W4: Anxiety Disorders

Question 1

What is the flight or fight response?

Answer 1

An evolutionary survival system including sudden changes in sympathetic nervous system it is an inbuilt system in our bodies that prepares us to fight off danger or run away from it

Question 2

Anxiety is multifaceted explain

Answer 2

There is a cognitive component of what the person is thinking

There is a physiological component on what is happening to the body and sympathetic nervous system

And there is a behavioural component on what the person is doing this can be helpful or make the problem worse

Question 3

What are some common themes in anxiety disorders

Answer 3

Overestimation of the likelihood of something bad happening

Underestimating their ability to cope

Activation of the flight or fight system to different degrees

Question 4

What are the five main anxiety disorders in the DSM

Answer 4

Specific phobia
Social anxiety disorder
Panic disorder
Agoraphobia
Generalised anxiety disorder

Question 5

What is a specific phobia

Answer 5

The fear and avoidance of specific objects or situations

Question 6

What are some subtypes of phobias

Answer 6

Animals such as spiders snakes or dogs

Natural environment such as storms and heights

Situationally such as flying bridges and elevators

And blood injection injury such as injections or seeing blood

Question 7

What makes blood injection injury different to other phobias

Answer 7

Different in the sense that they often experience a drop in blood pressure and then they faint this doesn’t happen with any other phobia there is a genetic component to it

Question 8

What does the DSM say about specific phobia

Answer 8

Marked fear or anxiety about a specific object or situation

The object or situation

• almost always provokes immediate fear or anxiety
• is actively avoided or endured with intense fear or anxiety

It is out of proportion to the actual danger posed

Lasting for longer than six months
Causing significant distress or impairment
Not better explained by another mental disorder

Question 9

What is social anxiety disorder

Answer 9

The fear of negative evaluation in social performance situations

The fear is unrealistic and intense with a belief that others will see them are stupid or foolish

Often involves a lot of unhelpful self talk

Question 10

What does the DSM say for social anxiety disorder

Answer 10

Marked fea/anxiety about one or more social situation in which the individual is exposed to possible scrutiny by others

Fears that they will act in a way or show anxiety symptoms that will be negatively evaluated

Social situations
almost always provoke fear or anxiety
are avoided or endured with intense fear or anxiety

The fear is out of proportion to the actual threat

Lasting for at least six months

Causes clinically significant distress or disturbance in functioning -Not due to the effect of a drug or other medical condition and also not due to another mental disorder

Question 11

What is generalised anxiety disorder

Answer 11

Uncontrollable worries about a number of real world events

Asking what if

Question 12

What does the DSM say about generalised anxiety disorder

Answer 12

Excessive anxiety and worry occurring more days then not for at least six months about a number of events or activities not just one particular thing

The individual finds it hard to control their worry

Associated with three or more of the following six symptoms: restlessness or feeling keyed up or on edge, being easily distracted, difficulty concentrating or mind going blank, irritability, muscle tension, sleep disturbance

Causes clinically significant distress or impairment

Not attributable to the effects of the substance or another medical condition or mental disorder

Question 13

Worry is…

Answer 13

Normal it is when the worry becomes out of control that is a problem

Question 14

What is the cognitive behavioural model of generalised anxiety disorder

Answer 14

Behavioural factors that maintain worry include avoidance of the situations, reassurance seeking from others, distracting self when they worry

Cognitive factors that maintain worry or attempts to suppress thoughts that could trigger worry

Emotional factors that maintain worry our worries trigger increase in anxiety symptoms that validate the worry

Question 15

What is panic disorder

Answer 15

Panic attacks that come out of the blue symptoms usually come on quite rapidly within 10 minutes
- fear of the meaning and implications of unexpected attacks as well as worrying about having more in the future

Question 16

Will everyone that has panic attacks have panic disorder

Answer 16

No

Question 17

What does the DSM say for panic disorder

Answer 17

Recurrent unexpected panic attacks

At least one of the attacks has been followed by one month or more of both of the following: The persistent concern or worry about additional panic attacks or the consequences, a significant maladaptive change in behaviour related to the attacks

Not attributable to the effects of substance or another medical condition or mental disorder

Question 18

What are the types of panic attacks in panic disorder

Answer 18

Unexpected: these occur spontaneously without any situational trigger

Situationally bound: These attacks occur immediately after exposure to the feared stimuli such as being in a confined seat in a cinema being in a lift being trapped etc

Situationally predisposed: occur on exposure to the feared stimuli but not always immediately after every exposure

Question 19

What is agoraphobia

Answer 19

Feeling anxious in places where it would be difficult to escape if a panic attack or other anxiety related event occurred

For example crowded places public transport traffic bridges

Question 20

How many feared or avoided places are there in agoraphobia

Answer 20

The number of places tends to grow over time

Question 21

What does the DSM say for agoraphobia

Answer 21

Marked fear or anxiety about two or more of the following five situations: using public transport, being in open spaces, being in the enclosed spaces, standing in line or being in a crowd, being outside of the home alone

The individual fears or avoid these situations because of thoughts that escape might be difficult or might not be available in the event of developing panic like symptoms or other incapacitating or embarrassing symptoms

The agoraphobic situation almost always provokes fear or anxiety

That actively avoided and require the presence of a companion or are endured with intense fear and anxiety

It is out of proportion to the actual danger

Lasts for six months or more

Cause significant distress or impairment

Not better explained by the symptoms of another mental disorder

Question 22

What happens if you keep avoiding situations

Answer 22

We never find out that they aren’t that bad and the cycle will continue

Question 23

Explain relaxation training in anxiety disorders

Answer 23

Used as a part of CBT to help manage the symptoms of anxiety and stress

The relaxation response is the opposite reaction to the fight or flight response directly assessing the sympathetic nervous system and managing arousal symptoms

May include deep breathing meditation or yoga

Question 24

Explain what the three different kinds of exposure therapy are

Answer 24

Graded exposure - the psychologist helps the client to develop a fear hierarchy the client is exposed to each step of the hierarchy

Flooding- using the exposure hierarchy to begin exposure with the most difficult tasks learning it doesn’t harm you although you do need fully informed consent because it is very intense

Systematic desensitisation - exposure is combined with relaxation exercising and coping skills this is a kinder approach

Question 25

Explain cognitive restructuring

Answer 25

The psychologist helps the client to identify their automatic thoughts and un helpful self talk

The use of thought diaries can assist this process you can record the situation that triggered the emotional response, the behaviours they were engaging in, the associated thoughts, the feelings triggered by the thoughts, and any other related responses

Question 26

Explain behavioural experiments

Answer 26

Another way psychologist can help the clients to test their beliefs and cognitive distortions

They are an information gathering exercise design to test the accuracy of an individual‘s beliefs about themselves others in the world

For example when I do this I look really sweaty and people will notice it- You can then take a video of them doing it and show it to them and see if they notice that they look sweaty

Question 27

What is the most evidenced-based treatment for anxiety

Answer 27

CBT incorporating behavioural and cognitive techniques such as relaxation training, exposure therapy, cognitive restructuring, and behavioural experiments