WK2 PSY124 Flashcards
What is anxiety?
“A negative mood state
characterised by bodily symptoms
of physical tension and by apprehension about
the future”. APA 2013
How is it different to fear?
Anxiety→Apprehension about future problem
Worry about encountering a snake in the
future
Fear→Reaction to an immediate danger
Encountering a dangerous snake
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Introduction to Anxiety
Fight or flight response
prepares us to respond to environmental stimuli
(essentially an arousal response)
Inbuilt system in our bodies that prepares us to:
• Fight off danger
• Flight - run away from a threat
But this system also triggers two other ‘F’ responses: • Freeze
• Fornicate (often another F word is used here!)
Not everyone has the same fight or flight response when presented with a threat…
Remember – anxiety and fear are normal, and are usually adaptive.
But when these responses become maladaptive, we need to consider if there is an anxiety disorder…
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Panic Attack: peaks within 10 minutes, and involves 4 + of the following symptoms: ▪ Heart palpitations/racing pulse Numbness/tingling sensations ▪ Shortness of breath/difficulty breathing ion ▪ Chest pain/discomfort ▪ Hot/cold flashes ▪ Choking sensation ▪ Dizziness ▪ Fear of imminent death ▪ Numbness/tingling sensations ▪ Derealisation/depersonalisation ▪ Nausea/Abdominal discomfort ▪ Sweating ▪ Trembling ▪ Fear of loss of control/going insane
Note: Having a single (or even repeated) panic attack does not mean you have panic disorder
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Panic Disorder
Characterised by unexpected and
repeated panic attacks.
To diagnose,
- at least one of the attacks must have been
followed by one month (or more) of one or both
of the following:
1. Persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attack, going “crazy”)
2. A significant maladaptive change in behaviour related to the attacks (e.g., behaviours designed to avoid having panic attacks).
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Generalised Anxiety Disorder (GAD)
Chronic, excessive anxiety that
occurs for at least 6 months, for more
days than not.
Characterised by presence of at least 3 of the following:
▪ Restlessness or feeling keyed up or on edge
▪ Being easily fatigued
▪ Difficulty concentrating or mind going blank
▪ Irritability
▪ Muscle tension
▪ Sleep disturbance
Prevalence Rate of GAD is 2% in males and 3.5% in females
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Anxiety Disorders - Phobia
a. Agoraphobia
- Fear of being in places or situations from which
escape might be difficult (or embarrassing) or
in which help might not be available in the event
of having unexpected panic-like symptoms.
b. Social Phobia
- A fear of one or more social or performance
situations in which the person is exposed to
unfamiliar people or to possible scrutiny by
others and feels they will act in an embarrassing
manner.
Exposure to the feared social situation provokes anxiety, which can take the form of a panic attack.
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c. Specific Phobia
Chronic excessive fear that is cued
by the presence or anticipation of a
specific object or situation.
4 main types Specific Phobia
ANIMAL: Spiders - Snakes - Dogs
SITUATIONAL:
- Flying, Bridges, Elevators
NATUAL ENVIRONMENT: - Storms - Heights
BLOOD INJECTION INJURY:
- Injections
- Seeing blood
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But anything can become the object of a specific phobia:
- Fear of dolls/clowns - Fear of vomiting
Exposure provokes immediate anxiety, which can take the form of a panic attack.
Patients recognize that the fear is excessive or unreasonable.
The distress in the feared situation interferes significantly with the person’s normal routine, occupational functioning, or social activities or relationships.
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Learning Processes
▪ Classical conditioning (see following slides)
▪ Operant Conditioning (see following slides)
▪ Modelling – observing someone else be afraid of something
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Learning Process - Classical Conditioning
“A process where a previously neutral stimulus elicits a response after being paired with a stimulus that automatically elicits a response”
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Learning Process- Operant Conditioning
Reinforcement: Any event or consequence that occurs which increases the likelihood of behaviour occurring again.
Positive Reinforcement: The delivery of a pleasant consequence following the behaviour. Behaviour is likely to increase in order to achieve the pleasant/rewarding outcome/consequence again.
Negative Reinforcement: The removal of an unpleasant stimuli when a desired behaviour occurs. Removing unpleasant stimuli are considered reinforcements as this should increase likelihood of same behaviour occurring again as the organism tries to remove or escape from the unpleasant situation.
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Operant Conditioning –
Punishment
A stimulus/environmental consequence which decreases the likelihood of the behaviour occurring again.
Positive Punishment: The introduction of an unpleasant stimulus (or consequence) following a behaviour. The behaviour should decrease as the organism tries to avoid experiencing the negative stimulus in the future.
Negative Punishment: The removal of a pleasant stimuli/environment, or the failure to provide a positive consequence following the behaviour. The behaviour should decrease as the organism tries to maintain the pleasant stimuli/environment.
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Classical conditioning can explain how phobias develop.
Pairing a scary stimuli with a neutral stimuli – become conditioned to fear the previously neutral stimuli
What do we do if we experience (or expect to experience) the thing we fear?
Avoid it – in other words, we remove an unpleasant stimuli (negative reinforcement), and so avoidance behavior is rewarded and increases (operant conditioning). This means the anxiety/fear is maintained
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biopsychosocial
Cognitive Processes
▪ Interpretation of information and/or physiological arousal as threatening
▪ Coping strategies and personality type
▪ Appear important in most anxiety disorders
Environmental Factors
▪ Stressful life events are associated with development of anxiety disorders such as Panic Disorder and PTSD.
Genetic Factors
▪ Different gene types can influence biology/physiology of the brain, eg increase brain reactivity to perceived threats
▪ Appears important in OCD, GAD some phobias
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Summary
Anxiety and fear are normal, and activate our fight or flight system
However they can become excessive, and our fight or flight system can become too reactive. This can be maladaptive and lead to the development of anxiety disorders
• We briefly described some common anxiety disorders:
- Panic Disorder
- Generalised Anxiety Disorder
- Phobias
• Learning theory can explain why we develop anxiety disorders, and also can be used to treat anxiety disorders
• The biopsychosocial model offers a range of factors which can explain why some people develop anxiety disorders whereas others don’t.
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