W4: Anxiety Disorders Flashcards
What is the flight or fight response?
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
Anxiety is multifaceted explain
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
What are some common themes in anxiety disorders
Overestimation of the likelihood of something bad happening
Underestimating their ability to cope
Activation of the flight or fight system to different degrees
What are the five main anxiety disorders in the DSM
Specific phobia Social anxiety disorder Panic disorder Agoraphobia Generalised anxiety disorder
What is a specific phobia
The fear and avoidance of specific objects or situations
What are some subtypes of phobias
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
What makes blood injection injury different to other phobias
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
What does the DSM say about specific phobia
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
What is social anxiety disorder
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
What does the DSM say for social anxiety disorder
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
What is generalised anxiety disorder
Uncontrollable worries about a number of real world events
Asking what if
What does the DSM say about generalised anxiety disorder
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
Worry is…
Normal it is when the worry becomes out of control that is a problem
What is the cognitive behavioural model of generalised anxiety disorder
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
What is panic disorder
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
Will everyone that has panic attacks have panic disorder
No
What does the DSM say for panic disorder
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
What are the types of panic attacks in panic disorder
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
What is agoraphobia
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
How many feared or avoided places are there in agoraphobia
The number of places tends to grow over time
What does the DSM say for agoraphobia
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
What happens if you keep avoiding situations
We never find out that they aren’t that bad and the cycle will continue
Explain relaxation training in anxiety disorders
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
Explain what the three different kinds of exposure therapy are
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
Explain cognitive restructuring
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
Explain behavioural experiments
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
What is the most evidenced-based treatment for anxiety
CBT incorporating behavioural and cognitive techniques such as relaxation training, exposure therapy, cognitive restructuring, and behavioural experiments
