Panic Disorders Flashcards

1
Q

Long-standing debate about whether anxiety should be included in …..

A

mood disorders

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2
Q

Why should anxiety be grouped in with mood disorders (4 reasons)

A
  1. high rates of comorbidity
  2. serve as a predisposition to mood disorders

3.can shape severity of symptoms

  1. those with cormorbid disorders = greater illness severity ( with anxiety)
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3
Q

Why should anxiety NOT be included in mood disorders ( 3 reasons)

A

1.earlier age of onset

2.more of a feeling that we all experience

3.may be more independently transmitted

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4
Q

Why do depression and anxiety cooccur at high rate? (4 reasons)

A
  1. high prevalance rate
  2. overlapping symptoms
  3. poor placement of diagnostic boundaries
  4. shared etiology
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5
Q

4 causes of shared etiology between depression and anxiety …

A
  1. Shared genetic liability
  2. Shared environmental risks / responsible brain regions
  3. Shared temperament/personality traits
  4. Shared maintaining processes
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6
Q

Neuroticism is defined as sensitive to ______, tendency to experience ______.

A

negative stimuli, subjective distress

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7
Q

Neuroticism __________ vulnerability to almost all ___________, especially _______ and ______ disorders.

A

increases, psychopathology, mood, anxiety,

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8
Q

The shared maintaining process between depression and anxiety include

Attentional biases to ________

Also ________ and _______, which involve the same ________

A

negative stimuli, worry, rumination, processes

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9
Q

Tripartate model is a framework for parsing out _______ and ______ symptomology based on their _______ and _______

A

depressive, anxiety-like, similarities, differences

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10
Q

Triparte model has three dimensions

A
  1. depression
  2. anxiety
  3. both/overlapping
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11
Q

Triparte model: Depression is characterized by ….

A

low positive affect

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12
Q

Triparte model: Anxiety is characterized by….

A

physiological hyperarousal

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13
Q

Triparte model: Both/Overlapping is characterized by …

A

negative affect

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14
Q

Triparte model was intended to …

A

help diagnostic accuracy

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15
Q

other self questionnaire scales meant to help diagnostic accuracy ….

A

(PANAS)
(MASQ)
(DASS)

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16
Q

HiTOP (Hierarchical Taxonomy of Psychopathology) Pros: (4) …..

A
  1. Developed from real clinical data
  2. Multi-dimensional
  3. Higher reliability
  4. Comorbidity is built into the system
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17
Q

HiTOP (Hierarchical Taxonomy of Psychopathology) Cons (3) : ……

A
  1. Does not consider developmental course
  2. Does not consider etiology
  3. Harder to use to make categorical decisions
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18
Q

Anxiety Disorders are between ________ and _________ disorders

A

Depressive, Obsessive compulsive

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19
Q

Anxiety Disorders include excessive _______, _________, and ______ to these emmotions.

A

fear, anxiety, abnormal responses

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20
Q

Anxiety is defined as an …

A

emotional response to anticipation of
future threat

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21
Q

Fear is defined as an ….

A

emotional response to real/perceived
imminent threat

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22
Q

Anxiety includes increased ________ and ________ in preperation

A

muscle tension, vigilance

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23
Q

Fear includes surges of __________, and _________.

A

autonomic arousal, fight -or-flight response

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24
Q

Panic disorder 12 month prevalence……

A

2-3%

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25
Q

Panic disorder has a ______ ratio of biological females to males

A

2:1

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26
Q

Panic disorder lifetime prevalence….

A

4.7%

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27
Q

Panic disorder median age onset is ..

