PSY1003 SEMESTER 2 - WEEK 7

Question 1

give epidemiology of GAD

Answer 1

2x common in women
more prevalent in unemployed, live alone but not necessarily causal
onsets 21years

Question 2

explain cognitive aspect of GAD

Answer 2

can’t tolerate uncertainty, feel losing mind (negative belief about worry), believe worrying will help or prepare (positive belief about worry), catastrophising (increasing anxiety levels, worrying make problems worse)

Question 3

outline physiological aspect of GAD

Answer 3

constantly adrenaline response, can’t relax, tense, insomnia, heachache, restlessness

Question 4

outline behavioural aspect of GAD

Answer 4

avoidance, checking things, seeking reassurance, try stop thought via distractions

Question 5

give diagnostic criteria for GAD

Answer 5

disproportionate fears/anxiety relating to different life aspect
anxiety relate to 2 areas of activity (work, study, relationship) for 3+ months
feelings of anxiety accompany symptoms of restlessness, muscle tension, agitation
feelings of worry associate with behaviour like avoidance, seeking reassurance, excessive preparing
impaired social, occupational or important functioning
unexplain by other

Question 6

explain genetic theory of GAD

Answer 6

low heritability, suggest genetic component, tend to inherit vulnerability to anxiety disorders overall or neuroticism

Question 7

outline biological theory of GAD

Answer 7

hyper-responsivity in amygdala, and larger (mediates fear), predisposition (female not male)
decreased connectivity between amygdala and prefrontal cortex (complex cognitions like decision making, planning)

Question 8

explain environmental factors in GAD

Answer 8

1. attachment style: anxious/insecure more likely to report feeling parent rejection, emotionally controlled, linked to feeling unsafe, uncertain
2. negative life events: childhood trauma, abuse, child questions safety and stability of world and feel anxious in situations out of their control
3. modelling: parents act anxious, influences childs interpretation of threat

Question 9

give dispositional characteristics of GAD

Answer 9

1. intolerant of uncertainty
2. perfectionist
3. feel responsible for negative outcome
4. poor problem-solving confidence
5. experience negative mood facilitating worrying (promote systematic, deliberate effortful info-processing style and high performance standards)

Question 10

outline cognitive biases in GAD

Answer 10

info processing bias, attentional bias, threat-interpretation bias

Question 11

define info processing bias in GAD

Answer 11

mantains hypervigilance, seeing threats when not present

Question 12

define attentional bias in GAD

Answer 12

pay more attention to negative than to positive info

Question 13

define threat-interpretation bias in GAD

Answer 13

resolve ambiguity through selecting more negative and threatening interpretations of ambiguous info

Question 14

define outcome bias in GAD

Answer 14

biased toward expecting a negative outcome

Question 15

outline worries function theory for GAD

Answer 15

persist with worry despite distress suggesting worrying serves function, used to anticipate problem, avoid and find solutions

Question 16

explain role of metacognition for GAD

Answer 16

develops metacognitive beliefs on worry which drive worry:
positive belief = worrying help to find solutions
negative belief = worrying is uncontrollable and causes harm
this contradiction between 2 belief set cause GAD

Question 17

explain how GAD could be a protective emotion mechanism

Answer 17

worrying reinforced to distract individual from experiencing other negative emotions, evidence showing worrying produces low physiological and emotional arousal, blocking processing of emotional images

Question 18

outline pharmalogical interventions for GAD

Answer 18

benzodiazapines (stimulate GABA receptors which reduce excitatory impulse)
beta blockers (blocks adrenaline effect, decrease flight-flight response, reducing HR and BP so reduce anxiety)
SSRIs: solve comorbidity of GAD/depression

Question 19

evaluate benzodiazpines in GAD

Answer 19

alcohol produce same effect = self-medication
addictive
less prescribed, not for long-period

Question 20

evaluate pharmacological interventions of GAD

Answer 20

help symptom not cause and individual remain on drugs for long time without solving issues

Question 21

explain stimulus control treatments in GAD interventions

Answer 21

limit worrying to specific time - set 30min to worry, process and think about worry, stopping constant worry, giving patient control
requires persistence and can take months

Question 22

state 4 CBT stages in GAD interventions

Answer 22

1. self-monitoring
2. relaxation training
3. cognitive restructuring
4. behavioural rehearsal

Question 23

explain self-monitoring in GAD CBT interventions

Answer 23

asked to make list of behaviours that trigger worry- often thoughts about future that unlikely to actually occur, so draw clients attention to ideas being cognitively constructed (not real)

