Week 4

Question 1

What are the biological, emotional and cognitive, and behaviour affects on anxiety ?

Answer 1

• Biological - Limbic, HPA axis, hormones, neurotransmitters, inheritance (?)
• Emotiona & cognitive - seeing a situation as dangerous; CBT
• Behavioural - operant and classical operating at the same time

Question 2

What is anxiety ?

Answer 2

• a state
• label thoughts as feeling
• unease, exhaustion, restless

Question 3

What are the vulnerabilities to anxiety disorders ?

Answer 3

• Biological vulnerability - stress is activator, diathesis-stress model, irritable, tension
• Specific psychological vulnerability - physical sensations are potentially dangerous, somatic preoccupation, panic symptoms
• General psychological vulnerability - low confidencem self-esteem, self-efficacy , inability to cope, helplessness

Question 4

What are the common comobidities w/ physical disorders

Answer 4

• Thyroid disease - Hyperthyroid -> increased anxiety
• Respiratory disease - Asthma -> symtptoms cause you to panic; inhaler can cause anxiety
• Gastrointestinal disease
• Arthritis
• Migraine
• Headaches
• Allergies

Question 5

What is the DSM-5 criteria for GAD ?

Answer 5

A. excessive anxiety and worry occuring constantly for at least 6 months, about a # of events or activities
B. Difficult to control worry
C. Associated w/ 3 of the 6 symptoms
* restlessness, easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tention, sleep disturbance
D. Cause some sort of problem
E. Not attributable to the direct physiological effects of a substance
F. Not better explained by another mental disorder

Question 6

What is Barlow’s model of GAD ?

Answer 6

GPV (world is unpredictable and dangerous) and GBV (tension and anxiety) -> stress (from life events) -> anxious apprehension ( increases muscle tensions and vigilance) -> worry process (failed attempt to cope and problem solve) -> 4 factors -> GAD

Question 7

What is used to treat GAD ?

Answer 7

• Benzodiasepines
• SSRI’s (antidepressants)
• CBT

Question 8

What is CBT-G ?

Answer 8

• Use cognitive techniques to consdier alternative thoughts and thinking styles
• Provide a model of intolerance of uncertainty, unhelpful thoughts and avoidance

Question 9

What is the model of therapy ?

Answer 9

sitaution -> “what if..?”, “wouldn’t it be terrifble if…” -> worry -> anxiety -> demoralization/exhaustion (burnt out)

Question 9

What is the DSM-5 criteria for Panic Disorder ?

Answer 9

A.Reaccurent unexpected panic attacks
B. At least one of the attacks has been followed by 1 month (or more) of one of both of the following: concern or worry about additional panic attacks or a significant maladaptive change in behaviour related the attacks (i.e: avoidanace)
C. Disturbance is not attributable to the psysiological effects of a substance or another medical condition
D. Not better explained by another mental disorder

Question 10

What are the treatments used for PD ?

Answer 10

• Benzodiapines
• SSRI’S and SNRI
• CBT-P

Question 11

What is the structure of CBT for PD ?

Answer 11

• Introduction to panic and axiety
• Psychoeducation about panic
• Breathing retraining
• Cognitive recontructioning

Question 12

What is the panic mechanism ?

Answer 12

Sensation (physical) -> sensitivity (very stong sensitivity to sensations) -> fear (fear of sensations of arousal) = panic

Question 13

What are the behavioural elements for PD ?

Answer 13

• Identification of feared/avoided activities
• Cease safety behaviour/avoidance
• Interoceptive exposure - exposure to symptoms

Question 14

What is involved in nocturnal panic ?

Answer 14

• Sleep loss lowers panic thresholds
• Insomnia

Question 15

What is involved in CBT-NP ?

Answer 15

• Understand that panic attacks occur due to the excessive dear of the sensations of arousal
• Accept that the sensation pose no real threat

Question 16

How does a phobia develop ?

Answer 16

• Experiential
• Vacarious (if warned about danger, you can begin to fear the situations)
• Alarm symptoms in presence of object
• Recipe - scary experience/sitaution, genetic predispostion, post-experience focus on whether it’ll occur

Question 17

What is the DSM-5 criteria for specific phobia ?

Answer 17

A. Marked fear/anxiety about a specific object/situation
B. phobic situation/object almost always provokes immediate fear or anxiety
C. phobic situation/object is actively avoided or endured with intense fear or anxiety
D. the fear/anxiety is out of proportion to the actual danger posed by phobic situation/object
E. the fear/anxiety/avoidance is persistent ( 6 months or more)
F. The fear/anxiety/acvoidance casues distress or impairment
G. Not better explained by another mental disorder

Question 18

What are the subtypes of specific phobias ?

Answer 18

• Animal
• Natural environment
• Blood-injection injurt
• Situational
• Other - clowns (ex)

Question 19

What is the DSM-5 criteria for SAD ?

Answer 19

A. Marked by fear or anxiety about one ormore social situations in which the individual is exposed to possible scrunity by others
B. The individual fears that they will act in a way or show anxiety symptoms that’ll be negatively evaluated
C. The social situations almost always provooke fear or anxiety
D.The social situations are avoided or endured with marked fear or anxiety
E. The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context
F, G,H,I,J - same as others

Question 20

What is Barlow’s Social Anxiety model ?

Answer 20

GPV and GBV -> stressors -> no alarm, false alarm, true alarm, -> Anxious apprehension -> SPV -> Social phobia
* Direct experience -> stressors
* False alarm and true alarm -> learned alarm which causes Anxious apprehension

Question 21

What are the treatments for Social Anxiety ?

Answer 21

CBT and SSRI’s