A

20-24 years old

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28
Q

Development of Panic Disorder is _____ in children, while _______ in older adult population

A

Low, declining

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29
Q

Panic Attack Symptoms (list (approximately 13 symptoms presented )…

A
  1. Palpitations/accelerated heart rate.
  2. Sweating.
  3. Trembling or shaking.
  4. shortness of breath
  5. Feelings of choking.
  6. Chest pain or discomfort
  7. Nausea or abdominal distress.
  8. Feeling dizzy, light-headed
  9. Chills or heat sensations.
  10. Paresthesias (numbness or tingling sensations)
  11. Derealization or depersonalization
  12. Fear of losing control or “going crazy.”
  13. Fear of dying
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30
Q

panic attacks is what defines ________, and can also act as a ________ for a majority of all disorders.

A

panic disorder, specifier

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31
Q

Specifier: with panic attack follows the same symptoms as described in ……

A

panic attack symptomology

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32
Q

Panic attack is not a _______ disorder. Panic attacks can occur in the context of any ______ disorder as well as other _______ disorders, and some _________.

A

mental, anxiety, mental, medical
conditions

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33
Q

Type of panic attacks …

A

Unexpected, Expected, Limited symptom attacks

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34
Q

Unexpected panic attack =

A

no obvious cue / trigger of an attack

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35
Q

Expected panic attack =

A

obvious cue / trigger of an attack

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36
Q

Limited symptom panic attacks =

A

attacks that meet all other criteria, but have fewer than four symptoms

37
Q

panic attacks can arise from a ______ or ______ state and can _______ to either state

A

calm, anxious, return

38
Q

Panic Disorder, Diagnostic Criteria: Experiences ________, _________ panic attacks and is worried about having ______ and therefore changes their _______.

A

recurrent, unexpected, more, behavior

39
Q

With panic attacks (specifier) are associated with _______ symptom severity, _________ of comorbidity and suicidality, and _______ treatment response

A

increased, higher rates, poorer

40
Q

Panic Disorder Diagnostic Criteria: Panic attack usually peaks within ______ during which time ______or more of these symptoms might occur.

A

minutes, 4

41
Q

Panic Disorder Diagnostic criteria: At least ______ of the attacks has been followed by ______ or more of one or both of the following:

  1. _________.
  2. _________.
A

one, 1 month

Persistent concern or worry about additional panic attacks or their
consequences

Significant maladaptive change in behavior related to the attacks

42
Q

With Panic Disorder: The _______ attack is recurrent and unexpected, and frequently occurs after a ________.

A

first, stressful event

43
Q

With Panic Disorder, the frequency and severity of the panic attacks ….

A

vary tremendously

44
Q

One ________ panic attack is required for the ________ of panic disorder

A

unexpected-full-symptom, diagnosis

45
Q

Panic disorder causes _________ to ensue :

A

maladaptive behavioral responses
1. Avoidance behaviors
2. Probability overestimation
3.Catastrophic thinking

46
Q

Probability overestimation is to …

A

overestimate probability that a negative event will occur

47
Q

Catastrophic thinking is the …

A

tendency to exaggerate the consequences of negative events

48
Q

Cognitive theory of panic is when people are…

A

hypersensitive to their bodily sensations and are prone to giving them the most dire interpretation

49
Q

Why do people keep having panic attacks if nothing bad happens afterward ?

A

Engagement of safety behaviors

50
Q

Only people that _________ can go on to develop a panic disorder

A

catastrophize

51
Q

Many attribute the “nothing happened” to their ……

A

safety behaviors

52
Q

Comprehensive Learning Theory includes __________, anxiety becomes ________ to ________ associated with ________.

A

Interoceptive / exteroceptive conditioning, conditioned, neutral cues, panic attacks

53
Q

Interoceptive Conditioning Example

A

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

54
Q

Exteroceptive Conditioning Example

A

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

55
Q

Anxiety sensitivity is a …

A

fear/trait-like belief that certain bodily symptoms may have harmful consequences.

56
Q

scoring high on anxiety sensitivity early on is a _______ factor for developing _______.

A

risk, anxiety disorders

57
Q

Anxiety sensitivity ->

Tendency to ________ sensations as ________.

Lack of perceived ________.

Mistake bodily sensations for _________.