Question 24

explain relaxation training in GAD CBT interventions

Answer 24

practice and learn breathing exercises- reduce physiologcal symptoms, visual therapies (art)

Question 25

explain cognitive restructuring in GAD CBT interventions

Answer 25

challenge bias, generate thoughts which are more accurate of situation, outcome/situations realisticity

Question 26

explain behavioural rehearsal in GAD CBT interventions

Answer 26

practice and imagine situation, develop coping strategies so individual has more confidence in their abilities of coping

Question 27

explain metacognitive therapy in GAD interventions

Answer 27

challenge, replace dysfunctional metacognitive belief about worrying

Question 28

state symptoms of panic attack

Answer 28

1. nausea, hyperventilation, heart palpitation, chill, hot flash, sweat, tremble, numbness and tingling, dizziness 2. real terror feelings, severe apprehension, depersonalisation

Question 29

define depersonalisation

Answer 29

feels not connected to own body or in contact with worlds around them

Question 30

give characteristics of panic disorder

Answer 30

repeated panic attacks, unexpected and spontaneous but not situationally bound with trigger as more likely to be a specific phobia

Question 31

state diagnostic criteria for panic disorder

Answer 31

1. spontaneous, unpredictable panic attacks 2. recurring 3. worry about having more panic attack 4. modify behaviour to avoid panic attack 5. unexplained by other

Question 32

define agoraphobia

Answer 32

fear of place of not feeling safe or trapped, accompanied with strong urge to escape to safe place and assocaited with fears of having panic attacks, avoidance

Question 33

outline biological theory of panic disorder - dysfunctional fight-flight

Answer 33

individual has overactive sympathetic nervous system, experiences physiological symptoms and believes has severe medical condition

Question 34

outline biological theory of panic disorder - hyperventilation cycles

Answer 34

dysfunctional breathing pattern triggers autonomic series regarding regulating 1. stressor cause hyperventilation 2. too much CO2 3. changed blood pH 4. less efficient oxygen delivery 5. symptom causes apprehension 6. cycle repeat

Question 35

what research gives support for panic disorder hyperventilation cycle theory

Answer 35

biological panic test- panic attack induced by giving CO2, only evoke panic attack in patient with disorder showing causal factor is interpreting physiological change resulting from biological challenge

Question 36

explain suffocation alarm theory of panic disorder

Answer 36

sensitivity to increased CO2 and oversensitive suffocation alarm system, cause intense terror, report more symptoms of short breath or suffocation experience

Question 37

what evidence contradicts suffocation alarm systems theory

Answer 37

when ppt asked to hold breath, don't report greater anxiety level than control suggesting don't possess more sensitive suffocation alarm systems

Question 38

explain brain area theory for panic disorder

Answer 38

locus coeruleus in brain stem - main source of norepinephrine, release in stress response and activate biological reaction = panic disorder patient has greater NE sensitivity and and sensitivity for drugs increaseing locus coreleus activity

Question 39

outline panic disorder cognitive model - Clarke's panic cycle (catastrophic misinterpretation of bodily sensation)

Answer 39

trigger stimulus causes a perceived threat. cause apprehension, body sensation and interpretation of sensation is catastrophic trigger stimuli either external/internal believe something seriously medical wrong "cognitive bias" regular medical checks

Question 40

evaluate Clarke's panic cycle (catastrophic misinterpretation of bodily sensation) for panic disorder

Answer 40

evidence- patient attends to and discriminates bodily sensations more closely, reporting more thought of imminent danger develop panic attack in placebo CO2 challenge (expecting attack enough to trigger a attack)

Question 41

outline anxiety sensitivity, cognitive theory for panic disorder

Answer 41

fears of anxiety symptoms based on belief that symptom has harmful consequence (ilness)

Question 42

how is anxiety sensitivity measured-panic

Answer 42

AIS (anxiety sensitivity index), measure anxiety sensitivity using questions. individuals with panic disorder score higher than nonclinical control or other anxiety disorder, and high ASI predicts occurrence of attack

Question 43

provide potential causes for anxiety sensitivites in panic disorder

Answer 43

possible genetics: moderate (61%) heritability in twin research stressful life events

Question 44

outline classical conditioning cognitive model for panic disorder

Answer 44

fearing fear, detect internal signs of panic attack and forms fear, causes one = interoceptive classical conditioning internal CS is internal cue however unsure if symptoms is CS or UCS anxiety thought to be anticipatory, prepare systems for trauma and panic deal with trauma, with anxiety being CR to detection of CS (symptom)

