PSYU3337- Anxiety Disorders Flashcards
What are the types of Anxiety DIsorders?
Generalized anxiety disorder
Panic Disorder & Agoraphobia
Specific Phobias
Social Anxiety Disorder
Separation Anxiety Disorder
Selective Mutism
Outline Generalized Anxiety Disorder
excessive anxiety more days than not (>6months)
- difficulty controlling worry
- other physical symptoms
- clinically significant distress
- not due to substance use / medical condition
GAD prevalence
Prevalence = low-moderate
Increased in the elderly (as high as 10%)
Typically begins in adolescence / early adulthood
GAD associated factors
Threat beliefs: tendency to believe the world is dangerous and they are unable to cope with life’s demands
Poor problem solving
Overestimate likelihood of feared events
Catastrophize costs
Intolerance of uncertainty
Engagement in unnecessary safety behaviour
Outline the model postulated as an explanation for why GAD is maintained
When people worry - they worry with words.
When people think with words, rather than images, they have less physiological responding.
Worry is negatively reinforced because it allows people to reduce the level of distress when confronted by a stressor.
Relief is heightened when feared event does not occur.
Worry prevents effective problem solving and emotional processing of stressful stimuli.
Outline Clark’s Model for Panic Attacks
- Something triggers a change
- if this trigger is perceived as indicator of danger, it will start the cycle
- apprehension and fear
- overbreathing
- body sensation s
- thoughts that body sensations are a sign of catastrophe
Outline panic disorder
- involves recurrent unexpected panic attacks, AND the anxiety, worry / fear of another panic attack
- persists for > 1 month
- some may have unexpected panic attacks in Non-REM sleep
Outline agoraphobia
- fear for two or more: public transportation, open spaces, enclosed spaces, standing in line, being outside the home alone
- concern about being unable to escape or get help in the event of panic symptoms or other unpleasant physical symptoms
- > 6 months
Outline panic disorder as a culture bound syndrome
Susto = mysterious frights happen, taking away the essence of the person
ataque de nervios = similar to panic disorderP
Prevalence of panic disorder
females are more likely to experience panic disorder than men (2:1)
Prevalence is around 4%
Typically begins in adolescence / early adulthood and the symptoms wax and wane
What are the associated factors and treatments of panic disorder and agorophobia
- threat beliefs: both physical (throwing up, choking) and mental (panic attack in the future)
- engagement in unnecessary safety behaviour (cease exercise, might avoid caffeine, might avoid stressful situations)
Treatments:
- medication (benzos and SSRIs which have high relapse rates)
- CBTs - involving exposure to interoceptive cues, feared situations, to challenge beliefs
Outline specific phobias
- fear about a specific object / situation
- phobic object / situation almost always provokes immediate fear, and is actively avoided
> 6 months
prevalence of specific phobias
high prevalence (12.5%)
females are more likely to experience - 4:1 ratio
typically begins during childhood
Outline specific phobias associated factors and treatments
- direct experience, vicarious experience and information transmission may produce these phobias
- avoidance maintains these phobias
Treatment:
- exposure therapy
Outline social anxiety disorder, and the continuum
- anxiety about a social situation involving scrutiny by others
- fear will act in way that will be negatively evaluated
- > 6 months
Continuum:
- transitory shyness, shy personality, non-generalized social phobia, generalized social phobia, avoidant personality disorder
Prevalence and cultural differences in social anxiety disordre
Prevalence: high (one of the most prevalent) 12%
Higher prevalence in ages 18-29 - 14%
Equal ratio of sexes
Cultural difference = japan (taijin kyofusho)
- fear of offending others or making them uncomfortable
- more common in men
Associated factors and treatments of social anxiety disorder
- generalized psychological vulnerability (threat beliefs about themselves not being skilled enough, and about others being critical)
- biological vulnerability (propensity toward anxiety)
- self focused attention
- anticipatory processing (focus on the negative aspects of past social situations and use this to predict the future)
- post event rumination
- aovidant of social situations
- safety behaviours
Treatment:
- medication
- beta blockers (deal with stage fright)
- benzos: help in the moment
Separation anxiety disorder outline
- developmentally inappropriate and excessive anxiety ocncerning separation from home or from the individual to whom they are attached
- more than 4 weeks in children and 6 weeks in adults
During separation - children may socially withdraw, appear sad, have difficulty concentrating, may get angry, have unusual perceptual experiences (seeking people staring at them), may fear monsters / the dark, etc)
Prevalence and treatment of separation anxiety disorder
low-moderate (4% of children)
- may start as early as preschool
- often develops after a life stressor
Treatment:
- parent training plus cbt
Selective mutism
- consistent failure to speak in specific social situations where there is an expectation for speaking
- interferes with educational or occupational achievement
- > 1 month
- prevalence < very low
- presents before age 5
- treatment = CBT
What are the most common anxiety disorders?
Specific phobias and social anxiety disorder
How does culture influence the expression of anxiety
taijin kyofusho –> japanese version of social anxiety (fear of offending others / making them uncomfortable)
- susto (panic disorder hispanic american)
What causal factors link the anxiety disorders together?
- threat beliefs
- classical and operant conditioning of anxiety and fear
Most effective treatment for anxiety disorders
CBT - cognitive behavioural therapy
- challenging threat beliefs and safety behaviours to dismantle the conditioning and reduce avoidance
