GAD Flashcards
GAD age onset:
median age is 30 years old, onset rarely occurs prior to adolescent
GAD diagnostic criteria:
excessive anxiety and worry occurring more days than not for at least 6 months having 3 or more of the 6 symptoms
GAD 6 symptoms:
- restlessness or feeling on edge
- being easily fatigued
- difficulty concentrating
- irritability
- muscle tension
- sleep disturbance (difficulty falling or staying asleep, restless, unsatisfying sleep)
only __ symptom required for children
1
how is GAD different from “normal” anxiety (5)
- GAD worry interferes with psychosocial function
- Gad worry is longer in duration and occurs frequently
- GAD worry is more likely to have physical symptoms
- GAD worry impairs individuals capacity to nothings quickly/efficiently
- GAd worry occurs on multiple fronts like worry about getting cancer even tho they are healthy
individuals worry tends to be ___ appropriate
age, adults thinking of routine life circumstances, children thinking of competence, punctuality
what is worry (apprehensive expectation)
living in a constant future oriented mood state of anxious apprehension and uneasiness
differences between rumination and worry
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
why do individuals worry?
helps people cope, prevents/avoids thinking about bigger issue, prepares for negative events, manages emotions, helps feel in control
GAd psychological causal factors: (4)
- cognitive avoidance theory of worry
- emotional dysregulation model
- metacognitive model
- intolerance of uncertainty model
cognitive avoidance theory of worry:
-superstitious/actual avoidance of catastrophe
-avoidance of deeper emotional topics
-coping and preparation
emotional dysregulation model
anxiety caused by difficulty in regulating emotions/emotional experience
metacognitive model:
anxiety caused by how one reacts to owns thoughts with preservative processing. “thinking about thinking, “worrying about worrying”
metacognitive model 2 types of worry:
type 1 worry: worries about everyday events
type 2 worry: worries about own thoughts/worries
intolerance of uncertainty model:
development and maintenance of anxiety caused by tendency to react negatively about uncertain situation (uncertainty is stressful, unfair)
mindfulness:
the practice of being present and aware of our inner thoughts, feelings, and surroundings
what is mindfulness shown to values in brain?
decrease amygdala activation, increase prefrontal cortex activation, and change in connectivity patterns within the frontoparietal default mode networks
emotional regulation therapy (ERT):
claims emotions are part of our motivational system and focuses on disorders of distress and negative self-referential processing (relating the world to oneself)
ERT 2 parts:
part 1: counteractive: psychoeducation and mindfulness based approaches with regard to emotional discomfort/distress
part 2: proactive: imaginary exposures, addressing obstacles
acceptance and commitment therapy (ACT):
goal is to increase psychological flexibility which is the ability to accept unpleasant feelings while staying in present moment
ACT 6 core processes:
- acceptance
- cognitive defusion
- being present
- self as context
- values
- committed action
cognitive delusion in ACT:
learning the process of thought rather than getting caught up or consumed in them
self-control desensitization in ACT:
process that diminishes emotional responsiveness to a negative, aversive, or positive stimulus after repeated exposure to it
self control desensitization 2 aspects:
- start with relaxation techniques and imagine themselves in experience that typically elicits worry
- clients signal to therapists when anxiety starts to rise, then client stops imagining and focuses on relaxation techniques
is GAD genetic?
minimal to mediate heritable component
parts of brain involved in GAD:
amygdala, BNST, cortex, hippocampus
amygdala in GAD:
emotion of fear/anxiety within limbic system
bed nucleus stria teminalis in GAD: (BNST)
vigilance, stress relay center to hypothalamus
cortex in GAD:
decision making, judgment, worrying activates the cortex areas
hippocampus in GAD:
learned emotional response
neurotransmitters involved in GAD:
GABA, serotonin, CRH (stress hormone)
what medications are used for GAD:
Buspirone (Buspar), safer and well tolerated than benzos but less preferred than SSRI’s
how long does it take for buspirone to show improvement?
2 to 4 weeks
mechanism of Buspirone:
activates serotonin receptor and inhibits dopamine receptor, does not act on GABA system
