Lecture IV

Question 1

Freud and anxiety

Answer 1

Anxiety as sign of inner conflict between id’s primitive desires and the ego/superego’s prohibitions on expression

Question 2

Fear vs. anxiety

Answer 2

Difficult to completely distinguish. Depends on whether source of danger is obvious and immediate (fear) or just possible and in the future (anxiety). Fear - flight-or-flight response in autonomic nervous system.

Question 3

Uncued panic attacks

Answer 3

Fear response occurs in absence of obvious danger. Symptoms nearly identical to fear response, and feeling impending doom

Question 4

Three components of fear/panic

Answer 4

(1) Cognitive/subjective: feeling afraid
(2) Physiological: heartrate, breathing
(3) Behavioral: urge to escape

Question 5

Anxiety

Answer 5

General feeling of apprehension about possible danger. Concerned with the future, more diffuse. Tension and chronic over-arousal, but not fight/flight. Adaptive in that helps to plan for possible threat, and enhances learning/performance.

Question 6

Three components of anxiety

Answer 6

(1) Cognitive/subjective: negative mood, worry, self-preoccupation, sense of lack of control
(2) Physiological: tension, chronic over-arousal, primed for flight/fight
(3) Behavioral: can lead to avoidance but not immediate fleeing

Question 7

DSM IV Anxiety disorders

Answer 7

7 types: specific phobia, social phobia, panic disorder, generalized anxiety disorder, obsessive-compulsive disorder, acute stress disorder, post-traumatic stress disorder

Question 8

DSM V Anxiety disorders

Answer 8

5 types: specific phobia, social phobia, panic disorder, agoraphobia, generalized anxiety disorder. OCD and PTSD, etc have been moved to different section

Question 9

Anxiety disorders similarities and differences

Answer 9

Similarities: bio causes, psych causes, treatment. Differences: relative mix of fear/panic vs anxiety, kinds of objects or situations

Question 10

Biological causes of anxiety disorders

Answer 10

Personality trait of neuroticism, brain structures and neurotransmitters (limbic system, cortex; Nt: GABA, NE, 5HT

Question 11

Psychological causes of anxiety disorders

Answer 11

Classical conditioning, lack of control, distorted cognitions

Question 12

Effective treatments for anxiety disorders

Answer 12

Graduated exposure, cognitive restructuring, medications

Question 13

Phobias

Answer 13

Most common anxiety disorder, where patient irrationally fears a specific object or situation. Fear leads to avoidance. Three categories: specific phobia , social phobia, agoraphobia

Question 14

Specific phobia

Answer 14

Fear that is triggered by object or situation. Avoidance. Subtypes: animal, natural environment, blood, situational, etc. Psychoanalytic viewpoint is that it is caused by repressed id - displacement on an external object. Behaviorists believe that it is learned behavior and evolutionary preparedness. Genetic factors. Temperament - inhibited - vulnerability. Exposure therapy is treatment of choice

Question 15

Social phobia

Answer 15

Fear of one or more social situation where will be exposed to scrutiny and negative evaluation, humiliation, embarrassment. 2 subtypes: performance (public speaking) and non-performance (eating in public). Learned behavior. Evolution: predisposition based on social hierarchies. Cognitive biases: danger schemas, negatively biased interps. Perceptions of uncontrollability, unpredictability. 30% due to genetic. Temperament - inhibition, avoidant. Treatment: cognitive therapy, behavior therapy, medications (tho relapse higher w meds)

Question 16

Panic disorder

Answer 16

Unexpected panic attacks; worry about more attacks which may cause avoidance. Brief but intense. Four or more of list of phys symptoms. First attack often after stressful life occurrence. Many adults can experience once without getting disorder. Can be with or without agoraphobia

Question 17

Agoraphobia

Answer 17

Anxiety about being in places from which escape might be difficult or embarrassing: crowds, theaters, malls, line, elevator, etc. May begin in place where panic attack occurred then generalize

Question 18

Panic attack diagnosis

Answer 18

An isolated panic attack is not a codeable disorder - must be recurring and cause distress/alteration to be diagnosed.

Question 19

Agoraphobia diagnosis

Answer 19

Under DSM IV, was viewed strictly as an adjunct to panic disorder. However, DSM V views it as a distinct disorder, as many with agoraphobia do not experience panic.

Question 20

[START] Panic attacks and comorbidity

Answer 20

83% of people with panic disorder have at lease one comorbid disorder such as GAD, Social Anxiety, PTSD, Depression, substance abuse. May also have dependent or avoidant personality disorder. Increased risk for suicidal ideation

Question 21

Panic disorder biological factors

Answer 21

Moderate heritable component. Biochemical provocation agents. Several areas of brain implicated - amygdala, locus coeruleus.

Question 22

Panic Disorder Psychological Factors

Answer 22

Comprehensive learning theory, cognitive theory, anxiety sensitivity, control, cognitive biases. Interpret ambiguous bodily sensations and situations as threatening.

Question 23

Comprehensive Learning Theory of Panic Disorder

Answer 23

Initial attack associated with neutral interoceptive and exteroceptive cues through conditioning. Anxiety becomes conditioned to these CS’s and conditioning strengthened over time.

Question 24

Panic Disorder Medications

Answer 24

Anxiolytics (Xanax, Klonopin), Antidepressants.

Question 25

Panic Disorder CBT

Answer 25

Exposure therapy, interoceptive exposure targeting panic attacks, cognitive restructuring - treatment targets agoraphobia, avoidance, panic attacks. Breathing exercises, thought challenge, exposure.