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Psychopathology and Mental Health > Exam 2 - Anxiety Disorders > Flashcards

Exam 2 - Anxiety Disorders Flashcards

1
Q

Anxiety:

The 5 CORE Anxiety Disorders

A
  1. Specific Phobias
  2. Social Anxiety Disorder (SAD)
  3. Generalized Anxiety Disorder (GAD)
  4. Panic Disorder
  5. Agoraphobia
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1
Q

Anxiety: Fear vs. Anxiety

A

Fear:
* Present focused: response to immediate danger/threat
* Intensity builds quickly

**Anxiety: **
* Future focused: anticipate and prepare
* ongoing feeling/worry of anticipation
* Example: Thinking about an upcoming project that’s due

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2
Q

Anxiety:

The Yerkes-Dodson Law: Inverted U-Model

A

There is an optimal level of arousal (stress) that maximizes performance

  • Low arousal = low performance
  • Moderate arousal = Optimal Performance
  • High arousal = declining performance
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3
Q

Anxiety: (fear/anxiety)

“Normal” to “Disordered”

A

Disordered when…

  1. Symptoms are pervasive and persistent
  2. It involves excessive avoidance
  3. It causes significant distress and impairment
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4
Q

Anxiety:

Comorbidity Rates

A

Internal:

  • > 50% of ppl with one anxiety disorder meet criteria for another anxiety
    disorder

External:

  • 75% meet criteria for another psychological disorder
  • 60% also have depression
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5
Q

Anxiety: Prevalence

A

Anxiety Disorders = one of the most common mental disorders

BUT

  • only ~25% of people who qualify for diagnosis seek treatment (so estimates are likely off)
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6
Q

Anxiety Disorders: Specific Phobia

A

Textbook Definition: Persistent, irrational, narrowly defined fears that are associated with a specific object or situation.

DSM-5 Definition: Intense, persistent fear of a specific object or situation that is excessive or unreasonable.

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7
Q

Anxiety Disorders: Specific Phobia

DSM-5 Diagnostic Criteria

A
  • Immediate fearful response to phobia exposure
  • Avoidance / Endured w intense Distress
  • Persistent fear, anxiety, & avoidance: 6+ months
  • Affects daily life
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8
Q

Anxiety Disorders: Specific Phobia

Prevalence

A
  • ~12% of the general population (may be an underestimation)
  • 3x more common in women
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9
Q

Anxiety Disorders: Specific Phobia

Facts (course, age, comorbidity)

A
  • Chronic – phobias don’t usually go away with treatment
  • Age of onset varies widely
  • Often comorbid with other specific phobias
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10
Q

Anxiety Disorders: Specific Phobia

Etiology (Causes)

A

Evolutionary Adaptation - being scared helped protect us from harm

Classical Conditioning - When a stimulus is paired with something scary, we can become conditioned to fear the stimulus.

  • ie: Baby Albert wasn’t scared of the Rat, but when it was paired with a load noise (feared stimulus) → the baby became conditioned to fear the Rat
    • phobia translated
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11
Q

Anxiety Disorders: Specific Phobia

Treatments

A

Medications – NOT recommended

  • Meds = Short-Term Solution (can become a “safety behavior”)
  • Benzodiazepines = addictive & short-term solution
  • Beta Blockers = not addictive, but are short-term solutions

Cognitive Behavioral Therapy (CBT) –- Highly Effective and Quick!

  • Exposure therapy
    • In-vivo exposure (real life exposure)
    • Imaginal exposure
      Levels of exposure, slowly increase (ie: level 1 = room filled with dog toys, level 10 = petting a dog)
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12
Q

Anxiety Disorders: Social Anxiety Disorder
(aka: Social Phobia)

Definition

A

DSM-5 Definition: “Fear or anxiety specific to social settings, where you feel noticed, observed, or scrutinized.”

  • Social Anxiety Disorder = ALMOST identical to Specific Phobia definition in DSM-5
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13
Q

Anxiety Disorders: Social Anxiety Disorder

DSM-5 Diagnostic Criteria

A
  • Fear of social rejection (and that others will notice your anxiety)
  • Social interaction cause distress
  • Social interaction is avoided or endured with intense anxiety/distress
  • Fear and anxiety are disproportionate to the situation

_KEY COMPONENT: Fear of Evaluation_

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14
Q

Anxiety Disorders: Social Anxiety Disorder

Prevalence

A
  • ~12% of the general population
  • Slightly higher rates in women
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15
Q

Anxiety Disorders: Social Anxiety Disorder

Facts (course, age, comorbidity, impairment)

A
  • Chronic – doesn’t usually go away with treatment
  • Onset age: Adolescents – Early Adulthood
  • High comorbidity with other anxiety disorders and depression
  • Impairment Ranges: moderate to severe
16
Q

Anxiety Disorders: Social Anxiety Disorder

Treatments

A

Medication:

  • SSRIs → Very effective
    • BUT relapse rates = high when medication is stopped

Psychological Treatments:

  • Cognitive Behavioral (Preferred method of treatment by AMA)
    • ie: exposure, rehearsal, role-play in group settings
  • Social Skills Training
    • ie: Extensive modeling of behaviors
  • Attention Bias Modification Training
    • A computer-based method that helps retreain people to focus on positive stimuli instead of negative stimuli.
    • seems to help reduce anxiety (more data needed to know how long affects last)
17
Q

Anxiety Disorders: Generalized Anxiety Disorder (GAD)

Definition

A

Textbook Definition: “Excessive and uncontrollable worry about a number of events or activities, and associated with symptoms of (physical) arousal.”

