Stress & Anxiety Disorders

Question 1

HPA axis

Answer 1

one of the primary systems involved in the fight or flight system comprising the hypothalamus, pituitary gland which secretes ACTH, and adrenal glands which secrete cortisol, epinephrine, and norepinephrine

Question 2

What are the effects of extreme or prolonged stress?

Answer 2

extensive physical and psychological problems like increased reactivity in sympathetic nervous system, decreased efficacy of immune system and psychological self-efficacy, personality deterioration, and death

Question 3

2 types of psychosocial contributing factors

Answer 3

external and internal (in terms of the stressor, crisis, and resources available)

Question 4

External vs Internal stressor

Answer 4

the nature of the stressor (e.g. accidental or intentional) vs the perception of the stressor (e.g. having a sense of control) affects how we process it and cope with it

Question 5

External vs Internal crisis

Answer 5

life changes that occur due to crisis (the aftermath) vs the experience of the crisis (the meaning or what you make of it; may lead to posttraumatic growth)

Question 6

External vs Internal resources

Answer 6

social and financial support vs stress tolerance (biological and psychological resources)

Question 7

Posttraumatic stress disorder (PTSD)

Answer 7

exposure to an event that threatened death, serious injury, or sexual violence through direct experience, witnessing others’ experience, learning about it happen to close friends/family, or repeated/extreme exposure to aversive details of the event (e.g. in the news)

Question 8

4 basic categories of PTSD symptoms

Answer 8

intrusion (nightmares and flashbacks), avoidance of things associated with trauma, negative cognitions and mood, arousal and reactivity

Question 9

Negative cognitions and mood that occur with PTSD

Answer 9

detachment, anger, shame, distorted blame with self/others

Question 10

How does heightened arousal and reactivity occur in PTSD?

Answer 10

insomnia, difficulty concentrating, hypervigilance, heightened startle response

Question 11

4 most common triggering events of PTSD

Answer 11

combat, physical or sexual assault, natural disaster, and torture

Question 12

What are the binary gender differences in rates of PTSD?

Answer 12

men are more exposed to traumatic events but women are 2x more likely to experience to PTSD and have more severe symptoms (typically due to sexual assault)

Question 13

3 factors that affect the gravity of psychological problems caused by sexual assault

Answer 13

past coping skills, current psychological functioning, ability to disclose experience of assault to others

Question 14

What biological mechanism causes transgenerational trauma?

Answer 14

epigenetics

Question 15

How do genes affect the occurence of PTSD?

Answer 15

genes account for 33% of the variance in symptom severity

Question 16

Neurobiological factors of PTSD

Answer 16

a hyperactive limbic system with increased norepinephrine, decreased serotonin and endogenous opioids (decreased ability to tolerate pain), higher cortisol levels (for women)

Question 17

Psychological factors of PTSD

Answer 17

threat-related psychological processes (e.g. hypervigilance and increased vulnerability), high neuroticism, negative attributions or maladaptive appraisal, low cognitive ability

Question 18

Social factors of PTSD

Answer 18

previous experience of trauma and severity of current trauma, early experience of uncontrollable/unpredictable events, membership in a minoritized group, low social support, lack of education, engaging in combat or war

Question 19

How does being involved in combat influence the experience of PTSD?

Answer 19

acceptability of war goals and one’s identification with their unit lessens likelihood while returning to an unaccepting social environment after war increases likelihood

Question 20

Neurobiological symptoms of PTSD

Answer 20

fear learning in the amygdala (i.e. perceiving threats and responding physiologically), cell death in and reduced size of hippocampus due to cortisol, hyperactive limbic system and sustained release of cortisol

Question 21

Psychological symptoms of PTSD from diagnosis

Answer 21

persistent re-experience (nightmares and flashbacks), avoidance of things associated with trauma and emotional numbing, increased arousal (insomnia and difficulty concentrating)

Question 22

Social symptoms of PTSD from diagnosis

Answer 22

avoidance of things associated to trauma and emotional numbing (e.g. detachment from others and restricted range of affect)

Question 23

Biological treatment of PTSD

Answer 23

beta-blockers (e.g. propranolol) and SSRIs

Question 24

When are beta-blockers taken for PTSD?

