w2- anxiety disorders Flashcards
clincal features of anxiety disorders
What are the 4 symptoms of anxiety disorders?
what type of emotional response? affect? time? unxplained by?
1) emotional response to FUTURE/anticipated problem - excessive related behavioral disturbances
2) min- 6 months,
3) clinical distress, affect functioning, impairment
4) unexplained by other med condition/substance/MD
clincal features of anxiety disorders
fear vs worry vs anxiety
hint: time? component? similarities?
fear - negative emotional reaction to REAL percieved PRESENT danger, arousal
anxiety - negative emotional reaction to ANTICIPATED/FUTURE danger, high arousal
worry - cognitive component of anxiety, more in GAD, self talk/thoughts to avoid feelings
prevalence
How common is anxiety? %
20%
What are effects of anxiety to the society?
accident, risks of conditions, medical costs, suicidal ideation, unemployment, marital failures
prevalence:
What disorder does 60% of people with anxiety also have?
major depressive disorder
prevalence:
What gender has more anxiety? What 4 reasons explain why?
women 18%
1) more likely to report
2) more life events
3) more biologically reactive to stress
4) gender role in society (men social pressures less reports, stigma)
prevalence:
How does culture influence anxiety? What are atttudes towards it?
stress levels, psych disorderfs, family relationships, expressions of symptoms differ!!
risk factors
Name 3 biological risk factors of anxiety disorders
1) genes - heritability (20-40%)
2) brain regions - amygdala highly active, medial PFC (regulator) inhibited/deficienct
3) dec GABA, Serotinin, inc Norepinephrine
Which 2 NT is less found in anxious individuals?
** think: anxious people have happy hormones/NT
GABA
serotonin
Which 1 NT is found more in anxious individuals?
** think anxious hormones/NT
norepinephrine
How many % is panic disorder heritable?
50%
risk factors
Name 1 behavioral and 2 personality based risk factor for anxiety
1) behavioral 2 factor mdoel (fear response) in conditioning
2) personality - beahvioral inhibition
3) personality- neuroticism
risk factors
Name the 5 sub points of cognitive based risk factors for anxiety
hint: NUPPA
1) NEGATIVE beliefs about future- fears likely to happen
2) Uncertainty intolerance - unfamilairity env, stimulus
3) Percieved lack of control
4) Perfectionism
5) Attention to threat cues
disorder #1 phobia
What could be factors in which phobias develop? Name 3
trauma
modelling
verbal instruction
disorder #1 phobia
7 criteria for phobia disorder
1) fear/anxiety towards a specifier (env, object, situational)
2) fear avoided or else intensely anxious
3) always provoke fear (not sometimes)
4) fear disproportionate to actual threat/danger
5) clinical distress
6) unexaplined by med condition/substance
7) uncaused by MD
disorder #1 phobia
Use the 2 factor model of behavioral conditioning to explain aetiology of phobia disorder
1) conditioning - US (neutral stimuli specifier) is conditioned to threat –> CS
2) reinfored by avoidant behavior to avoid/dec anxiety
disorder #1 phobia
Explained what prepared learning is in the context of phobias
some stimuli are more reacted and evolutionary adapted as more common fears (spiders heights) compared to others (flowers)
disorder #1 phobia
Name 1 treatment for phobias
gradual consistent exposure therapy
disorder #2 social anxiety disorder/social phobia
Which gender, age, and SES is more prevalent in social anxiety disorders?
women, younger, lower SES
disorder #2 social anxiety disorder/social phobia
How many % of adults have social anxiety disorder? At what age time frame does it onset?
3-13% adults
adolescent onset
disorder #2 social anxiety disorder/social phobia
9 criteria for social anxiety disorder/social phobia
1) intense fear of unfamilar people/social epxosure/observed
2) fear of showing anxiety symptoms - humailiated, neg evaluated
3) fear disproportional to threat
4) social situations always provoke fear/anxiety
5) must be avoided to stop or will endure
6) clinical distress
7) duration - min 6 months
8) unexplained by med condition/substance
9) uncaused by MD
disorder #2 social anxiety disorder/social phobia
Use behavorial model to explain aetiology of social anxiety disorder. What is used to reinforce the avoidance? How is negative feedback present?
2 factor model conditioning (negative social experience) -> fear
avoids with safety behaviors
safety behavior - eye contact, stand farther
negative feedback - others dissprove behavior, inc intensity
disorder #2 social anxiety disorder/social phobia
Use 4 cognitive factors to explain social anxiety disorder.
