Chapter 6 - Anxiety Disorders

Question 1

anxiety

Answer 1

An emotional state characterized byphsiological arousal, unpleasant feelings of tension, and a sense of apprehension or foreboding.

Question 2

anxiety disorder

Answer 2

A class of psychological disorders characterized by excessive or maladaptive anxiety reactions.

Question 3

anxiety disorder

Answer 3

A class of psychological disorders characterized by excessive or maladaptive anxiety reactions.

Question 4

Panic Disorder:

Description

Answer 4

Repeated panic attacks (episodes of sheer terror accompanied by strong phsiological symptoms, thoughts of imminent danger or impending doom, and an urge to escape).

Question 5

Panic Disorder:

Associated Features

Answer 5

Fears of recurring attacks may prompt avoidance of situations associated with the attacks or in which help might not be available; attacks begin unexpectedly but may become associated with certain cues or specific situations; may be accompanied by agoraphobia, or general avoidance of public situations.

Question 6

Generalized Anxiety Disorder:

Description

Answer 6

Persistent anxiety that is not limited to particular situations.

Question 7

Generalized Anxiety Disorder:

Associated Features

Answer 7

Excessive worrying; heightened states of bodily arousal, tenseness, being “on edge.”

Question 8

Specific Phobia:

Description

Answer 8

Excessive fears of particular objects or situations.

Question 9

Specific Phobia:

Associated Features

Answer 9

Avoidance of phobic stimuls or situation; examples include acrophobia (fear of heights), claustrophobia (fear of small or confined spaces), and fears of blood, small animals, or insects.

Question 10

Social Phobia:

Description

Answer 10

Escessive fear of social interactions.

Question 11

Social Phobia:

Associated Features

Answer 11

Characterized by an underlying fear of rejection, humiliation, or embarrassment in social situations.

Question 12

Agoraphobia (without Panic Disorder):

Description

Answer 12

Fear and avoidance of open, public places.

Question 13

Agoraphobia (without Panic Disorder):

Associated Features

Answer 13

May occur secondarily to losses of supportive others to death, separation, or divorce.

Question 14

Obsessive-Compulsive Disorder (OCD):

Description

Answer 14

Recurrent obsessions (recurrent, intrusive thoughts) and/or compulsions (repetitive behaviours the person feels compelled to perform).

Question 15

Obsessive-Compulsive Disorder (OCD):

Associated Features

Answer 15

Obsessions generate anxiety that may be at least partially relieved by performance of the compulsive rituals.

Question 16

Acute Stress Disorder:

Description

Answer 16

Acute maladaptive reaction in the days or weeks followign a traumatic event.

Question 17

Acute Stress Disorder:

Associated Features

Answer 17

Similar features as PTSD, but characterized more by dissociation or feelings of detachment from oneself or one’s environment—being in a “daze.”

Question 18

Physical Features of Anxiety Disorders

Answer 18

May include jumpiness, jitteriness, trembling or shaking, tightness in the pit of the stomach or chest, heavy perspiration, sweaty palms, light-headedness or faitness, dryness in teh mouth or throat, shortness of breath, heart pounding or racing, cold fingers or limbs, and upset stomach or nausea, among other physical symptoms.

Question 19

Behavioural Features of Anxiety Disorders

Answer 19

May include avoidance behaviour, clinging or dependent behaviour, and agitated behaviour.

Question 20

Cognitive Features of Anxiety Disorders

Answer 20

May include worry, a nagging sense of dread or apprehension about the future, preoccupation with or keep awareness of bodily sensations, fear of losing control, thinking the same disturbing thoughts over and over, jumbled or confused thoughts, difficulty concentrating or focusing one’s thoughts, and thinking that things are getting out of hand.

Question 21

panic disorder

Answer 21

A type of anxiety disorder characterized by repeated episodes of intense anxiety or panic.

Question 22

agoraphobia

Answer 22

Excessive, irrational fear of open or public places.

Question 23

For a diagnosis of panic disorder to be made, the person must have experienced repeated, unexpected panic attacks and at least one of the attacks must be followed by one of these features:

Answer 23

a) At least a month of persistent fear of subsequent attacks

b) Worry about the implications or consequences of the attack (e.g., fear of losing one’s mind or “going crazy” or having a heart attack)
c) Significant change in behaviour (e.g., refusing to leave the house or venture into public for fear of having another attack).

Question 24

True or False:

The same drugs used to treat schiophrenia are also used to control panic attacks.

Answer 24

FALSE: Drugs used to treat schizophrenia are not used to treat panic disorder. However, antidepressants have therapeutic benefits in helping control panic attacks.

