end anxiety begin trauma (T3) Flashcards
What are the main two types of antidepressants?
SSRIs (selective serotonin reuptake inhibitors)
• TCAs (tricyclic antidepressants)
What are the two main types of medication for anxiety?
antidepressants and beta-blockers (often for physical symptoms)
What are the limitations of meds?
Symptom reduction, but not remission (still anxious)
• Temporary relief. Relapse when discontinued
• Don’t address underlying cognitive & behavioral processes that maintain problems
• Side effects (physical symptoms, sleep disturbance, etc.)
• Tolerance & dependency problems
What are the results of the Child-Adolescent Anxiety Multimodal (CAMS) Study (2008)?
results of sertraline alone are about equal to the results of CBT alone. CBT and sertraline combined yielded the best results.
What is exposure therapy?
A variant of behavior therapy, involves prolonged confrontation with feared object/situation. Can be gradual or flooded, real or theoretical. Recommended for social anxiety, selective mutism, and phobias in particular.
What are the aspects of exposure-based behavior therapy?
behavioral contract, contingency management, modeling, systemic desensitization.
What is behavioral contract?
A component of exposure-based behavioral therapy, client is rewarded when they face the feared stimulus.
What is contingency management?
“Little Peter” exposure + reward
What is modeling?
watching another child enjoy petting a dog.
What is systemic desensitization?
exposure hierarchy + incompatible relaxation response.
What is cognitive behavior therapy (CBT)?
identify and change automatic thoughts in order to change feelings and behavior. Process
- Identify cognitive distortions
- cognitive reappraisal
- teach F.E.A.R plan
What are cognitive distortions?
unrealistic negative thoughts. e.g., fortune-telling (I know this will go bad), catastrophic thoughts, etc. Identifying these is the first step of CBT.
What is cognitive reappraisal?
modifying self-talk, statements like, “I don’t know how it will go, but I can probably stand it, even if I don’t like it”. second step to CBT.
What is the F.E.A.R. plan?
Feelings, Expectations, Attitudes, Results. (example - I am sweaty and my stomach hurts, I will mess up - I will fail - people will laugh at me, I can practice - I did good last time - even if I do mess up it’s okay, I did it, I did well, nobody laughed at me - my reward is going to the movies with mom and dad).
Which anxiety disorders respond well to CBT?
GAD, SAD, and social anxiety.
What are the four components of CBT for panic disorder?
relaxation training, interoceptive exposure, cognitive restructuring, graded in vivo exposure.
What is relaxation training?
The first component of CBT for panic disorder, involves reducing physiological arousal.
What is interoceptive exposure?
The second component of CBT for panic disorder, produce physiological symptoms of panic, then use relaxation techniques to cope with these symptoms.
physiological symptom types:
Respiratory: breath through straw, climb stairs
Cardiac: run in place, ingest caffeine
Vestibular: shake head side-to-side, spin in chair, etc.
Dissociation: stare at something
What is cognitive restructuring?
The third component of CBT for panic disorder, involves challenging cognitive biases and distortions.
What is graded in vivo exposure?
The fourth component of CBT for panic disorder, a hierarchy of situations.
What are the three basic components of CBT for OCD and related disorders?
information gathering, exposure and response prevention, generalization.
