General Anxiety Disorder Flashcards
how could we differentiate between
someone who has depression and anxiety if they have the same symptoms?
1.) Worry
2.) Timing of these symptoms
GAD 12 month prevalence in adolescents …..
0.9%
GAD 12 month prevalence in adults …….
2.9%
GAD lifetime prevalence……
4.7%
GAD ratio of females to males is ….
2:1
GAD onset = median age is ______ (_______ than most anxiety disorders). Although individuals report that they have felt anxious ________.
30 years old, later, all their lives
GAD development: onset rarely occurs ________. Peaks in ______ then _______ across later years in life
prior to adolescent, middle age, declines
Generalized Anxiety Disorder (GAD)
Diagnostic Criteria (A)
1) Excessive anxiety and worry occurring more days than not for at least 6 months
Generalized Anxiety Disorder (GAD)
Diagnostic Criteria (B)
Individual finds it difficult to control the worry
Generalized Anxiety Disorder (GAD)
Diagnostic Criteria (C)
The anxiety and worry are associated with three (or more) of the six
symptoms presented
Generalized Anxiety Disorder (GAD)
Diagnostic Criteria (D)
The symptoms cause clinically significant distress or impairment
Generalized Anxiety Disorder (GAD)
Diagnostic Criteria (E)
The disturbance is not better explained by another mental disorder
GAD Diagnostic Symptoms (6)
1) Restlessness or feeling on edge
2) Being easily fatigued
3) Difficulty concentrating or mind going blank
4) Irritability
5) Muscle tension
6) Sleep disturbance
GAD Diagnostic symptoms in regards to children ….
only one of the symptoms is required
GAD specifier with panic attack …..
An abrupt surge of intense fear or intense discomfort that reaches a peak within minutes during which time 4 (or more) symptoms might occur
Examples of GAD with panic symptoms ….
1) accelerated heart rate
2) Sweating
3) Trembling or shaking
4) shortness of breath
5) Chest pain
6) abdominal distress
7) light-headed
8) Fear of dying
9) Fear of losing control
10) Paresthesias
11) Derealization
12) Chills or heat sensations.
GAD with panic results in ….
1) worse long-term outcome
2) severity of the disorder
(GAD) worry is a chain of thoughts and images, _______ and relatively _______
negatively affect-laden, uncontrollable
(GAD) worry is primarily an _______ process involving ______, primarily ________ related to possible _______ and their ________.
anticipatory cognitive, repetitive, verbal thoughts, threatening outcomes, consequences
(GAD) worry is living in a relatively ______, ________ mood state of _______ and _______.
constant, future-oriented, anxious apprehension, uneasiness
Worry is _______, Rumination is oriented on the _______
future-oriented, past / present
Worry is concerned with _______, Rumination is concerned with _______
fear/threat, failure/loss
Worry is linked with _______, Rumination is linked with ________
anxiety, depression
Worry focuses on _______ Rumination focuses on _______
many things, one/few things
Worry is ______ questions Rumination is a ______ to ______
“What if”, coping response, mood
GAD worry is _______ and interferes with _______
excessive, psychosocial function
GAD worry is longer in _______, and occurs _______ without _______
duration, frequently, precipitants
GAD worry is more likely to be accompanied by ________.
physical symptoms
GAD worry impairs individual’s capacity to do things ______ and _______
quickly, efficiently
GAD worry usually occurs on _______
multiple fronts
With GAD, individuals worry tends to be ……
age appropriate
Adults worry about ….
routine life circumstances
Children worry about ______ of their performance, _______, _______ events
competence or quality, punctuality, catastrophic
Most _______ focus on what is _______ worry in individuals with GAD
psychological theories, maintaining
Worrying helps the individual ______,
_______ thinking about the bigger issue, ______ me for negative events, helps ______ emotions, helps individual feel ______
cope, prevents/avoids, prepares, manage, in control
worry is…..
maladaptive problem solving
Cognitive Avoidance Theory of Worry includes …..
1) Superstitious / actual avoidance of catastrophe
2) Avoidance of deeper emotional topics
3) Coping and preparation
Cognitive Avoidance Theory of Worry: worrying just ______ to fear-inducing images mutes _______ and _______ responses ( _______ reinforcement
prior, physiological, emotional, negative
Cognitive Avoidance Theory of Worry: worrying helps _____ one from _______ (_______ that allows for someone to have a sense of _______)
avoid, dysphoric feelings, defense mechanism, control
Emotional dysregulation Model is how the ……
development and maintenance of anxiety are caused by difficulty in
regulating emotions / emotional experience
Emotional dysregulation Model: With GAD experience emotions more ______, ______, and with
more _______
quickly, easily, heightened intensity
Emotional dysregulation Model: With GAD there is difficulty _______ from a _______ mood state
recovering, negative
Emotional dysregulation Model: With GAD there are sharp increases in
________ to _______ emotional states
negative, positive
Emotional dysregulation Model: Persons with GAD would rather have _______ low levels of ______ and _______ bad things to happen than to have ______ in mood
sustained, distress, expecting, sharp shifts
Metacognitive model is how the …….
development and maintenance of anxiety are caused by how one reacts to one’s own thoughts with preseverative processing
Metacognitive model: An individual has 2 types of worry when confronted with anxiety …..