Question 25

Elements of Cognitive-Behavioural Programs for Treatment of Panic Disorder:

Self-Monitoring

Answer 25

Keeping a log of panic attacks to help determine situational stimuli that might trigger them.

Question 26

Elements of Cognitive-Behavioural Programs for Treatment of Panic Disorder:

Exposure

Answer 26

A program of gradual exposure to situations in which panic attacks have occurred. During exposure trials, the person engages in self-relaxation and rational self-talk to prevent anxiety from spiraling out of control.

Question 27

Elements of Cognitive-Behavioural Programs for Treatment of Panic Disorder:

Development of Coping Response

Answer 27

Developing coping skills to interrupt the vicious cycle in which overreactions to anxiety cues or cardiovascular sensations culminate in panic attacks. Cognitive methods focus on modifying catastrophic misinterpretations of bodily sensations. Breathing retraining may be used to help the individual avoid hyperfentilation during panic attacks.

Question 28

phobia

Answer 28

An excessive, irrational fear.

Question 29

specific phobia

Answer 29

A phobia that is specific to a particular object or situation.

Question 30

True or False:

People with phobias believe their fears to be well founded.

Answer 30

FALSE: Actually, many people with phobias recognize that their fears are exaggerated or unfounded, but remain fearful.

Question 31

social phobia

Answer 31

Excessive fear of social interactions or situations.

Question 32

two-factor model

Answer 32

A theoretical model that accounts for the development of phobic reactions on the basis of classical and operant conditioning.

Question 33

Central Elements of the Cognitive Perspective on Phobias

Answer 33

1. Oversensitivity to threatening cues.
2. Overprediction of Danger
3. Self-defeating thoughts and irrational belieffs.

Question 34

systematic desensitization

Answer 34

A behaviour therapy technique for overcoming phobias by means of exposure to progressively more fearful stimuli (in imagination or by viewing slides) while remaining deeply relaxed.

Question 35

fear-stimulus hierarchy

Answer 35

An ordered series of increasingly fearful stimuli.

Question 36

gradual exposure

Answer 36

In behaviour therapy, a method of ocercoming fears through a stepwise process of exposure to increasingly fearful stimuli in imagination (imaginal exposure) or in real-life situations (in vivo exposure).

Question 37

flooding

Answer 37

A behavoiur therapy technique for overcoming fears by means of exposure to high levels of fear-inducing stimuli.

Question 38

virtual reality therapy (VRT)

Answer 38

A form of exposure therapy involving the presentation of phobic stimuli in a virtual reality environment.

Question 39

cognitive restructuring

Answer 39

A cognitive therapy method that involves replacing irrational thoughts with rational alternatives.

Question 40

obsesesive-compulsive disorder (OCD)

Answer 40

A type of anxiety disorder characterized by recurrent obsessions, compulsions, or both.

Question 41

obsession

Answer 41

A recurring thought, image, or urge, that the individual cannot control.

Question 42

compulsion

Answer 42

A repetitive or ritualistic behaviour that the person feels compelled to perform.

Question 43

generalized anxiety disorder (GAD)

Answer 43

A type of anxiety disorde characerized by feelings ofdread and foreboding and heightened states of bodily arousal.

Question 44

acute stress disorder (ASD)

Answer 44

A traumatic stress reaction occurring during the month following exposure to a traumatic event.

Question 45

posttraumatic stress disorder (PTSD)

Answer 45

A prolonged maladaptive reaction to a traumatic event.

Question 46

Common Features of Traumatic Stress Disorders

Answer 46

• Avoidance behaviour
• Reexperiencing the trauma
• Emotional distress and impaired functioning
• Heightened arousal
• Emotional numbing

Question 47

What are anxiety disorders?

Answer 47

Anxiety, a generalized sense of apprehension or fear, is normal and disreable under some conditions, but it can become abnormal when it is excessive or inappropriate. Disturbed patterns of abnormal behaviour in which anxiety is the most prominent features are labeled anxiety disorders.

Question 48

What is panic disorder?

Answer 48

Panic disorder characterized by often immobilizing, repeated panic attacks, which involve intense physical features, notably cardiovascular symptoms, that may be accompanied by sheer terror and fears of losing control, losing one’s mind, or dying. Panic attack sufferers often limit their outside activities for fear of recurrent attacks. This can lead to agorophobia, the fear of venturing into public places.

Question 49

How is panic disorder understood in contemporary views?

Answer 49

The predominant model conceptualizes panic disorder in terms of a combination of biological factors (e.g., genetic proneness, increased sensitivity to bodily cues) and cognitive factors (e.g., catastrophic misinterpretation of bodily sensations, anxiety sensitiity). IN this view, panic disorder involves physiological and psychological factors interacting in a vicious cycle that can spiral into a full-blown panic attack.

