week 7 Flashcards
difference between fear and anxiety
fear is a response to an immediate threat whereas anxiety is worrying about the future as a threat - both involve a physiological arousal (sympathetic nervous system)
three interrelated anxiety response systems
- physical system - brain sends response to sympathetic nervous system which produces fight or flight mode which activates chemicals such that initiate things such as trembling, tight chest light headed etc
- cognitive system - subjective feelings of worry, nervousness, panic etc
- behavioural system - aggression and/or escape, avoidance, safety seeking etc.
parasympathetic division
constricts pupils stimulates salivation decreases respiration decreases heart rate stimulates gastric juice production speeds up digestion contrasts bladder relaxes rectum
sympathetic division
dilates pupils inhibits salivation increases respiration increases heart rate inhibits gastric juice production inhibits digestive process relaxes bladder muscles contracts rectum
genetic risk factors
twin studies suggest heritability - 20-40% for phobias, GAD and PTSD and around 50% for panic disorder
neurobiological risk factors
over activity of fear circuit, amygdala (zuckerman 1991) - medical prefrontal cortex deficits
factors linked with anxiety
genetics
neurobiology
preparedness
anxiety sensitivity
preparedness
seligman 1971
baby monkey studies?
Anxiety sensitivity
the fear of anxiety symptoms based on beliefs that such symptoms have harmful consequences e.g rapid heartbeat predicts heart attack
anxiety disorders
involve experiencing excessive and debilitating negative emotions
shaped curve (yerkes and Dodson)
- absence of anxiety interferes with performance
- moderate levels of anxiety improves performance
- high levels of anxiety are detrimental to performance
Age of onset
- begin much earlier than other disorders (anxiety)
- most specific phobias start in childhood
- social phobia and OCD in. adolescence/early adulthood
- panic disorder, agoraphobia and GAD later, more widely dispersed
- first treatment usually starts in adulthood
mental disorders under anxiety category
- separation anxiety
- selective mutism
- specific phobia
- social anxiety
- panic disorder
- agoraphobia
- generalised anxiety disorder
- substance/medication induced anxiety disorder
panic disorder
repeated, unexpected panic attacks
- begin suddenly without triggers
- usually last minutes but can last hours
- produce strong urge to escape situation
For one month must be followed by one or both of:
- persistent fear of subsequent attacks or of the feared consequences )e.g having a heart attack, going crazy)
- significant maladaptive changes in behaviour (e.g limiting activities, avoidance behaviours)
features of panic attacks
- pounding heart
- sweating trembling or shaking
- experience of choking
- fears of losing control
- pain in the chest
- tingling sensations
- nausea
- dizziness
- hot flushes
how panic attacks begin
predicted by individuals catastrophically misinterpreting bodily sensations as threatening (clark, 1986)
individuals with panic disorder:
- attend to their bodily sensations more than others
- will interpret ambiguous signs as threatening
- having panic attacks triggered merely by the expectancy of an attack (Sanderson et al, 1989)
cognitive biological model
panic proneness (genetics ; sensitivity to anxiety) triggering events (bodily sensations ; threat cues) ->perception of threat -> worry of fear -> changes in bodily sensations -> misinterpretations ->
phobia
- an evolutionary necessity
- much of what we know comes form research on specific phobias
- classical conditioning
- operant conditioning
- mowrers two process theory (Mowrer 1939, 1960)
- modelling/observational conditioning
classical conditioning
Pavlov's dog little Albert (Watson and Rayner 1920) Little Peter (cover-jones)
operant conditioning (skinner)
negative and positive reinforcement. punishment.
Mowrer two process theory
Step 1 - classical conditioning;
UCS (dog bite) & CS (dog) creates a CR of fear of dogs
step 2 - operant conditioning; the strong fear response acts as a stimulus or drive which leads to overt avoidance response.
most common phobias
- social phobia
- blood-injury-injection phobia
- animals
- dental
- water
- hight
- claustrophobia
cognitive factors
- information & interpretation bias
- interpret performance significantly more critically
- show self-focused attention
- indulge in excessive post-event processing of social events
agoraphobia
fear of open, busy areas (public spaces)
fear situations where it might be difficult to escape or help might not be available and can become housebound for months or years
Generalised anxiety disorder (GAD)
high levels of anxiety that aren’t specific to one object or situation - excessive difficult to control accompanied with physical symptoms
must be accompanied by:
- marked emotional distress or significant impairment in daily functioning
common features and prevalence of GAD
- arising in mid-teens to mid 20s
- twice as common in women as men
common features: - tense, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep problems
treatment of phobic, anxiety disorders
learning based: - systematic desensitisation - gradual exposure - flooding cognitive based: - cognitive restructuring drug based: - antidepressants useful in treating social anxiety, may be used in conjunction with psychotherapy
symptoms of OCD
obsessions:
- intrusive recurring thoughts that the individual finds distressing (e.g. causing harm to someone you love)
- beyond the persons ability to control
compulsions:
- excessively repetitive behaviour patterns
- responsibility to prevent catastrophic outcomes
types of compulsions: religious, sexual, aggressive
- inflated responsibility
treatments for OCD
Exposure with response prevention (ERP)
- exposed to situations that provoke obsessive thoughts
- prevent compulsive response from happening
- learn to control anxiety; realise nothing nothing bad happened
SSRIs
- some therapeutic benefits but symptoms often persist
- can be used alongside CBT for better results
