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Psychopathology > Task 3 - Anxiety & Panic Disorder > Flashcards

Task 3 - Anxiety & Panic Disorder Flashcards

1
Q

Panic Attack

A

Discrete period of intense fear or discomfort;
-symptoms develop abruptly and peak within 10 minutes
in absence of triggers
-> certain situations but not every time

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2
Q

Panic Attack Symptoms

A 
Heart Palpitations
Sweating
Trembling, shaking
Shortness of breath or choking
Chest pain, discomfort
Nausea
Dizziness
Derealization/depersonalization
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3
Q

Panic Disorder DSM criteria

A

A. Recurrent unexpected panic attacks
B. at least one attacks followed by one month or more of:
1. persistent concern about additional attacks
2. worry about implications of attack or consequences
3. clinically significant change in behavior related to attacks

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4
Q

Panic Disorder Characteristics

A
  • diagnosis when panics attacks become common occurrence
  • can go with many episodes in a short time and then some time without panic attack
  • fear of possessing life threatening illness
  • tends to be chronic
  • many show generalized anxiety, depression, alcohol abuse
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5
Q

Panic Disorder Prevalence

A

3-5% lifetime prevalence

  • more common in women
  • onset usually between late adolescence and mid-thirties
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6
Q

Agoraphobia

A

Fear of places where there might be trouble escaping or getting help if they become anxious or have panic attack
-> frequently developed by people with panic disorder

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7
Q

Panic Disorder Genetic correlates

A

10% of first-degree relatives also have it

  • twin studies: 30-40% due to genetics (transmitted vulnerability)
  • Agoraphobia: attributable in part due to genetics
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8
Q

Panic Disorder Neurobiological Contributors

A

Different functioning in limbic system (amygdala, hippocampus, hypothalamus)

  • dysregulation of norepinephrine in locus ceruleus in brain stem
  • > poorly regulated fight-or-flight response
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9
Q

Panic Disorder Cognitive Model

A

Psychological Factors associated with disorder;

  • anxiety sensitivity: belief that bodily symptoms have harmful consequences
  • > interoceptive awareness: heightened awareness of bodily cues
  • > interoceptive conditioning: slight increases in anxiety elicit conditioned fear
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10
Q

Panic Disorder Integrated Model

A

Genetic vulnerability leads to vulnerability to dysreguulation of neurotransmitters involved in anxiety

  • > lead to cognitive vulnerability: hyperattentive and misinterpretation of bodily sensations
  • > anticipatory anxiety (panic disorder) and sometimes conditioned avoidance response (panic disorder + agoraphobia)
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11
Q

Biological Treatments for Panic Disorder

A

Trycyclic Antidepressants
SSRIs & SNRIs
Benzodiazepines

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12
Q

Tricyclic Antidepressants

A

Can reduce panic attacks and improve functioning of norepinephrine system & influence serotonin levels
-disadvantages: side effects and relapse upon discontinuation

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13
Q

SSRIs & SNRIs

A
  • effective in anxiety relief
  • better tolerated than tricyclic antidepressants
  • side effects as well (not as severe as trcyclic)
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14
Q

Benzodiazepines

A

Suppress CNS by influencing GABA, norepinephrine, and serotonin

  • effective at reducing panic attacks
  • physically and psychologically addictive: withdrawal symptoms, can interfere with cognitive and motor functioning
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15
Q

Cognitive Behavioral Therapy & Panic Disorder

A
  • Confrontation with situations and thoughts causing anxiety: changing and challenging thoughts to extinguish behaviors
  • components:
    1. teaching of relaxation and breathing techniques
    2. clinician guides in identifying catastrophic cognitions
    3. practicing relaxation & breathing techniques while experiencing panic symptoms
    4. Therapist challenges catastrophizing thoughts and teaches to challenge them
  • > relief of panic attacks of 85-90% within 12 wweeks
  • > better at preventing relapse
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16
Q

Social Anxiety Disorder DSM criteria

A

A. marked and persistent fear of one or more social or performance situations; exposed to unfamiliar people or possible scrutiny by others
B. exposure to feared social situation provokes anxiety
C. person recognizes that fear is excessive or unreasonable
D. feared social or performance situations are avoided
E. avoidance/anticipation or distress in situations interferes with normal routine/functioning
F. under 18: duration at least 6 months
G. not due to effects of substance or medication
H. Criterion A is unrelated to another present medical condition

