Overview of Anxiety Disorders Flashcards

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1
Q

5-6 disorders within the realm of “Anxiety Disorders”?

A
PTSD - won't be called anxiety disorder in DSM V, though.
OCD
Specific Phobia
Social Phobia (aka. SAD)
Panic Disorder
Generalized Anxiety Disorder (GAD)
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2
Q

Does people’s to phobias always correspond to their genuine perceived threat from the object/situation?

A

Not always.

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3
Q

How is blood/injection/injury phobia unique among phobias?

A

People pass out after getting revved up. (and that’s generally not considered an evolutionarily favorable response to threatening stimuli)

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4
Q

5 categories of specific phobias?

A
Animal type
Natural environment type
Blood/injection/injury type
Situation type
Other type
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5
Q

How heritable is having a specific phobia?

A

about 43%

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6
Q

What does “preparedness and the non-randrom distribution of fears and phobias” refer to?

A

People are more likely to develop phobias of things… that you can make an evolutionary argument for being afraid of: E.g. snakes, spiders, heights, social exclusion.

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7
Q

What’s the preferred treatment for specific phobia? How effective is it?

A

One-session Treatment.

Very effective: over 90% report “much improved or completely recovered” after 4yrs.

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8
Q

What 2 areas of the brain are most overactive in specific phobias?

A

Left insula and ACC.

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9
Q

What are 4 causal factors for social phobia?

A
Temperamental factors (higher risk for inhibited kids).
Genetic factors.
Evolutionary context (instinctual fear of social isolation).
Cognitive variables (risk and cost of feared outcomes such as blushing).
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10
Q

Overactive areas of brain in social phobia?

A

Bilateral amygdala, insula, etc. etc. etc.

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11
Q

What effect does nefazodone (an SRI) have on brain activity in patients with SAD: What increases in activity? What decreases?

A

Increased: insula, middle frontal gyrus, ACC, hippocampus, etc. (somewhat unexpectedly)
Decreases: dorsolateral and medial PFC, and dorsal ACC (areas for “cognitive control and self-reference)

I think the notes might be wrong - from the original article: Nefazodone treatment was associated with marked clinical improvement. Comparison of social anxiety-related neural activations prior to and after nefazodone administration indicated greater activity in the precentral gyrus, insula, midbrain/hypothalamus, and middle frontal and anterior cingulate gyrus prior to treatment, and greater activity in the left middle occipital and bilateral lingual gyri, postcentral gyrus, gyrus rectus, and hippocampus after treatment.

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12
Q

What differentiates panic from anxiety?

A

Panic is acute - peaks at 10 minutes, typically lasts 15 or less.

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13
Q

What are the 2 central features (not diagnostic criteria) of panic disorder?

A

Persistent, recurrent panic attacks.

Fear of future attacks.

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14
Q

How heritable is panic disorder?

A

A little less than some: 30-40%.

agoraphobia is more heritable

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15
Q

What is an “interoceptive fear”?

A

Fear of fear. Much of panic disorder illness is driven by avoiding situations that will precipitate panic attacks.

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16
Q

3 areas of brain implicated in panic disorder?

A

Insula, ACC, periaqueductal gray matter.

17
Q

Do CBT and medications work synergistically for panic disorder?

A

Actually, no. CBT seems to have longer-lasting effects without medication.
(recall the woman drinking caffeine before exposure therapy to actually increase anxiety/panic)

18
Q

What medications can be used for Panic Disorder and Agoraphobia?

A

SSRIs, SNRIs, TCAs, and benzos.

Recall discussion in psych small group about the utility of benzos for panic disorder.

19
Q

How does CBT for panic disorder affect the brain: What 4 areas have decreased activity? Which area has increased activity? (vs. pre-treatment)

A

Decreased: hippocampus, ACC, cerebellum, & pons (less contextual fear)
Increased: mPFC (more emotional control)

20
Q

What must the duration be to diagnose generalized anxiety disorder (GAD)?

A

Excessive and uncontrollable worry for >6 mos.

21
Q

What additional symptoms does GAD have?

A

Sleep problems, muscle tension, concentration problems.

22
Q

What’s up with the notion of GAD as a cognitive strategy?

A

People with GAD could be using worry as a strategy do dampen emotion.