?

A
  1. Repetitive behaviors or mental acts…
    → feels compelled to perform in response to an obsession or according to rules applied rigidly
    → reduces anxiety or prevents some dreaded event from happening
    → Not connected in realistic way OR are clearly excessive
23
Q

5 most common types of compulsions?

A
  1. Checking (& re-checking)
  2. Decontamination
  3. Repeating
  4. Ordering and arranging
  5. Mental acts: (Prayers, counting, repeating words)
24
Q

OCD course of disorder?

A
  • Typically chronic if untreated
  • Revision rates for adults are quite low
25
Q

Big picture goals of CBT for OCD?

A
  • Change how to relate and interpret intrusive thoughts
    → Try to be more accepting of the thoughts
  • Learn more adaptive long-term strategies
    → Break cycle of rituals
26
Q

4 common beliefs & misinterpretations in OCD?

A
  1. Responsibility exaggeration
  2. Importance of thoughts
    → Obsessions reveal something true about them
  3. Thought-action fusion
    → thoughts mean you actually did it
  4. Need to control thoughts
27
Q

Exposure & Response Prevention:

A
  • Expose client to the fear (thing they’re obsessed about) & prevent them from engaging in compulsions / rituals
  • Goal is to show them that they don’t need the rituals
  • keep track of resists & submits
28
Q

Panic attacks: def? theory? symptoms?

A
  • discrete episodes of intense fear or dread
  • key symptom of panic disorder
  • can be considered a normal fear response at inappropriate time

Symptoms:
- Physical (heavy breathing)
- Cognitive (gonna die, crazy)
- Behavioral (fleeing situation)
- Sudden, abrupt onset, brief duration

29
Q

3 types of panic attacks? def?

A
  1. Situationally bound
    → Panic attacks are expected or cued by particular thing
  2. Situationally predisposed
    → more likely to have a panic attack where she had one before, but having one is not inevitable
  3. Unexpected
    → Comes out of the blue, not cued at all
30
Q

Panic disorder criteria?

A
  1. Recurrent, unexpected panic attacks (uncued)
  2. Followed by at least one month of one or both of the following:
    → Persistent worry ab having additional attacks or their consequences
    → Significant behavioral change
31
Q

Etiology of panic disorder: cognitive factor? limitation?

A
  • Catastrophic misinterpretation
    → interpret normal body sensations or physiological arousal as response to danger, and they experience it as a panic attack
  • cannot account for all panic attacks
    –> some happen at night while sleeping
32
Q

3 treatments for panic disorder?

A
  • Situational exposures
    → Confronting places or situations that the person avoids due to fear of having a panic attack
  • Interoceptive exposures
    → Confronting bodily sensations that the person associates with panic attacks
    → Exposure to symptoms like shortness of breath and racing heart rate without experiencing panic attack
  • Teaching clients distress tolerance
    → Sitting with uncomfortable anxiety w/o a panic attack
33
Q

Agoraphobia def?

A
  • Anxiety about being in places or situations from which:
    → Escape might be difficult or embarrassing
    → Help may not be available if one has a panic attack
  • Fear of escape, being embarrassed about panic symptoms occurring in public
34
Q

Specific phobia def?

A
  • focused on specific thing
  • irrational
  • persistent & excessive or unreasonable
  • exposure always provokes fear
  • avoidance/anxiety interferes with routine or functioning
35
Q

5 phobia subtypes: (ex / details?)

A
  1. Animals
  2. Natural environment
    → Storms, heights, water
    → Usually has childhood onset
  3. Blood, injection, injury
    → Giving blood / Needles
    → Don’t go to the doctor,
  4. Situational
    → Public transit, bridges, elevators
  5. Other
    → Choking, vomiting, clowns, costumes
36
Q

3 theories for etiology of phobias? Limitations?

A
  1. Evolutionary adaptation
    → phobias were at one point useful for survival
    → applies to snakes/spiders, NOT to clowns
  2. Negative information
    → hearing negative info from parents/media/news
    → doesn’t need to be direct exposure
  3. Preparedness/learning model
37
Q

Preparedness model for learning fears?

A
  • organisms are biologically predisposed / prepared to learn certain types of associations
  • these associations can lead to conditioned fear responses
38
Q

Treatments for specific phobias? Important concept used?

A
  • exposure therapy
  • progressive relaxation
  • imaginal & in vivo

Fear Avoidance Hierarchy
- pyramid of things that induce fear from least to most stressful

39
Q

Generalized Anxiety Disorder Criteria?

A
  • Excessive anxiety and worry occurring more days than not for at least 6 months
  • Beyond reasonable concern, difficult to control worry
  • impairs function
  • Anxiety accompanied by 3+ of the following:
    → Restlessness,
    → easily fatigues,
    → difficulty concentrating
    → irritability
    → muscle tension
    → sleep disturbance
40
Q

4 cognitive vulnerabilities for GAD?

A
  1. Positive beliefs about worry
  2. Sense of uncontrollability
  3. Intolerance of uncertainty
  4. Focus on threat-related stimuli that may indicate future negative events
    → Focus on negative rather than positive
41
Q

GAD treatment?

A
  • Progressive muscle relaxation is one of the most important parts
  • Relaxing the body can relax the mind
  • Goal is to be more aware of when your body is tense
42
Q

Social anxiety disorder def?

A
  • Fear of being negatively evaluated by others in one or more social or performance situations
  • Fear of humiliation, embarrassment, or rejection
43
Q

2 types of Social anxiety?

A
  • Generalized
    → Performance anxiety, participating in groups, parties, authority figures, eating in public
  • Performance only
    → Public speaking, music performance, etc.
44
Q

Social anxiety disorder criteria:

A
  • Persistent fear of 1+ social situations exposed to possible scrutiny
  • almost always present anxiety
  • Fears they’ll be negatively evaluated
  • Anxiety is unreasonable or excessive
  • Avoids or suffers through with distress
45
Q

2 cognitive biases with SAD?

A
  1. attentional bias
  2. maladaptive (often untrue) internal dialogue
    → Internal negative dialogue
    → Fear of positive evaluation
    → Emotional dysregulation
    → less likely to reciprocate self-disclosure
46
Q

SAD treatment??

A
  • exposure to feared situations (in vivo & imaginal)
  • includes distress ratings & outcome ratings / predictions
  • Simulating a feared situation
47
Q

Benzos: popularly prescribed until when? what NT do they affect? whats their problem?

A
  • popular til the 1990s
  • enhance activity of GABA neurons
  • side effects: sedation, psychomotor/cognitive impairments
  • RISK FOR ADDICTION
48
Q

Tricyclic antidepressants used successfully to treat what anxiety disorder?? Used less frequently because….?

A
  • panic disorder
  • unpleasant side effects
  • side effects can get so bad that they resemble anxiety itself

Psych 354 (10 decks)

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