GAD

Question 1

GAD age onset:

Answer 1

median age is 30 years old, onset rarely occurs prior to adolescent

Question 2

GAD diagnostic criteria:

Answer 2

excessive anxiety and worry occurring more days than not for at least 6 months having 3 or more of the 6 symptoms

Question 3

GAD 6 symptoms:

Answer 3

1. restlessness or feeling on edge
2. being easily fatigued
3. difficulty concentrating
4. irritability
5. muscle tension
6. sleep disturbance (difficulty falling or staying asleep, restless, unsatisfying sleep)

Question 4

only __ symptom required for children

Answer 4

1

Question 5

how is GAD different from “normal” anxiety (5)

Answer 5

1. GAD worry interferes with psychosocial function
2. Gad worry is longer in duration and occurs frequently
3. GAD worry is more likely to have physical symptoms
4. GAD worry impairs individuals capacity to nothings quickly/efficiently
5. GAd worry occurs on multiple fronts like worry about getting cancer even tho they are healthy

Question 6

individuals worry tends to be ___ appropriate

Answer 6

age, adults thinking of routine life circumstances, children thinking of competence, punctuality

Question 7

what is worry (apprehensive expectation)

Answer 7

living in a constant future oriented mood state of anxious apprehension and uneasiness

Question 8

differences between rumination and worry

Answer 8

worry focused on fear/threat, future oriented, linked with anxiety, focus on many things, “what if” questions/distractions.

rumination focused on past/present, concerned with failure/loss, linked with depression, focus on one/few things, coping response to mood

Question 9

why do individuals worry?

Answer 9

helps people cope, prevents/avoids thinking about bigger issue, prepares for negative events, manages emotions, helps feel in control

Question 10

GAd psychological causal factors: (4)

Answer 10

1. cognitive avoidance theory of worry
2. emotional dysregulation model
3. metacognitive model
4. intolerance of uncertainty model

Question 11

cognitive avoidance theory of worry:

Answer 11

-superstitious/actual avoidance of catastrophe
-avoidance of deeper emotional topics
-coping and preparation

Question 12

emotional dysregulation model

Answer 12

anxiety caused by difficulty in regulating emotions/emotional experience

Question 13

metacognitive model:

Answer 13

anxiety caused by how one reacts to owns thoughts with preservative processing. “thinking about thinking, “worrying about worrying”

Question 14

metacognitive model 2 types of worry:

Answer 14

type 1 worry: worries about everyday events
type 2 worry: worries about own thoughts/worries

Question 15

intolerance of uncertainty model:

Answer 15

development and maintenance of anxiety caused by tendency to react negatively about uncertain situation (uncertainty is stressful, unfair)

Question 16

mindfulness:

Answer 16

the practice of being present and aware of our inner thoughts, feelings, and surroundings

Question 17

what is mindfulness shown to values in brain?

Answer 17

decrease amygdala activation, increase prefrontal cortex activation, and change in connectivity patterns within the frontoparietal default mode networks

Question 18

emotional regulation therapy (ERT):

Answer 18

claims emotions are part of our motivational system and focuses on disorders of distress and negative self-referential processing (relating the world to oneself)

Question 19

ERT 2 parts:

Answer 19

part 1: counteractive: psychoeducation and mindfulness based approaches with regard to emotional discomfort/distress
part 2: proactive: imaginary exposures, addressing obstacles

Question 20

acceptance and commitment therapy (ACT):

Answer 20

goal is to increase psychological flexibility which is the ability to accept unpleasant feelings while staying in present moment

Question 21

ACT 6 core processes:

Answer 21

1. acceptance
2. cognitive defusion
3. being present
4. self as context
5. values
6. committed action

Question 22

cognitive delusion in ACT:

Answer 22

learning the process of thought rather than getting caught up or consumed in them

Question 23

self-control desensitization in ACT:

Answer 23

process that diminishes emotional responsiveness to a negative, aversive, or positive stimulus after repeated exposure to it

Question 24

self control desensitization 2 aspects:

Answer 24

1. start with relaxation techniques and imagine themselves in experience that typically elicits worry
2. clients signal to therapists when anxiety starts to rise, then client stops imagining and focuses on relaxation techniques

Question 25

is GAD genetic?

Answer 25

minimal to mediate heritable component

Question 26

parts of brain involved in GAD:

Answer 26

amygdala, BNST, cortex, hippocampus

Question 27

amygdala in GAD:

Answer 27

emotion of fear/anxiety within limbic system

Question 28

bed nucleus stria teminalis in GAD: (BNST)

Answer 28

vigilance, stress relay center to hypothalamus

Question 29

cortex in GAD:

Answer 29

decision making, judgment, worrying activates the cortex areas

Question 30

hippocampus in GAD:

Answer 30

learned emotional response

Question 31

neurotransmitters involved in GAD:

Answer 31

GABA, serotonin, CRH (stress hormone)

Question 32

what medications are used for GAD:

Answer 32

Buspirone (Buspar), safer and well tolerated than benzos but less preferred than SSRI’s

Question 33

how long does it take for buspirone to show improvement?

Answer 33

2 to 4 weeks

Question 34

mechanism of Buspirone:

Answer 34

activates serotonin receptor and inhibits dopamine receptor, does not act on GABA system