Question 50

What are the major treatment approaches for panic disorder?

Answer 50

Cognitive-behavioural treatment of panic disorder incorporates self-monitoring, controlled exposure to panic-related cues, including bodily sensations, and developmesnt of coping responses for handling panic attacks without catastrophic misinterpretations of bodily cues. Biomedical approaches incorporate use of antidepressant drugs, which have antianxiety and antipanic effects as well as antidepressant effects.

Question 51

What are phobic disorders?

Answer 51

Phobias are excessive irrational fears of specific objects or situations. Phobias involve a behavioural component, avoidance of the phobic stimulus, in addition to physical and cognitive features. Specific phobias are excessive fears of particular objects or stuations, such as mice, spiders, tight places, or heights. Social phobia involves an intense fear of being judged negatively by others. Agoraphobia involves fears of venturing into public places. Agoraphobia may occur with, or in the absence of, panic disorder.

Question 52

How do phobias develop?

Answer 52

Learning theorists explain anxiety disorders through conditioning and observational learning. Mowrer’s two-factor model incorporates classical and operant conditioning in the explanation of phobias. Phobias, however, appear to be moderated by cognitive factors, such as oversensitivity to threatening cues, overpredictions of dangerousness, and self-defeating thoughts and irrational beliefs. Genetic factors also appear to increase proneness to development of phobias. Some investigators believe we are genetically predisposed to acquire certain types of phobias that may have had survival value for our prehistoric ancestors.

Question 53

What is obsessive-compulsive disorder?

Answer 53

Obsessive-compulsive disorder, OCD, involves recurrent patterns of obsessions, compulsions, or a combination of the two. Obsessions are nagging, persistent thoughts that create anxiety and seem beyond the person’s ability to control. Compulsions are apparently irresistible repetitious urges to perfrom cerain behaviours, such as repeated elaborate washing after using the bathroom.

Question 54

How is obsessive-compulsive order understood?

Answer 54

Within the psychodynamic tradition, obsessions represent leakage of unconscious impulses into consciousness, and compulsions are acts that help keep these impulses repressed. Research on biological factors highlights roles for genetics and for brain mechanisms involved in signaling danger andcontrolling repetitive behaviours. Research evidence shows roles for cognitive factors, such as overfocusing on one’s thoughts, exaggerated perceptions of risk of unfortunate events, and perfectionism. Learning theorists view compulsice behaviours as operant respones that are negatively reinforced by relief of anxiety produced by obsessional thinking.

Question 55

How is OCD disorder treated?

Answer 55

The major contemporary treatment approaches include learnin-based models (exposure with response prevention), cognitive therapy (correction of cognitive distortions), and the use of SSRI-type antidepressants.

Question 56

What is generalized anxiety disorder (GAD)?

Answer 56

Generalized anxiety disorder is a type of anxiety disorder involving persistent anxiety that seems to be “free floating” or not tied to specific situations.

Question 57

How is GAD understood?

Answer 57

Psychodynamic theorists view anxiety disorders as attempts by the ego to control the conscious emergence of threatening impulses. Feelings of anxiety are seen as warning signals that threatening impulses are nearing awareness. Learning-based models focus on the generalization of anxiety across stimulus situations. Cognitive theorists seek to account for generalized anxiety in terms of faulty thoughts or beliefs that underlie worry. Biological modles focus on irregularities in neurotransmitter functioning in the brain.

Question 58

How is GAD treated?

Answer 58

The two major treatment approaches are cognitive-behavioural therapy (CBT) and drug therapy (typically paroxetine).

Question 59

What are the two types of traumatic stress disorders?

Answer 59

The two types of stress disorders are acute stress disorder and psottraumatic stress disorder. Both involve maladaptive reactions to traumatic stressors. Acute stress disorder occurs in teh days and weeks following exposure to a traumatic event. Posttraumatic stress disorder persists for months or even years or decades aftesr the traumatic experience and may not begin until months or years after the event.

Question 60

How might we understand the development of PTSD?

Answer 60

Learing theory provides a framework for understanding the conditioning of fear to trauma-related stimuli and the role of negative reinforcement in maintaining avoidance behaviour. However, other factors come into play in determining vulnerability to PTSD, including degree of exposure to the trauma and personal characteristics, such as a history of childhood sexual abuse and lack of social support.

Question 61

What relationships exist between ethnicity and the prevalence of anxiety disorders?

Answer 61

Evidence from nationally representative samples of U.S. adults showed generally lower rartes of some anxiety disorders among ethnic minorities.