lecture 4 material Flashcards
Anxiety, Trauma & Stressor-Related, and Obsessive-Compulsive Related Disorders
Compare Anxiety, Fear and Panic Attacks
Anxiety = Apprehensive, future-oriented, lower intensity (compared to fear)
- Somatic symptoms: muscle tension, restlessness,
elevated heart rate
Fear = Immediate, present-oriented (emotions felt in the moment), high intensity
- Sympathetic nervous system activation: sweating,
heart palpitations, rapid breathing, urge to run
Panic Attack = Abrupt experience of intense fear when there is no
real danger
What are some anxiety disorders classified in the DSM-5
- Generalized Anxiety Disorder
- Panic Disorder and Agoraphobia
- Specific Phobias
- Social Anxiety Disorder
- Separation Anxiety Disorder
- Selective Mutism
How is Generalised Anxiety Disorder classified
It is the excessive anxiety and worry about multiple things occurring more days than not for at least 6 months
Involves:
* Difficulty controlling the worry
* Anxiety and worry associated with other physical
symptoms
* Anxiety causes clinically significant distress or
impairment
* Not due to substance use or medical condition
* Not better explained by another mental disorder
What are some associated factors of Generalised Anxiety Disorder
- Threat beliefs: tend to believe the world is unpredictable and believe they are unable of coping with the demands
- Poor problem-solving: may think they dont have the ability to problem solve and/or are unable to
- Overestimate likelihood of feared events
- Catastrophise costs
- Intolerance of uncertainty: prefer to know something uncertain may happen rather than be uncertain
- Engagement in unnecessary safety behaviour
What is the Cognitive Avoidance Model
Model that explains why people develop and maintain GAD
- This model infers that ‘worry’ is a verbal-linguistic process, which may produce less physiological responding than imagery (worrying in words rather than images in their mind)
- Worry allows people to avoid further INCREASES in negative emotions –> found that people with GAD would rather feel somewhat bad/on edge all the time, rather then be struck with large amounts of distress from events (i.e. trying to avoid any huge spike of negative emotions)
- Worry is negatively reinforced because it allows people to reduce their level of distress when confronted by stressor
- Relief is heightened when feared event does not occur
- Worry prevents effective problem-solving
- Worry prevents emotional processing of stressful stimuli
What is treatment for Generalised Anxiety Disorder
Cognitive-behavioral treatments
* Exposure to worry process
* Confronting anxiety-provoking images
* Coping strategies to deal with stressors in an effective manner
* Teach them relaxation strategies to help make them less worrisome
What are the indicators of a panic attack
4+ of the following:
* Palpitations, pounding heart, or accelerated heart rate
* Sweating
* Trembling or shaking
* Feeling of choking
* Chest pain or discomfort
* Nausea or abdominal distress
* Feeling dizzy, unsteady, light-headed or faint
* Chills or heat sensations
* Paresthesia
* Derealisation
* Fear of losing control or going crazy
* Fear of dying
What are the stages involved in Clark’s (1986) Model for Panic Attacks
1) trigger (thoughts/images/events)
2) perceived danger
3) apprehension/fear
4) over-breathing
5) body sensations
6) thoughts that body sensations are a sign of catastrophe
(and then the cycle continues back from the beginning)
What is the criterion for Panic Disorder
- Recurrent unexpected panic attacks
- Anxiety, worry, or fear of another attack
- Persists for 1 month or more
- Not attributable to substance use
- Not better explained by another mental disorder
What is Agoraphobia and how is it Classified
Agoraphobia = Marked fear/anxiety for two or more: public
transportation, open spaces, enclosed spaces, standing in line, being outside the home alone
Concern about being unable to escape or get help in the
event of panic symptoms or other unpleasant physical
symptoms (e.g., incontinence, vomiting, falling)
Criterion:
* Avoids these situations
* Situations always provoke fear
* Anxiety not proportional to real danger
* Distress/avoidance persists for 6 mos+
* Distress/avoidance is excessive/causes impairment
* Not better explained by another mental disorder
Associated factors:
* Threat beliefs
* Engagement in unnecessary safety behaviour
What are treatment methods for Panic Disorder and Agoraphobia
Medications:
Benzodiazepines, SSRIs
* Has high relapse rates
Cognitive-behavioral treatment
* Exposure to interoceptive cues
* Exposure to feared situations
* Challenge beliefs through exposure
How are ‘Specific Phobias’ Classified
Specific Phobias = Marked fear or anxiety about a specific object or
situation
* Phobic object or situation almost always provokes
immediate fear or anxiety
* Phobic object/situation is actively avoided
* Phobic object/situation out of proportion to actual danger
* Lasts more than 6 months
* Clinically significant distress
* Not better explained by symptoms of another mental disorder
Examples of common phobias
- Blood-Injection-injury phobia
- Natural environment phobia
- Animal phobia
- Situational phobia
all of these are fear out of proportion to real danger
How can phobias arise
- Direct experience –> e.g. got bitten by a dog and now fear dogs
- Vicarious experience –> e.g. saw someone else get bitten by a dog and now fear dogs
- Information transmission –> e.g. someone told you that dogs are dangerous thus causing fear of dogs
- Preparedness
- Avoidance: maintains phobias as individual wont learn there is nothing to fear
What is the best treatment for specific phobias
exposure therapy