1) worries about everyday events
2) worries about own thoughts/worries
Metacognitive model: A person holds _______ (worry is _____) and
________ (worry is ______)
positive beliefs, useful, negative beliefs, uncontrollable / negative
Intolerance of Uncertainty Model states that the …..
development and maintenance of anxiety are caused by tendency to react negatively about uncertainty / ambiguous situations
Metacognitive model: When a person is trying to suppress worrying about _______ it makes things ______.
own thoughts/worries, worse
Intolerance of Uncertainty Model: worrying ______ feelings of ______ / helps ______
reduces, uncertainty, coping
Intolerance of Uncertainty Model: Persons prefer ______ outcome to an ______ one
negative, uncertain
Acceptance and commitment therapy (ACT) goal is to ….
increase psychological flexibility
Intolerance of Uncertainty Model: Disorder leads to ______ instead of ________
worry, problem-solving
psychological flexibility is the …
ability to accept unpleasant
thoughts/feelings while staying present in the moment, and then
choosing helpful behaviors based on the situation or one’s personal values
Acceptance and commitment therapy (ACT) is _______, not necessarily _______
acceptance-based, change-based
Acceptance and commitment therapy (ACT) is rooted in
_______ and _______
mindfulness, self-acceptance
Acceptance and commitment therapy (ACT) is tailored to the ______, can be ______, ______, and/or _______, also can be brief or long in _______.
individual client, individual, couples, grouped, duration
Acceptance and commitment therapy (ACT) is achieved via 6 core processes called ..
Hexaflex model
Hexaflex Model Stages ….
1) Acceptance
2) Cognitive defusion
3) Being present
4) Self as context
5) Values
6) Committed action
Hexaflex Model: 1) Acceptance includes ….
1) practicing non-judgemental awareness
2) accepting the experience of negative emotions
Hexaflex Model: 2) Cognitive defusion includes …..
learning the process of thought rather than getting caught up or consumed by them
Hexaflex Model: 3) Being present includes …..
be grounded and fully engaged with one’s sensory experiences in the present moment
Hexaflex Model: 4) Self as context includes …..
individual is not just the content of their thoughts and emotions
Hexaflex Model: 5) Values includes …..
process of identifying what is important to an individual , and what qualities of behavior one would like to live with
Hexaflex Model: 6) Committed action includes …..
taking steps toward committed values
Self-control desensitization is a …….
treatment or process that diminishes emotional responsiveness to a negative, aversive or positive stimulus after repeated exposure to it
Counter-Conditioning Model for Gradual Anxiety Extinction operates under the …..
reciprocal inhibition concept
The Reciprocal Inhibition Concept states ……
patient can not be relaxed and anxious / tense at the same time
Counter-Conditioning Model for Gradual Anxiety Extinction: State The R’s
React, Retreat, Relax, Recover, Repeat
Counter-Conditioning Model for Gradual Anxiety Extinction has 2 aspects ….
1) Create an anxiety stimulus hierarchy for anxiety-provoking
situations with ratings
2) Anxiety-producing events paired with relaxation
GAD has a ______ to _______ heritable component
minimal, moderate
_______ of variance in liability to GAD due to _______.
30-40%, genetics
Amygdala: _____ and ______ within the ________, ________ with other brain areas
fear, anxiety, limbic system, bidirectional
BNST: extension of ______, _______, and ________ center to hypothalamus (worry increases _______ levels)
amygdala, vigilance, stress relay, cortisol
Cortex: ________ thinking, ________, worrying statements ______ the ______ areas and don’t return to ______.
higher order, judgment, activate, cortex, baseline
Hippocampus: learned _______ (conditioned ______ memories)
emotional response, fear
Neurotransmitter systems involved ……
GABA, serotonin, CRH
Anxiolytics are minor _______. They are muscle ________, have _______ properties, and _______ tension
tranquilizers, relaxant, sedative, reduce
Anxiolytics (Buspirone) take _______ to show improvement
2 to 4 weeks,
Anxiolytics (Buspirone) are ______, well tolerated than _______; but less preferred than _______.
safer, benzos, SSRIs
Anxiolytics (Buspirone) have less side effects compared to _______
benzos
Anxiolytics (Buspirone) do not lead to …..
physiological dependence
Anxiolytics example for GAD ……
Buspirone (Buspar)
Buspirone is a partial and full ______ of _______ receptor (______)
agonist, 5-HT1a
Buspirone is an _______ of ________ receptor
antagonist, dopamine D2
Buspirone does not act on the ______
GABA system
SSRIs don’t create physiological dependence to the degree that _________ do
benzodiazepines
SSRIs can alleviate cormorbid _______ symptoms
depressive
SSRIs takes about ______ to have any noticeable effects
2-6 weeks
SSRIs have ______ undesirable side effects; may see ______ in anxiety first ______, which can reduce ________
mild, increase, 2 weeks, treatment compliance
SSRIs have _______ benefit/risk analysis therefore ……..
positive, “first line of defense”
SSRIs are still _______ in terms of long-term effects
unknown
SSRIs short-term effects: blocks ______, therefore more ______ is present in the _______
serotonin reuptake transporter (SERT), serotonin, synaptic cleft
Notion that _______ underlies GAD
serotonin
Anxiolytics (Benzodiazepines) examples for GAD ……
Xanax, Klonopin, Valium, Ativan
Anxiolytics (Benzos) can induce _______ side effects, examples ….
undesirable
cognitive functions
aggression
increase suicide risk
Anxiolytics (Benzos) have very _______, within ________, they are _______ and _____
rapid effects, minutes, sedative, muscle relaxing
Anxiolytics (Benzos) can cause _______, therefore can lead to ______, and relapse of _______
physiological dependence, withdrawal, anxiety disorders
Anxiolytics (Benzos) do not treat comorbid symptoms …..
with depression
Benzos are an _______ by binding to _______ receptors and alter the
_______ of the _______ when ______ binds
allosteric modulator, GABA-A, responsiveness, ion channel, GABA
Benzos increase …..
chloride ion conductance
Benzos move the ______ more ______ and prevent further _______ or ______
resting membrane potential, negative, depolarization, activation
Benzos potentiate …..
GABAergic inhibitory synaptic transmission
