Panic Disorder

Question 1

why is there a long standing debate about whether anxiety should be included in mood disorders?

Answer 1

are depressive and anxiety disorders distinct, a variation of a single disorder, or should there be a third category

Question 2

why do depression and anxiety cooccur at high rates? (arising stuff)

Answer 2

arises from chance, arises from overlapping symptoms, arises from poor placement of diagnostic boundaries

Question 3

why do depression and anxiety cooccur at high rates? (shared stuff)

Answer 3

shared genetic liability, shared environmental risks/responsible brain regions, shared temperament/personality traits, shared maintaining processes

Question 4

neuroticism=

Answer 4

sensitive to negative stimuli, tendency to experience subjective distress

Question 5

tripartite model and affect:

Answer 5

framework for parsing out depressive and anxiety-like symptomology based on their similarities and differences. affect=expression of emotion/feeling

Question 6

tripartite model divided based on 3 dimensions:

Answer 6

depression
anxiety
both/overlapping

Question 7

depression characteristic in tripartite model:

Answer 7

characterized by low positive effect; anhedonia, no pleasure from anything, fatigue, low energy

Question 8

anxiety characteristic in tripartate model:

Answer 8

characterized by physiological hyperarousal, increased heart rate, dizzy, sweating, shortness of breath

Question 9

both/overlapping characteristic in tripartite model:

Answer 9

characterized by negative affect, general distress, insomnia, difficulty concentrating, worrying, restlessness, irritability

Question 10

general components of anxiety disorders:

Answer 10

excessive fear, anxiety, and related behavioral disturbances

Question 11

anxiety:

Answer 11

emotional response to anticipation of future threat

Question 12

fear:

Answer 12

emotional response to real/perceived imminent threat

Question 13

panic attack symptoms:

Answer 13

physical symptoms like palpitations, sweating, trembling, chest fain, feelings of choking, cognitive symptoms like fear of losing control or “going crazy”, fear of dying

Question 14

the only specifier for panic attacks:

Answer 14

with panic attack

Question 15

panic attacks are associated with:

Answer 15

increased symptom severity, higher rates of comorbidity and suicidality, and poorer treatment response

Question 16

panic disorder diagnostic criteria:

Answer 16

experiences recurrent, unexpected panic attacks and is worried about having more panic attacks and changes their behavior. usually peaks within minutes and during time 4 or more of the symptoms may occur

Question 17

at least one of the attacks has been followed by:

Answer 17

1 month or more of one of the following: persistent worry or concern about having additional panic attacks, significant maladaptive change in behavior related to attacks

Question 18

the 3 maladaptive behaviors in panic disorder:

Answer 18

1. avoidance behaviors
2. probability overestimation
3. catastrophic thinking

Question 19

probability overestimation:

Answer 19

overestimate probability that a negative event will occur eg. had a panic attack while driving so therefore will have one every time I drive

Question 20

catastrophic thinking:

Answer 20

tendency to exaggerate the consequences of negative events ie. worst case scenario. increased heart rate= “im having a heart attack”

Question 21

cognitive theory of panic

Answer 21

people are hypersensitive to their bodily sensations and are prone to giving them misinterpretation, only people that catastrophize can go on to develop panic disorder

Question 22

engagement of safety behaviors:

Answer 22

why do people keep having panic attacks if nothing bad happens afterward? used as coping mechanisms and can lead to overanalyzes of situations and can worsen situations.

Question 23

comprehensive learning theory

Answer 23

interoceptive/exteroceptive conditioning- anxiety becomes conditioned to neutral cues associated with panic attacks

Question 24

interoceptive conditioning:

Answer 24

heart palpitations have been paired with panic many times, then basic heart palpitations can trigger a panic attack without anything else

Question 25

exteroceptive conditioning:

Answer 25

have panic attacks while making mood disorder slides, then just being on a computer can trigger a panic attack

Question 26

anxiety sensitivity:

Answer 26

fear/trait like belief that certain bodily symptoms may have harmful consequences/outcomes (scoring high on this early on is a risk factor for developing anxiety disorders)

Question 27

biological causal factors of panic disorder:

Answer 27

genetics, dysfunction in fear network, (heightened/overly sensitive system)

Question 28

amygdala in panic disorder:

Answer 28

emotion of fear within the limbic system (activates locus coeruleus)

Question 29

locus coeruleus:

Answer 29

fight or flight response, activates sympathetic nervous system

Question 30

cortex:

Answer 30

higher order thinking- “im dying, im losing control”

Question 31

hippocampus:

Answer 31

learned emotional/fear response (conditioned response)

Question 32

neurotransmitter systems involved:

Answer 32

GABA, noreoinprine (activates sympathetic nervous system), serotonin (decreases norepinephrine activity)

Question 33

CBT basic tenet:

Answer 33

change conceptualization of how the person structures their moods, experiences, and behaviors

Question 34

panic control treatment (PCT)

Answer 34

cognitive restructuring so the patient can identify and correct maladaptive thoughts

Question 35

interoceptive exposure:

Answer 35

deliberate exposure to feared internal sensations (i.e. exercise to increase heart rate, spinning in a chair, hyperventilating to induce respiratory change

Question 36

relaxation techniques:

Answer 36

breathing, muscle relaxation, guided imagery

Question 37

mindfulness training

Answer 37

psychological process of bringing one’s attention to experiences at the present moment

Question 38

panic disorder medications:

Answer 38

anxiolytics: benzos (i.e. xanax, klonopin, valium, ativan)

Question 39

anxiolytics:

Answer 39

very rapid effects. within minutes, can develop physiological dependence

Question 40

anxiolytics mechanism:

Answer 40

modulator by binding GABA-A receptors and alter the responsiveness of the ion channel when GABA binds. potentiate GABAergic inhibitory synaptic transmission

Question 41

SSRIS comparison to benzos:

Answer 41

can’t create physiological dependence to the degree that benzos do, takes about 4 weeks to have any noticeable effects