Cognitive Therapy for Anxiety Disorders Flashcards
What is the difference between fear and anxiety?
Fear is a primitive automatic neurophysiological state of alarm involving the cognitive appraisal of imminent threat or danger to the safety and security of an individual.
Anxiety is a complex cognitive, affective, physiological and behavioral response system (ie threat mode) that is activated when anticipated events or circumstances are deemed to be highly aversive because they are perceived to be unpredictable, uncontrollable events that could potentially threaten the vital interests of an individual.
In other words, fear is at the core process of anxiety disorders, but anxiety is the enduring state of threat or apprehension.
What are the five criteria to distinguish normal anxiety from a clinical (abnormal) state?
1) Dysfunctional cognition (False assumptions or reasoning about danger or threat - e.g. “that tiny dog is dangerous”)
2) Impaired functioning (e.g., freezing, counter-productive responses)
3) Persistence (anxiety lasts a long time)
4) False alarms (e.g., panic attacks with no immediate threat cues)
5) Stimulus hypersensitivity (anxiety activated by wide range of low threat stimulus. e.g., any household spider)
What is the main problem with a categorical approach to anxiety (and depression) disorders?
There is strong evidence of symptom and disorder co-morbidity. In other words, 2/3 to 3/4 of anxiety patients had another current to lifetime anxiety disorder.
When conceptualizing a case of anxiety, what else should be assessed, based on co-morbidity research?
Major depression, alcohol abuse, and other anxiety disorders.
Given the high rate of anxiety disorders and symptoms in the general population, what should clinical assessment include?
Specification of symptom frequency, intensity, and measures that enable differential diagnosis between disorders.
What is the gender difference in anxiety prevalence?
Women have higher incidence rate of anxiety disorders than men, due to increased vulnerability (higher negative affectivity, differential socialization towards dependency, prosocial, empathic, less assertive and controlling, heightened sensitivity to threat reminders, tendency to engage in more avoidance, worry, and rumination.
From a cultural perspective, what should anxiety assessment focus on?
Individual’s cultural, social, and familial environment, and its influence on SUBJECTIVE experience of anxiety
What are the four general categories of symptoms?
Physiological, cognitive, behavioural, affective
What are the common physiological symptoms of anxiety? (12)
Increase heart rate, palpitations Shortness of breath, rapid breathing Chest pain or pressure Choking sensation Dizzy, lightheaded Sweaty, hot flashes, chills Nausea, upset stomach, diarrhea Trembling, shaking Tingling or numbness in arms, legs Weakness, unsteady, faintness Tense muscles, rigidity Dry mouth
What are the common cognitive symptoms of anxiety? (10)
Fear of losing control, unable to cope Fear of injury or death Fear of going crazy Fear of negative evaluation by others Frightening thoughts or memories Perceptions of unreality or detachment Poor concentration, confusion Narrowing of attention, hypervigilance for threat Poor memory Difficulty in reasoning, loss of objectivity
What are some common behavioural symptoms of anxiety? (7)
Avoidance of threat cues or situations Escape, flight Pursuit of safety, reassurance Restlessness, agitation, pacing Hyperventilation Freezing, motionless Difficulty speaking
What are some common affective symptoms of anxiety? (4)
Nervous, tense, wound-up
Frightened, fearful, terrified
Edgy, jumpy, jittery,
Impatient, frustrated
