PSYU3337- Anxiety Disorders

Question 1

What are the types of Anxiety DIsorders?

Answer 1

Generalized anxiety disorder
Panic Disorder & Agoraphobia
Specific Phobias
Social Anxiety Disorder
Separation Anxiety Disorder
Selective Mutism

Question 2

Outline Generalized Anxiety Disorder

Answer 2

excessive anxiety more days than not (>6months)
- difficulty controlling worry
- other physical symptoms
- clinically significant distress
- not due to substance use / medical condition

Question 3

GAD prevalence

Answer 3

Prevalence = low-moderate
Increased in the elderly (as high as 10%)

Typically begins in adolescence / early adulthood

Question 4

GAD associated factors

Answer 4

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

Question 5

Outline the model postulated as an explanation for why GAD is maintained

Answer 5

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.

Question 6

Outline Clark’s Model for Panic Attacks

Answer 6

• 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

Question 7

Outline panic disorder

Answer 7

• 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

Question 8

Outline agoraphobia

Answer 8

• 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

Question 9

Outline panic disorder as a culture bound syndrome

Answer 9

Susto = mysterious frights happen, taking away the essence of the person
ataque de nervios = similar to panic disorderP

Question 10

Prevalence of panic disorder

Answer 10

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

Question 11

What are the associated factors and treatments of panic disorder and agorophobia

Answer 11

• 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

Question 12

Outline specific phobias

Answer 12

• fear about a specific object / situation
• phobic object / situation almost always provokes immediate fear, and is actively avoided
  > 6 months

Question 13

prevalence of specific phobias

Answer 13

high prevalence (12.5%)
females are more likely to experience - 4:1 ratio

typically begins during childhood

Question 14

Outline specific phobias associated factors and treatments

Answer 14

• direct experience, vicarious experience and information transmission may produce these phobias
• avoidance maintains these phobias

Treatment:
- exposure therapy

Question 15

Outline social anxiety disorder, and the continuum

Answer 15

• 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

Question 16

Prevalence and cultural differences in social anxiety disordre

Answer 16

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

Question 17

Associated factors and treatments of social anxiety disorder

Answer 17

• 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

Question 18

Separation anxiety disorder outline

Answer 18

• 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)

Question 19

Prevalence and treatment of separation anxiety disorder

Answer 19

low-moderate (4% of children)
- may start as early as preschool
- often develops after a life stressor

Treatment:
- parent training plus cbt

Question 20

Selective mutism

Answer 20

• 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

Question 21

What are the most common anxiety disorders?

Answer 21

Specific phobias and social anxiety disorder

Question 22

How does culture influence the expression of anxiety

Answer 22

taijin kyofusho –> japanese version of social anxiety (fear of offending others / making them uncomfortable)

• susto (panic disorder hispanic american)

Question 23

What causal factors link the anxiety disorders together?

Answer 23

• threat beliefs
• classical and operant conditioning of anxiety and fear

Question 24

Most effective treatment for anxiety disorders

Answer 24

CBT - cognitive behavioural therapy
- challenging threat beliefs and safety behaviours to dismantle the conditioning and reduce avoidance