hint: NINI
2 self neg, internal
2 env neg , internal
1) negative evaluating self’s social performance
2) internal states/sensations focused more than others perception
3) negative beliefs about consequences of social scrutiny/exposure/embarassment
4) internal cues more than external social cues
disorder #2 social anxiety disorder/social phobia
Name social anxiety disorder behavioral therapy, cogntive therpay, 3 medications
behavioral - role play, practice in groups
cognitive- CBTm challenge beliefs, negative thoughts and self talk
benzo, SSRI, SNRI
disorder #3 panic disorder
4 criteria of panic disorder
hint: brain and body related, anxious about it …
1) specific set of cognitions and body sensations
2) anxiety about recurrent unexpected panic attacks
3) unexplained by med condition/substance
4) uncaused by other MD
disorder #3 panic disorder
panic attacks are a sudden ________ with min of ____ physical symptoms
apprehension/terror
4
disorder #3 panic disorder
Name 7 panic disorder physical symptoms
1) choke
2) dizzy
3) heart palpitate
4) breathing difficult
5) chills
6) heat/tingles
7) trembling/muscles
disorder #3 panic disorder
Name 3 cognitive panic disorder symptoms
1) depersonalization
2) derealization
3) fear of losing control/dying
disorder #3 panic disorder
aetiology of panic disorder has 3 aspects: neurobio, behavioral, cognitive. What is the neurobio fear circuit and which is the main NT in charge?
locus coerculeus (LC)
norepinephrine
disorder #3 panic disorder
drugs that inc norepinephrine activation in the locus coerculeus (LC) does what to stress?
INC stress –>panic attacks
disorder #3 panic disorder
aetiology of panic disorder has 3 aspects: neurobio, behavioral, cognitive. What is the behavioral conditioning process of panic attacks?
interoceptive conditioning
disorder #3 panic disorder
What is interoceptive conditioning?
initial PRECURSORS of panic attack (somatic symptoms sweating, inc HR, muscle ache) –> CONDITIONED STIMULI CS
predict inc arousal
anxiety ABOUT SYMPTOMS = CR
panic attack
disorder #3 panic disorder
aetiology of panic disorder has 3 aspects: neurobio, behavioral, cognitive. What is the cognitive aspect of panic disorder?
hint: cycle of thought –> produce ? inc panic disorder pos feedback
catastrophic misinterpretations of doom/dizzy/dying when experiencing symptoms of panic attack –> inc anxiety –> produce more sensations (cycle)
disorder #3 panic disorder
What is the behavioral therapy for panic disorders?
exposure training to interoceptive sensations
breathing training, relaxation
Is benzo (GABA) or antidepressants (SNRI, SSRI) more addictive with greater side effects?
benzo (GABA) with more motor/cognitive side effects
disorder #4 agoraphobia
8 criteria for agoraphobia
1) anxiety about places where escaping is difficult - can’t get help
2) avoids places (public transport, larg crowds)
3) always produce intense fear, must be avoided to stop
5) fear out of proportion to actual threat
6) duration - min 6 months
7) clinical distress
8) unexplained by MD, substance, medical condition
disorder #4 agoraphobia
aetiology of cognitive model to explain agoraphobia
fear of fear hypothesis
1) FEAR NEGATIVE THOUGHTS about conseq of anxiety in public spaces (escaping is hard)
2) FEAR OF BELIEFS leading to socially unaccpetable outcomes
disorder #4 agoraphobia
agoraphobia treatment (behavioral) ex:
exposure therapy in graded scenarios
disorder #5 GAD
6 criteria for GAD
1) general distress pervasive worry, long lasting
2) not proportionate to actual worry
3) min 6 months, 3 symptoms
4) clinical distress
5) unexpalined by med conditions/substance
6) uncased by other MD
disorder #5 GAD
Name 6 symptoms of GAD
1) irritated easily
2) tired easily
3) restless
4) muscle tension
5) sleep disturbance
6) focus/concentraton difficulties
disorder #5 GAD
name 4 stages of GAD developing
what causes emotions? what’s felt? cognitive component? result?
1) early trauma
2) emotions of distress hard to understand
3) worry
4) neg emotions relieved
disorder #5 GAD
GAD vs anxiety disorders main difference is
GAD- general distress, worry focused, to avoid anxiety, no heightened physio response
anxiety - specific pattern of fear, specific heightened physio response
disorder #5 GAD
GAD people are more likely to experience ? than people with anxiety disorders?
major depressive disorder
anxiety treatment
graded exposure includeds maximum which 2 features?
maximizing features of trigger (spider’s specific features)
maximizing contexts of trigger (spiders in diff env)
anxiety treatment
behavioral approach of anxiety treatment is not “forgetting the fear” but learning to ?
learning to extinct the fear
anxiety treatment
cognitive approach of anxiety treatment includes challenging what 2 components?
1) person’s beliefs about likelihood of conseq/situation happening
20 person’s expectationss of self unable to cope/tolerate/control self
anxiety treatment
What 2 types of therapy is used in anxiety treatment apart from behavioral exposure and CBT?
ACT - acceptance commitment therapy
MCT - meta cognitive focus positive thinking therapy
anxiety treatment
What are the 2 types of anxiety anxiety treatment? What are classified under?
benzodiazipines
antidepressants
under anxiolytics
anxiety treatment
What are 4 examples of benzodiazipines?
Which NT is increased?
withdrawals? negatives?
valium, xanax, sedatives, tranquilizers
withdrawals, cog, motor, memory- addictions not preferred first line of med
anxiety treatment
What are the 2 main types of antidepressants?
side effects?
SSRI, SNRI
slight jitters, HR, less than benzo, preferred