Question 45

explain pharmacological interventions for panic disorder

Answer 45

benzodiazepines beta blockers SSRIs tricyclic antidepressants

Question 46

explain CBT for panic disorder intervnetion

Answer 46

challenge beliefs using educational info and experience to eliminate faulty emotional responding 1. recognise trigger 2. restructure maladaptive belief 3. breathing training 4. interoceptive exposure to reduce fear of body sensations 5. educate around fight/flight response 6. prevent safety behaviours

Question 47

outline exposure-based treatment as panic disorder intervention

Answer 47

experience conditions that precipitates attack (spin in chair, get dizzy, apply cognitive and physical coping strategy)

Question 48

evaluate psychological interventions in panic disorder

Answer 48

shown durable symptoms reduction, increased quality of life but not sure which components are actually most effective

Question 49

explain social anxiety disorder

Answer 49

severe and persistent fear of social, performance situation, trying to avoid any kind of social situation where believes may behave in embarrassing way or be negatively evaluated, including conversation, eating in public, performance

Question 50

describe epidemiology of social anxiety disorder

Answer 50

earliest age of onset than other anxiety disorders, mid-late teen

Question 51

outline diagnostic criteria for social anxiety disorder

Answer 51

distinct fear of social interactions avoiding social interaction, experiencing intense fear and anxiety (links to feelings of fear embarrassments and rejection) avoidance last over 6 month, cause significant distress, difficulty performing social occupational activities unexplained by other physiological symptom (trembling, heart palpitations, sweating, rosy cheeks)

Question 52

outline genetic factors for social anxiety disorder

Answer 52

inherit vulnerability to any anxiety disorder those with parents, may be due to early experiences, moderate genetic influences in twin research

Question 53

outline early childhood behavioural style factor for social anxiety disorders

Answer 53

behaviourally inhibited behavioural style (nervous about environment exploration, stranger interactions, withdrawal in social context) more likely to develop social anxiety disorder, however many do not so not a thorough explanation

Question 54

explain impact of parent-child interaction on developing social anxiety disorder

Answer 54

greater control, less warmth, less sociable, exhibit behaviours signalling fears of social evaluation, avoidance of situation, shame as discipline

Question 55

for Clarke & Wells cognitive theory of social anxiety disorder, what occurs before social interaction

Answer 55

detailed thinking of possible negative outcome, negative predictions way before event, refer to past failure/experience, negative self view in similar situation and potential rejection, triggers physiological symptom

Question 56

for Clarke & Wells cognitive theory of social anxiety disorder, what occurs during social interaction

Answer 56

cognitive, physiological symptoms; mental blanks, feel under pressure, under scrutiny and scrutinise self, rumination (self-focuses attention). believe look as anxious as feeling, safety behaviours (avoiding eye contact)

Question 57

for Clarke & Wells cognitive theory of social anxiety disorder, what occurs after social interaction

Answer 57

constant worrying and rumination of what happened, what was said, regret, detailed analyse negatively reinforcing self beliefs, stored in memory which is then drawn up when in next social situation, underestimates own social skills, difficult to process positive social feedback, believe own performances flawed

Question 58

outline cognitive bias in social anxiety disorder

Answer 58

focus on negative aspect and struggle processing and accepting positive aspect maintain dysfunctional belief, info processing and interpreting bias (believe future event bad due to past perceived negative experiences, critical self view)

Question 59

give pharmacological interventions for social anxiety disorder

Answer 59

benzodiazepines beta blockers SSRI SNRI

Question 60

describe stages of social anxiety disorder CBT internvetions

Answer 60

1. form rapport, brief client on what therapy will targets 2. role play, identify safety behaviour, aiming removal 3. encourage focus on external, not internal situation 4. constructive feedback, involve social skills training 5. exposure 6. challenge cognitions

Question 61

outline exposure therapy for social anxiety disorder interventions

Answer 61

either real or therapist role plays

Question 62

outline social skills training in social anxiety disorder interventions

Answer 62

modelling, behaviours rehearsal, corrective feedback, positive reinforcement

Question 63

outline cognitive restructuring for social anxiety disorder interventions

Answer 63

challenges and replace negative biases in info processing and dysfunctional negative self-evaluation on social performances, decreasing self focused attention

Question 64

evaluate interventions on social anxiety disorder

Answer 64

integrated CBT programme give gain maintenance for 6-12 month VR for those unable to seek in-person therapy ABM (attentional biases modification) successfuly augment CBT for SAD via moving attention from threat, but lack effectivity when is used alone using both pharmacological and psychological inervention together maintains therapeutic gain