18
Q

Anxiety Disorders: Generalized Anxiety Disorder

DSM-5 Diagnostic Criteria

A
  • Excessive worry at least 50%
    • Trouble controlling these worries

At least 3 of the following:

  • Restlessness or feeling “keyed up” or on edge
  • Easily fatigued
  • Difficulty concentrating or mind going “blank”
  • Irritability
  • Muscle tension
  • Sleep disturbance (falling asleep, restless sleep)
19
Q

Anxiety: Generalized Anxiety Disorder vs. Major Depression Disorder

GAD symptoms vs. MDD Symptoms)

A

Big Differences:

  • GAD = Big worries + Trouble controlling worries
  • MDD = Sad Mood + Anhedonia (difficulty experiencing pleasure)
20
Q

Anxiety Disorders: Generalized Anxiety Disorder

Prevalence

A
  • Lifetime prevalence ~ 6%
  • Gender: 2x more women than men (approximately 2:1 ratio)
21
Q

Anxiety Disorders: Generalized Anxiety Disorder

Facts (course, heritability, comorbidity)

A
  • Often a chronic condition
  • Heritability ~33%
  • Comorbidity: High overlap with MDD
22
Q

Anxiety Disorders: Generalized Anxiety Disorder

Treatment

A

Cognitive Behavioral Therapy (CBD)

  • Identify, track, and challenge worries

Mindfulness Based Cognitive Therapy

  • Focus on present moment
  • When mind wanders to ‘what ifs’, gently bring it back to present
  • Relaxation strategies
  • Identifying thoughts + emotions remembering anxieties aren’t facts
  • Self-compassion

Medications
* SSRIs
* Benzos – not a good solution

23
Q

Anxiety Disorders: Panic Disorder/ Panic Attack

Definition

A

DSM-5 (in class) Definition: “A sudden onset of intense apprehension, terror, and/or feelings of impending doom, peaks quickly (10 minutes)”

24
Q

Anxiety Disorders: Panic Attack

Symptoms

A

Physical Symptoms:

  • shortness of breath, chills, chest pain, etc…

Psychological symptoms:

  • Depersonalization—feel like outside body
  • Derealization—feel like world isn’t real
  • Fear of losing control/going “crazy”
  • Fear of dying
25
Q

Anxiety Disorders: Panic Attacks / Disorder

Prevalence, gender, course

A
  • ~3-4% of the population
  • 2x as prevalent in women
  • ~20% of college students have a panic attack (most only have one)
  • Intermittent Course - goes away, but comes back
26
Q

Anxiety Disorders: Panic Attacks / Disorder

Facts

A
  • First attack usually experienced after high stress situation
  • The _response_ to panic attack determines if one develops Panic Disorder
  • Many adults who experience attack, never go on to develop Panic Disorder
27
Q

Anxiety Disorders: Panic Disorder

DSM-5 Diagnostic Criteria

A
  • Recurrent, unexpected panic attacks
  • Persistent worry about having another panic attack
    • or about the consequences of another attack (losing control, having heart attack, “going crazy,” etc.)
  • Significant change in behavior because of/related to attacks (ie: avoidance)
  • Can occur with or without Agoraphobia (The Fear of being in a situation difficult to escape or receive help)
28
Q

Anxiety Disorders:

Agoraphobia Definition

A

The fear or anxiety about being in situations difficult to escape or receive help

29
Q

Anxiety Disorders: Agoraphobia

DSM-5 Criteria

A

Fear or anxiety about being in situations
difficult to escape or receive help

  • These situations are avoided or endured with intense fear/anxiety

Note: Often portrayed as being house bound, but it’s not necessarily the case

30
Q

Anxiety Disorders: Panic Disorder

Treatment

A

Medication:

  • Benzodiazepines – not recommended, relapse frequent

Therapy:

  • Exposure is key – and very effective!
    • Interoceptive Exposure: exposure to physical sensations associated w panic attack
  • Goal: watch anxiety go up, cope with it, learn that you will be okay
31
Q

Anxiety Disorders

Genes & Heritability

A
  • Anxiety = 30-60% heritable
  • Some genes may elevate risk for disorders
  • Genetic vulnerability for anxiety &
    depression may overlap
32
Q

Anxiety Disorders

Neurobiological / Relevant Brain Regions

A

Relevant Brain Regions:

  • Limbic System is Key*
    * Heightened activity in the amygdala / insula
    * Diminished activity of the prefrontal cortex in response to threatening stimuli

Neurotransmitters:

  • Serotonin and GABA are disrupted
  • Norepinephrine levels increases

Sympathetic Nervous system involved: physical symptoms

33
Q

Anxiety Disorders: Panic Disorder

Positive Feedback Loop

A

Positive Feedback Loop

When a person reacts anxiously to their physical symptoms this increases their anxiety.

34
Q

Anxiety:

Types of Exposure Therapy

A

In Vivo Exposure: Exposed to the fear in real life

Imaginal Exposure: Imagining a fear vividly

Interoceptive Exposure Triggering physical sensations to learn they are not harmful

Virtual Reality Exposure: Being exposed to the fear via VR

35
Q

Anxiety:

Treatment DURING a Panic Attack

A

During a panic attack – focus on present moment

  • Focus on Breath
  • What can you see, hear, taste, smell to help bring you to present
  • wait for symptoms to lessen
36
Q

Anxiety Disorders:

Treatment Across Anxiety Disorders

A

Exposure Therapy: effective for 70–90% of clients who do it

Mindfulness/relaxation and acceptance: A promising approach

Medications: Effective, but high relapse rates when medications are stopped
(SSRIs better long-term choice)

Psychological treatments are the preferred method

37
Q

Anxiety Prevention

A

School prevention programs

  • may be helpful in reducing future anxiety symptoms / disorders BUT evidence is mixed

Psychopathology and Mental Health (10 decks)

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