Lecture 6 - Panic Attacks, GAD & PTSD Flashcards
What are the two ways in which panic attacks can be elicited?
In response to specific cues (PTSD and flashbacks) or unexpected attacks (two of which are needed for PD).
What are two key criteria for Panic Disorder?
Persistent worry/concern over future attacks and maladaptive behaviours that seek to reduce attacks.
What is the Cognitive Theory of Panic?
Panic results from physiological arousal (increased heart beat) that is associated with panic but is not necessarily panic (e.g. when angry). Specific behaviours maintain these thoughts (e.g. always bring a friend to social gatherings, which they see as calming).
What is the CBT treatment for PD and Agoraphobia? How effective is it?
Mainly cognitive restructuring, where the avoided stimuli/situations are present (or hyperventilating with PD) to stimulate arousal but then realise that the patient is fine. Very effective - 80-85%
Which symptoms of anxiety are not present for GAD?
No parasympathetic responses or panic sensations, just excessive worry about a range of outcomes.
What is normal worry? What does it achieve?
Concern about future events that may go poorly (mostly social concerns). Involves verbal thoughts rather than imagery (which is more distressing). Motivates action, begins problem solving, avoids negative outcomes and distracts us.
What occurs with social problem solving in pathological worriers?
Typically, people define a problem, generate solutions, evaluate them and then select one. But pathological worriers label ambiguous events as threatening, and negatively evaluate the situation, never pick a solution, and worry continues.
What is the Metacognitive Theory of Worry?
Type I worry is ‘normal’ worry that is used to cope with a threat. Type II worry is ‘meta worry’, where worrying is seen as negative and begin to worry about worry -> punish or suppress worry.
What is the Avoidance Theory of Worry?
We tend to verbalize worry internally rather than using imagery, as imagery is more distressing. Worry interferes with emotional processing, where people with GAD have a low tolerance of distress and subsequently do not learn how to identify, tolerate and modulate emotions.
What is the Intolerance of Uncertainty Theory of worry?
People with GAD have high levels of worry when the outcome is uncertain. Only when uncertainty is 0 will they act, even when the certain event is worse. Worry reduces this uncertainty but then you worry about minor details, instead of problem solving, preventing action.
What is the CBT treatment for GAD? How effective is it? Why is it so?
Change beliefs about worry, learn how to properly evaluate threat, restructure problem solving methods, and expose them to the event/distress/uncertainty. Only 50-60% success due to variety of theories.
What is the key characteristic of PTSD?
Strong, vivid and intrusive thoughts of a traumatic event experienced in the past. Must have been experienced, witnessed in person, learned of happening to a loved one.
What are the pre-trauma risk factors of PTSD? (5)
Childhood trauma, psychiatric history, family instability, substance abuse and economic disadvantage.
What are the trauma risk factors of PTSD? (5)
Degree of loss/threat, severity of exposure, location of trauma, their role in the trauma and meaning of the event.
What are the post-trauma risk factors of PTSD? (3)
Social support, coping style and ongoing stressors.