A

misinterpret, catastrophic, control, negative experiences

58
Q

Panic Disorder has a ________ heritable component: ________ of variance in liability to panic symptoms due to _______

A

moderate, 30-34%, genetics

59
Q

Amygdala: emotion of ______ within the ________ (activates _________)

A

fear, limbic system, locus coeruleus

60
Q

Locus coeruleus:

________ response

activates _________ nervous system

easily ________.

A

fight-or-flight, sympathetic, triggered

61
Q

The Cortex is in charge of

A

higher order thinking

62
Q

Hippocampus – learned _________ response

A

emotional/fear

63
Q

Neurotransmitter systems involved in Panic Disorder include: _______, ________ (which activates the _________ nervous system), and __________ (which _________ norepinephrine activity)

A

GABA, norepinephrine, sympathetic, serotonin, decreases

64
Q

CBT Basic Tenet for treating Panic Disorders: is to change the ______ of how the individual ______ and ______ their moods, experiences, and behavior into ______

A

conceptualization, structures, interprets, evidence-based

65
Q

CBT for Panic Disorders, Post-treatment response rates :

A

53%

66
Q

Panic Control Treatment (PCT) includes ______ so the patient can _____ and ______, ______ thoughts

A

cognitive restructuring, identify, correct, maladaptive

67
Q

Interoceptive exposure is….

A

deliberate exposure to feared internal sensations

68
Q

Panic Control Treatment (PCT) involves _________ treatment for _________.

Also has _________, _______, and ________ components

A

integrative, logical reanalysis, physical, cognitive, behavioral

69
Q

With Interoceptive Exposure hopefully _______ of _________ will ensue

A

habituation, conditioned panic attacks

70
Q

Relaxation techniques includes ……

A

breathing, muscle relaxation, guided imagery

71
Q

Mindfulness training is the _______ process of bringing one’s _______ to experiences at the _______

A

psychological, attention, present moment

72
Q

Relaxation techniques do not work in a _________.This is about controlling the _______.

A

full blown-out panic attack, escalation

73
Q

Exposure (situational) based therapy is exposing individuals to ______ situations to _____ up a ______ for the ______ that _______ existed for those situations

A

feared, build, tolerance, discomfort, previously

74
Q

Exposure (situational) Based Therapy, introduces the individuals to the “feared” situation in a ________. This is similar to ________. Used for _______ cues

A

step-wise manner, phobias, external

75
Q

Anxiolytics include …..

A

benzodiazepines

76
Q

examples of anxiolytics …

A

Xanax, Klonopin, Valium, Ativan

77
Q

Anxiolytics have very _____ effects, within ________, which are ______ and _______.

A

rapid, minutes, sedative, muscle relaxing

78
Q

Anxiolytics can induce _________ side effects -> _______, ________, and increased _________.

A

undesirable, cognitive, aggression, suicide risk

79
Q

With anxiolytics, can develop _________, therefore can lead to _________, and relapse of _________.

A

physiological dependence, withdrawal, panic disorders

80
Q

Mechanism of Anxiolytics: _________ by binding to _________ receptors and altering the _________ of the ______ when ______ binds

A

allosteric modulator, GABA-A, responsiveness, ion channel, GABA

81
Q

Anxiolytics increase ……

A

chloride ion conductance

82
Q

Anxiolytics move the ________ more ________ and prevent further
__________.

A

resting membrane potential, negative, depolarization / activation

83
Q

Anxiolytics potentiate……

A

GABAergic inhibitory synaptic transmission

84
Q

SSRIs don’t create ________ to the degree that ________ do.

A

physiological dependence, benzodiazepines

85
Q

SSRIs can alleviate ……

A

comorbid depressive symptoms

86
Q

SSRIs takes about _______ to have any noticeable effects

A

4 weeks

87
Q

SSRIs have mild ________ side effects

A

undesirable

88
Q

Short term mechanism for SSRIs, blocks the ________, therefore more ________ is present in the ________.

A

serotonin reuptake transporter, serotonin, synaptic clef