w2- anxiety disorders

Question 1

clincal features of anxiety disorders

What are the 4 symptoms of anxiety disorders?

what type of emotional response? affect? time? unxplained by?

Answer 1

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

Question 2

clincal features of anxiety disorders

fear vs worry vs anxiety

hint: time? component? similarities?

Answer 2

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

Question 3

prevalence

How common is anxiety? %

Answer 3

20%

Question 4

What are effects of anxiety to the society?

Answer 4

accident, risks of conditions, medical costs, suicidal ideation, unemployment, marital failures

Question 5

prevalence:

What disorder does 60% of people with anxiety also have?

Answer 5

major depressive disorder

Question 6

prevalence:

What gender has more anxiety? What 4 reasons explain why?

Answer 6

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)

Question 7

prevalence:

How does culture influence anxiety? What are atttudes towards it?

Answer 7

stress levels, psych disorderfs, family relationships, expressions of symptoms differ!!

Question 8

risk factors

Name 3 biological risk factors of anxiety disorders

Answer 8

1) genes - heritability (20-40%)
2) brain regions - amygdala highly active, medial PFC (regulator) inhibited/deficienct
3) dec GABA, Serotinin, inc Norepinephrine

Question 9

Which 2 NT is less found in anxious individuals?

** think: anxious people have happy hormones/NT

Answer 9

GABA
serotonin

Question 10

Which 1 NT is found more in anxious individuals?

** think anxious hormones/NT

Answer 10

norepinephrine

Question 11

How many % is panic disorder heritable?

Answer 11

50%

Question 12

risk factors

Name 1 behavioral and 2 personality based risk factor for anxiety

Answer 12

1) behavioral 2 factor mdoel (fear response) in conditioning
2) personality - beahvioral inhibition
3) personality- neuroticism

Question 13

risk factors

Name the 5 sub points of cognitive based risk factors for anxiety

hint: NUPPA

Answer 13

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

Question 14

disorder #1 phobia

What could be factors in which phobias develop? Name 3

Answer 14

trauma
modelling
verbal instruction

Question 15

disorder #1 phobia

7 criteria for phobia disorder

Answer 15

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

Question 16

disorder #1 phobia

Use the 2 factor model of behavioral conditioning to explain aetiology of phobia disorder

Answer 16

1) conditioning - US (neutral stimuli specifier) is conditioned to threat –> CS
2) reinfored by avoidant behavior to avoid/dec anxiety

Question 17

disorder #1 phobia

Explained what prepared learning is in the context of phobias

Answer 17

some stimuli are more reacted and evolutionary adapted as more common fears (spiders heights) compared to others (flowers)

Question 18

disorder #1 phobia

Name 1 treatment for phobias

Answer 18

gradual consistent exposure therapy

Question 19

disorder #2 social anxiety disorder/social phobia

Which gender, age, and SES is more prevalent in social anxiety disorders?

Answer 19

women, younger, lower SES

Question 20

disorder #2 social anxiety disorder/social phobia

How many % of adults have social anxiety disorder? At what age time frame does it onset?

Answer 20

3-13% adults
adolescent onset

Question 21

disorder #2 social anxiety disorder/social phobia

9 criteria for social anxiety disorder/social phobia

Answer 21

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

Question 22

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?

Answer 22

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

Question 23

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

Answer 23

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

Question 24

disorder #2 social anxiety disorder/social phobia

Name social anxiety disorder behavioral therapy, cogntive therpay, 3 medications

Answer 24

behavioral - role play, practice in groups
cognitive- CBTm challenge beliefs, negative thoughts and self talk
benzo, SSRI, SNRI

Question 25

# disorder #3 panic disorder 4 criteria of panic disorder | hint: brain and body related, anxious about it ...

Answer 25

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

Question 26

# disorder #3 panic disorder panic attacks are a sudden ________ with min of ____ physical symptoms

Answer 26

apprehension/terror 4

Question 27

# disorder #3 panic disorder Name 7 panic disorder physical symptoms

Answer 27

1) choke 2) dizzy 3) heart palpitate 4) breathing difficult 5) chills 6) heat/tingles 7) trembling/muscles

Question 28

# disorder #3 panic disorder Name 3 cognitive panic disorder symptoms

Answer 28

1) depersonalization 2) derealization 3) fear of losing control/dying

Question 29

# 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?

Answer 29

locus coerculeus (LC) norepinephrine

Question 30

# disorder #3 panic disorder drugs that inc norepinephrine activation in the locus coerculeus (LC) does what to stress?

Answer 30

INC stress -->panic attacks

Question 31

# disorder #3 panic disorder aetiology of panic disorder has 3 aspects: neurobio, behavioral, cognitive. What is the behavioral conditioning process of panic attacks?

