Problem 3 Flashcards
Panic attacks
Refer to short + intense periods in which one experiences symptoms of anxiety like
a) dizziness
b) intense dread
c) feeling of choking
–> arise in response to specific situations
Panic disorder
Refers to a disorders where the symptoms of panic attacks arise but are a common occurrence, thus do not arise in response to specific occasions
–> people feel like they’re going crazy or losing control
THUS: if not treated can result in depression
To what extent does genetics play a role in Panic disorder ?
Increased risk of getting it when ones parents were also diagnosed
–> genetically transmitted vulnerability
Neurological contributors to Panic disorder ?
- Fight-or-flight response is poorly regulated, due to poor regulation of several neurotransmitters
–> norepinephrine, serotonin, GABA
- Differences in some areas of the limbic system that are involved in the stress response
–> Hypothalamus, hippocampus, amygdala
- Dysregulation of norepinephrine systems in the locus ceruleus (=part of brainstem), which has pathways to limbic systems
Cognitive model of Panic disorders
Refers to an explanation on the basis of psychological factors
Suggests that people are
- very attentive to their bodily sensations
- thus, misinterpreting bodily sensations in a negative way
- exaggerate symptoms + their consequences
–> this kind of thinking increases the subjective sense of anxiety + physiological changes
Anxiety sensitivity
Refers to the belief that bodily symptoms have harmful consequences
Interoceptive awareness
Refers to a heightened awareness of bodily cues that may signal a coming panic attack
–> may lead to conditioned fear
Interceptive conditioning
When bodily cues that had occurred prior to a panic attack become conditioned, thus signal new attacks
Conditioned avoidance response
Avoiding the places that elicit the Panic attacks and therefore reducing the symptoms
–> this avoidance behavior is reinforced (Negative reinforcement)
Biological treatments for Panic disorder
- Tryciclic antidepressants
- -> immipramine, but are disadvantageous - Selective serotonin reuptake inhibitors (SSRI) or Serotonin-norepinephrine reuptake inhibitors (SNRI)
- Benzodiazepine
- -> suppress the CNS + influence the functioning of neurotransmitter systems
How does CBT reduce the symptoms of Panic disorders ?
- Allows irrational thoughts about the situations to be challenged and changed
- Extinguishing of anxious behaviors
Social anxiety disorder
SAD
Refers to an intense fear of social situations in which the individual believes they may be negatively evaluated
–> may create disruption in a persons daily life + are content specific
Gender differences of developing Social anxiety disorder ?
Women are more likely than men, particular in performance situations
When does Social phobia usually develop ?
Usually in early preschool or adolescence years
–> when people become self conscious + concerned about others opinions
PREVALENCE: 3-7%
What was Freuds explanation on how phobias develop ?
Phobias are a result of unconscious anxiety
–> people are afraid of the something else that is displaced onto a certain object
2 factor theory of phobias
Mowrer
- Classical conditioning lies to the fear of a phobic object
- Operant conditioning helps maintain the fear
Cognitive theory of phobias
- People with this phobia have excessively high standards for their social performance
- Focus on negative aspects of social interactions + evaluate the self harshly
Biological theory of phobias
A particular phobia in itself is not strongly heritable but the general tendency toward anxiety is
–> leads to a temperament that makes it easier for a phobia to develop
Behavioral treatments for phobias
- Desensitization
- Modeling
- -> therapist shows the patient that the fear is irrational by demonstrating his own indifference
ex.: touching snake, then making patient touch it
- Flooding
- -> intensively exposing a client to the feared object until the anxiety is extinguished
ex.: Claustrophiobia - locking the self into a closet
How can CBT be effective in patients with Social anxiety disorder ?
By making it in a group setting
–> can help challenge the individuals negative thoughts
Biological treatments for phobias
- Benzodiazepines
ex. : valium - Antidepressants
- -> MOI, SSRI
BUT: produce temporary relief, but phobia remains
Generalized anxiety disorder
When people are anxious at all times or in many situations
–> excessive worrying about everything, have to have 3 or more of the symptoms to be diagnosed
Interpretation bias
Interpreting ambiguous events as negative
–> play an important role in the maintenance of anxiety disorders
What are the differences in Interpretation bias for SPs vs Non-SPs ?
They are content specific.
–> SPs primarily interpret social events as more negative + threatening
Cognitive model of social phobia/anxiety
Clark + Wells
Suggests that SPs are
- already distressed, expecting to perform badly when entering the feared social situations
- Closely monitor others to make inferences
- Then use internal info to infer how they appear to others (Post-event rumination)
Memory bias Hypothesis
Clark + Wells
Selectively retrieving + dwelling on unfavorable information of how one thinks one is viewed by others (Pre-event rumination)
–> it is a function of social anxiety, as it only occurs at retrieval rather than encoding
Judgment bias
Overestimating the costs + probabilities of possible negative events
Theory of Rapee+ Heimberg
SPs from mental representations of the own external appearance
–> allocate all their mental resources to this + the perceived mental threat, then make predictions
DIFFERENCE: does not reference pre + post event rumination
Rumination
Refers to an intrusive + repetitive thinking process that revolves around the causes, implications + symptoms of ones own distress
–> serves to consolidate negative self perception into LTM
Where are social deficits in SPs really evident ?
Primarily in conversations, as they require more interpersonal skills (=unprepaired)
–> whereas situations with a performance character like a speech bring more cognitive distortions
Post event rumination
Absorbing the self in a repetitive + detailed review of subjective negative experiences following a social situation
Pre event rumination
Absorbing the self in a repetitive + detailed thoughts of before a feared social situation
Hoffmann Cognitive model of SAD
Is a combination of Clark+Wells and Rapee+Heimberg models
–> includes forming negative mental pictures (Negative mental representation) + Pre + Post event rumination (Safety behavior)
6 Cognitive processes in SAD
- Self efficacy
- -> discrepancy between perceived abilities as inadequate + high perceived expected standard of the social interaction - Negative performance appraisals
- Threat appraisals
- -> overestimation of probability + consequences of feared negative social outcome - Self imagery
- -> negative self impression from observers impression - Self concept
- -> negative beliefs of the self - Self focused attention
- -> detailed monitoring
Is the public or the private self more important to SPs ?
Its was more important to SPs how others view you
–> memory bias for less positive words of Public self referent
Comorbidity of PD ?
- Alcohol abuse
- Anxiety
- Depression
Agoraphobia
Fearing and avoiingd places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed
Why would giving a high amount of Co2 to people with PD lead to a panic attack ?
- Low Cognitive mediation
- -> perceived control over CO2 - High arousal
- Catastrophic misinterpretation
- -> over-exaggerating the impact of e.g. vastly beating heart