17
Q

Social Anxiety Disorder Characteristics

A
  • fear of being judged or embarrassed in front of others
  • causes disruptions in daily life
  • onset as early as preschool
  • > often related to bullying or high expectations of parents
18
Q

Social Anxiety Disorder Symptoms

A

in social situations:

  • trembling
  • feelings of confusion and dizziness
  • heart palpitations
  • full panic attacks
  • think others see nervousness and judge them negatively
19
Q

Social Anxiety Disorder Prevalence

A

3-7% lifetime prevalence worldwide (US: 12%)

  • more common in women
  • tends to develop in early preschool or adolescence
  • tends to be chronics once developing and if it remains untreated
20
Q

Biological Theory of SAD

A

-smaller amygdala

21
Q

Behavioral Treatments SAD

A

Exposure in absence of negative consequences to extinguish fear of object or situation

  • > systematic desensitization
  • Modelling
  • flooding
22
Q

Modeling

A

Method used in treatment of SAD

  • therapist may model (perform) each behavior before asking client to perform it
  • > association with calm response of therapist reduces anxiety
23
Q

Flooding

A

Intense exposure to feared object until anxiety is extinguished
-> therapist prepares patient with relaxation techniques

24
Q

Cognitive Behavioral Treatments of SAD

A

Combination of behavioral with cognitive techniques

  • > helps patient identify and challenge negative, catastrophizing thoughts when they’re anxious
  • good at preventing relapse
25
Q

Biological Treatment of SAD

A
  • e.g. Benzodiazepines
  • temporary relief but phobia remains
  • Antidepressants (monoamine oxidase inhibitors, SSRIs): effective but relapse prone
26
Q

Generalized Anxiety Disorder DSM Criteria

A

A. excessive anxiety & worry more days than not for at least 6 months about a number of events or activities
B. person finds it difficult to control worry
C. anxiety & worry associated with 3 or more symptoms (only one required for children
D. focus of anxiety and worry not due to another disorder
E. anxiety causes clinically significant distress or impairment in functioning
F. disturbance not due to effects of substance or medication

27
Q

Symptoms of generalized anxiety disorder

A
  1. Restlessness or feeling keyed up or on edge
  2. easily fatigued
  3. concentration problems
  4. irritability
  5. muscle tension
  6. Sleep disturbance
28
Q

Cognitive Mediation Hypothesis for Panic Attacks

A

panic disorder patients have a stronger tendency to misinterpret certain bodily sensations
-> more likely to interpret them as signs of impending physical or mental disorder

29
Q

Panic Disorder & Perceived Control

A

Interpretation believed to be most influential manipulation in inducing panic attacks as it facilitates expected affect and perceived control

30
Q

Catastrophic Cognitions in Panic Disorder and Agoraphobia

A

Hypervigilance to bodily sensations and tendency to focus on autonomic arousal

  • > misinterpretation of bodily sensations
  • cognitive constructs play role in misinterpretation: information, perceived, control, safety
  • attentional and memory bias in favor of physical threat cues
31
Q

Memory Bias in SAD

A

People high in Social Anxiety rated negative words as more descriptive than positive words (people low in SAD vice versa)

  • recalled significantly less positive words about public selves when anticipating giving a speech
  • > bias occurs at retrieval rather than encoding
32
Q

Social Performance Deficits in SAD

A
  • people with SAD underestimate social performance primarily during speech and to lesser extent during conversation
  • actual performance problems during conversation but not during speech
33
Q

Interpretation and judgmental biases in social phobia

A

Negative interpretation of all social events irrespective of valence: ambiguous, positive, and negative events rated negatively by SAD patients
-> judgment bias

34
Q

Clark & Wells cognitive model of SAD

A
  1. Social situations interpreted as threatening due to dysfunctional beliefs (high standards for social performance, conditioned beliefs about evaluation)
  2. Negative Evaluation expected because of dysfunctional beliefs
    - > cognitive, somatic, affective, and behavioral responses
35
Q

Rapee & Heimberg Model of SAD

A

SAD patients attach importance to receiving positive appraisal by others (assume others to be critical)

  • > form prediction about standard of performance they believe others expect & compare it to own mental representations
  • > negative evaluation anticipated if discrepancy is dected
  • > results in behavioral, cognitive and physical symptoms

Psychopathology (6 decks)

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