Answer 24

taken when knowingly going into a traumatic situation (e.g. combat) to decrease the likelihood of developing PTSD because it calms the limbic system

Question 25

Effects of taking SSRIs

Answer 25

decreases depression, intrusive thoughts and avoidance

Question 26

Cons of taking beta-blockers

Answer 26

suppression of natural warning signs and future reliance on medication

Question 27

5 psychological treatments for PTSD

Answer 27

cognitive-behavioral therapy (53% effective), prolonged exposure, eye movement desensitization and reprocessing (EMDR), cognitive processing therapy (CPT), building positive coping skills

Question 28

Prolonged exposure therapy

Answer 28

repeatedly processing a traumatic experience that increases anger (due to blame) and decreases shame

Question 29

Cognitive processing therapy

Answer 29

processing the consequences and beliefs attached to the traumatic experience to help see it in a new light

Question 30

How can you prevent PTSD?

Answer 30

stress-inoculation training

Question 31

Stress-inoculation training

Answer 31

advanced preparation to increase resistance to the effects of stressors (e.g. combat)

Question 32

Social treatment of PTSD

Answer 32

having social support and being able to disclose trauma

Question 33

5 main anxiety disorders

Answer 33

specific phobias, social anxiety disorder or social phobia, panic disorder, agoraphobia, general anxiety disorder (GAD)

Question 34

Etiology of anxiety disorders

Answer 34

biological and psychological causes include genes, neuroticism, classical conditioning, lack of perceived control; social factors depend on culture

Question 35

Presentation of anxiety disorders

Answer 35

unrealistic, irrational fears or anxieties at a disabling intensity

Question 36

What is the most effective treatment for anxiety disorders?

Answer 36

exposure

Question 37

2 factors that decrease anxiety

Answer 37

perceived controllability and predictability

Question 38

How does perceived threat influence anxiety?

Answer 38

a perceived threat leads to fear and anxiety, which then leads to an interpretive bias toward threat and an increase in perception of threat

Question 39

Specific phobia

Answer 39

strong fears of specific kind of situation or object that are unreasonable or out of proportion to the actual danger and and avoidance of that situation/object that becomes disruptive to daily life

Question 40

Examples of specific phobias

Answer 40

animal, natural environment, blood-injection-injury (3-4% of population, usually genetic), situational, choking, vomiting, etc.

Question 41

Rate of concurrence of specific phobias

Answer 41

75% of people with a specific phobia have at least one other specific fear

Question 42

Biological factors of specific phobias

Answer 42

increase likelihood with increased speed and strength of fear conditioning, having a first degree relative (particularly BII phobia), being behaviorally inhibited

Question 43

Psychological factors of specific phobias

Answer 43

prepared learning, traumatic conditioning of fear, high neuroticism (e.g. worrying a lot and poor handling of stress)

Question 44

Prepared learning

Answer 44

objects or situations that have an evolutionary reason to be feared (e.g. spiders) are more likely to be conditioned as things to be feared

Question 45

Social factors of specific phobias

Answer 45

modeling, vicarious learning, fear immunization, environment, parenting (inadvertent reinforcement increases fear)

Question 46

Fear immunization

Answer 46

gradually exposing a person to what they fear to immunize them against later fear development

Question 47

Biological symptoms of specific phobias

Answer 47

autonomic arousal pre-fight/flight in response to the presence or thought of the feared object/situation; decreased GABA and serotonin; higher norepinephrine

Question 48

Psychological symptoms of specific phobias

Answer 48

heightened vigilance to the feared object/situation, negative mood, worry about potential danger, self-preoccupation, have a lower sense of efficacy, diminished internal locus of control

Question 49

Social symptoms of specific phobias

Answer 49

avoidance of situations eliciting anxiety

Question 50

Biological treatments for specific phobias

Answer 50

though not often treated biologically: SSRIs and benzodiazepines (cause a short-term decrease in anxiety and increases avoidance instead of habituating or building tolerance)

Question 51

Psychological treatment of specific phobias

Answer 51

behavior therapy or exposure (most effective), modified exposure (e.g. virtual reality, combining cognitive techniques)

Question 52

Extinction

Answer 52

no longer feeling afraid of the object/situation

Question 53

Habituation

Answer 53

getting more used to the feared object/situation over time

Question 54

Systematic desensitization

Answer 54

technique used for habituation (gradual exposure)

Question 55

Flooding

Answer 55

sudden exposure to feared object/situation (but most people leave before habituation occurs)

Question 56

Social treatment of specific phobias

Answer 56

modeling (learning by imitating others' behavior)