chpt 5 Flashcards
components of anxiety
physiological: HR, shortness of breath…heightened lvl of arousal and phys activation
cognitive: subjective perception of anxious arousal and associated cog processes
behavioural: safety behaviours, avoidance
test anxiety
tension and apprehension in and in prep of tests w cog and phys symptoms
test-irrelevant thinking: inability to concentrate due to wandering mind
prevalence of anxiety
most common psych disorder
16% women, 9% ontario men
- highest percentage women 15-24
international prevalence: one year 10.6%, lifetime 16.6%
anxiety vs other disorders
lifetime morbid risk (LMR): lifetime prevalence for ALL anxiety disorders is 60% vs depression 29.9%
anxiety disorders have earliest/latest median age of onset
separation anxiety
fear and distress when away from person/fearing losing contact
specific phobias
unwarranted fears of objects/situations that are nondangerous
- individ acknowledges ungrounded fear
- often not strong enough for treatment
most common phobias
- animal 2. heights 3. enclosed spaces
also blood/injection, thunder, dentist, flying, water
pa-leng: chinese fear of cold due to yin energy, loss of life
social anxiety disorder
irrational fear of judgement from others, avoid evaluation
subtypes:
1. performance i.e. speaking
2. social interactions i.e. talk to clerk
3. public observation i.e. ride bus
taijin kyofusho: japanese fear of embarassing others by self appearance
onset and prevalence of SAD
adolescent onset, i.e. 13yrs and lasts 20yrs
lifetime prevalence: higher in women, unmarried, no post-secondary education, less support
SAD in children
often comorbid with other types of anxiety, mainly selective mutism
behavioural theories of phobias ans SAD
2-factor model: person learns via classical conditioning (associate -ve stim w behaviour) and operant conditioning (reward v punish)
modelling: learn vicariously through fears of others
prepared learning: predisposed to fear things that are intrinsically threatening i.e. snakes
diathesis: predisposition…ppl may have tendency to believe traumatic event will happen again
social skills defecit: develop SAD bcs don’t know how to interact w others
cognitive theories phobias and SAD
ppl w phobias and SAD:
- pay attention to -ve stimuli
- -vely interpret ambiguous info**
- believe -ve events will occur
SAD linked to:
- attentional bias to -ve social info
- memory bias where interpret own actions -vely
post-event processing: ppl w SAD will focus on what should have done
biological theories of phobias and SAD
autonomic nervous system: system becomes aroused
- autonomic lability: system easily aroused, results in labile/jumpy ppl
amygdala and insula more active
jerome kagan: found infants cry when shown toys, may be more likely to develop phobia
- inherited behaviour
psychoanalytic theories SAD and phobias
phobias are defense against anxiety caused by repressed id impulses
anxiety is displaced from id into objects it symbolizes
by avoiding stim, avoid conflict
panic attack symptoms
- rapid breathing
- nausea
- chest pain
- dizziness, trembling, sweating
- depersonalization: feel out of body, lose sense of reality
- derealization: feel world isn’t real, fear of losing control and going crazy
types of panic attacks
cued: strong association w trigger
situationally predisposed: some association w trigger
uncued: occur in benign states i.e. sleep, rest
- uncued triggers MUST occur to be diagnosed w panic disorder
prevalence and severity of panic disorder
canadian prevalence: 6.4% in one year
- some may be independent of ab psych
cultural issues: inuit kayak-angst, fear of drowning when solo hunting
agoraphobia
cluster of fears abt public places and being unable to escape
needs anxiety in 2/5 situations:
1. public transport
2. open spaces
3. closed spaces
4. lines/crowds
5. being out of house alone
panic disorder and agoraphobia
diagnosed w or w/o agora
w agoraphobia: when avoidance behaviour becomes widespread to many situations
- avoid places where attacks are dangerous or embarassing
biological theories of panic disorder
some illnesses cause symptoms
- mitral valve prolapse = heart palp
- inner ear disease = dizziness
noradrenergic overactivation: when system overly active can cause attack
genetic factors: disorder runs in families, more common in twins
psychological thoeires of panic disorder
fear-of-fear hypothesis: agoraphobia not from public places, but fear of having attack
misinterpretation of phys symptoms: ppl become attentive to and upset by sensations
vicious cycle: ppl become vigilant abt signs of attack, makes attack more freq
anxiety sensitivity: risk factor for anxiety
- predicts development of anxiety and other disorders
generalized anxiety disorder
all-encompassing worries
features: diff concentrating, irritability, tired, high lvl muscle tension
treatment not often successful, only 18%
high comorbidity w anxiety and mood disorders
psychological thoeries GAD
learning theories: anxiety classically conditioned w external stimuli
- need broad range stimuli
cognitive theories: perception of no control
intolerance of uncertainty: inability to tolerate uncertain outcomes, when ambig situation or assessing
approach-avoidance conflicts:
1. intolerance of uncertainty
2. fear of anxiety
role of worrying: distraction, does not produce physiological change and blocks emotional stimulus…anxiety does not dec
bio theories GAD
genetic component
benzodiazepines may decrease anxiety bcs they increase GABA
- when take drugs that inhibit it, anxiety increases
behavioural treatment of anx disorders
systematic desensitization: first used for specific phobias
- imagine series of increasingly frightening scenes while relaxed
in vivo exposure: home exercise where ppl exose to feared stim
- superior to imagination
- high dropout
VR exposure: as effective as in vivo
- AR only used for small animal phobias
- powerful impact, stable outcome
flooding: for phobias, exposure in full force…only last resort
recommendation for injection
tense muscles to prevent fainting, since relaxing may result in fainting spell
exposure treatment for panic disorder
panic-control therapy: three comps
1. relaxation training
2. combo ellis and beck CBT i.e. cognitive restructuring
3. interoceptive exposure: practice exercises that mimic feeling of anxiety
bio treatment of anxiety
anxiety reducing drugs: sedatives, tranquilizers, and anxiolytics (loosen)
barbituates: 1st used, highly addictive and risk OD
benzodiazepines: i.e. atvian, supplement to other drugs like xanax
depression drugs used for anxiety
- monoamine oxidase: as effective as CBT
- high blood pressure when eat cheese - selective serotonin reuptake inhibitors (SSRI): i.e. prozac, inc lvl of serotonin in brain
- preferred for SAD, not GAD or phobias
- 50% ineffective
- can inc anxiety, insomnia, anger