Answer 31

interoceptive conditioning

Question 32

# disorder #3 panic disorder What is interoceptive conditioning?

Answer 32

initial PRECURSORS of panic attack (somatic symptoms sweating, inc HR, muscle ache) --> CONDITIONED STIMULI CS predict inc arousal anxiety ABOUT SYMPTOMS = CR panic attack

Question 33

# 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

Answer 33

catastrophic misinterpretations of doom/dizzy/dying when experiencing symptoms of panic attack --> inc anxiety --> produce more sensations (cycle)

Question 34

# disorder #3 panic disorder What is the behavioral therapy for panic disorders?

Answer 34

exposure training to interoceptive sensations breathing training, relaxation

Question 35

Is benzo (GABA) or antidepressants (SNRI, SSRI) more addictive with greater side effects?

Answer 35

benzo (GABA) with more motor/cognitive side effects

Question 36

# disorder #4 agoraphobia 8 criteria for agoraphobia

Answer 36

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

Question 37

# disorder #4 agoraphobia aetiology of cognitive model to explain agoraphobia

Answer 37

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

Question 38

# disorder #4 agoraphobia agoraphobia treatment (behavioral) ex:

Answer 38

exposure therapy in graded scenarios

Question 39

# disorder #5 GAD 6 criteria for GAD

Answer 39

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

Question 40

# disorder #5 GAD Name 6 symptoms of GAD

Answer 40

1) irritated easily 2) tired easily 3) restless 4) muscle tension 5) sleep disturbance 6) focus/concentraton difficulties

Question 41

# disorder #5 GAD name 4 stages of GAD developing | what causes emotions? what's felt? cognitive component? result?

Answer 41

1) early trauma 2) emotions of distress hard to understand 3) worry 4) neg emotions relieved

Question 42

# disorder #5 GAD GAD vs anxiety disorders main difference is

Answer 42

GAD- general distress, worry focused, to avoid anxiety, no heightened physio response anxiety - specific pattern of fear, specific heightened physio response

Question 43

# disorder #5 GAD GAD people are more likely to experience ? than people with anxiety disorders?

Answer 43

major depressive disorder

Question 44

# anxiety treatment graded exposure includeds maximum which 2 features?

Answer 44

maximizing features of trigger (spider's specific features) maximizing contexts of trigger (spiders in diff env)

Question 45

# anxiety treatment behavioral approach of anxiety treatment is not "forgetting the fear" but learning to ?

Answer 45

learning to extinct the fear

Question 46

# anxiety treatment cognitive approach of anxiety treatment includes challenging what 2 components?

Answer 46

1) person's beliefs about likelihood of conseq/situation happening 20 person's expectationss of self unable to cope/tolerate/control self

Question 47

# anxiety treatment What 2 types of therapy is used in anxiety treatment apart from behavioral exposure and CBT?

Answer 47

ACT - acceptance commitment therapy MCT - meta cognitive focus positive thinking therapy

Question 48

# anxiety treatment What are the 2 types of anxiety anxiety treatment? What are classified under?

Answer 48

benzodiazipines antidepressants under anxiolytics

Question 49

# anxiety treatment What are 4 examples of benzodiazipines? Which NT is increased? withdrawals? negatives?

Answer 49

valium, xanax, sedatives, tranquilizers withdrawals, cog, motor, memory- addictions not preferred first line of med

Question 50

# anxiety treatment What are the 2 main types of antidepressants? side effects?

Answer 50

SSRI, SNRI slight jitters, HR, less than benzo, preferred