CCPX 4037: Introduction to Cognitive Behavior Therapy (CBT) Midterm

The final will focus on information from the second half of the semester (CBT for anxiety and other disorders). It will also consist of multiple choice, short answer, and essay.

Purposes of Anxiety

• Protection

• Anticipating danger

• Motivation

• Avoiding harm

CBT model for anxiety

Thoughts ⇔ Behavior ⇔ Emotions/Bodily sensations

Fear

Present danger, immediate response, fight/flight/fawn/freeze

Anxiety

Future threat, anticipatory response, worry/vigilance

The components of anxiety

1. Physiological (e.g., heart racing, sweating, muscle tension)

2. Cognitive (e.g., worry, catastrophic thinking, threat prediction)

3. Behavioral (e.g., avoidance, escape, safety behaviors)

When does anxiety become a disorder?

• Threat overstimulated

• Uncertainty becomes intolerable

• Avoidance prevents learning

• Alarm system fires too often

Panic disorder

Fear of internal sensations; trigger is physiological responses

Social Anxiety

Fear of social evaluation

Generalized Anxiety Disorder (GAD)

Chronic future threat monitoring (undiagnosed)

Specific Phobia(s)

Fear of specific things, objects, experiences, etc.

Anxiety disorder development

• Biological vulnerability (temperament)

• General psychological vulnerability

• Specific psychological vulnerability

Biological vulnerability (temperament)

Genetic tendency toward heightened emotional reactivity (e.g., genetic predisposition, sensitive nervous system, high pshysiological arousal

General psychological vulnerability

Inconsistent caregiving, overcontrolling parenting, early unpredictable experiences

Specific psychological vulnerability

Learning certain situation/objects are dangerous (e.g., dog bites → dog phobia)

Panic Attack DSM-V Criteria

Abrupt surge of intense discomfort that reaches peak w/in minutes; can occur from calm or anxios statedisorder

• Not a codable disorde; at least 4 symptoms present within 10 minutes

1. Palpatations, pounding heart, or accelerated heart rate

2. Sweating

3. Trembling or shaking

4. Sensations of shortness of breath or smothering

5. Choking sensation

6. Chest pain or discomfort

7. Nausea or abdominal distress

8. Feeling dizzy, unsteady, lightheaded, or faint

9. Chills or heat sensations

10. Paraesthesias (numbness or tingling sensations)

11. Derealization (feelings of unreality) or depersonalization (being detached)

12. Fear of losing control or going crazy

13. Fear of dying

Agoraphobia clinical implications

1. Treat “aloneness'“ not just the “places”

2. Address safety persons directly

3. Reframe fear

4. Exposure must include interpersonal dimensions