Anxiety Disorders Lecture Notes

Flashcards summarizing key concepts related to anxiety disorders, their diagnosis, and treatment.

Anxiety

In clinical settings, anxiety refers to a condition with specific subtypes that are addressed in clinical settings. It includes understanding stressors and panic disorders.

DSM 5 Anxiety Disorders

Include Separation Anxiety Disorder, Selective Mutism, Specific Phobias, Social Anxiety Disorder, Panic Disorder, Agorophobia, Generalized Anxiety Disorder, and Substance/Medication-Induced Anxiety Disorder, among others. Comorbidity is a common issue.

Anxiety vs. Normal Emotions

A diagnosable anxiety condition is distinct from normal emotions. Feeling anxious about big life events is normal, but not an anxiety disorder.

Fear

The emotional response to real or perceived imminent threat, often associated with fight or flight responses.

Anxiety

The anticipation of future threat, often associated with muscle tension, vigilance, and avoidant behaviors.

Generalized Anxiety Disorder (GAD)

Characterized by excessive anxiety and worry about various topics for at least six months, difficulty controlling worry, and physical or cognitive symptoms such as restlessness, fatigue, impaired concentration, and irritability.

Psychological Symptoms of Anxiety

Include restlessness, a sense of dread, feeling constantly 'on edge', difficulty concentrating, irritability, and withdrawal from social contact.

Physical Symptoms of Anxiety

Include dizziness, tiredness, palpitations, muscle aches and tension, trembling, dry mouth, excessive sweating, shortness of breath, stomach ache, and insomnia.

Autonomic Nervous System (ANS) in Anxiety

Anxiety activates the ANS, triggering the flight or fight response, resulting in bodily symptoms like panic attacks, fast pulse, and tight chest, based on adrenalin.

Adrenalin

Hormone that prioritizes blood supply to areas needed for quick escape and decision-making during perceived danger, such as arms, legs, and specific brain regions, while taking blood from areas like the stomach and sex organs.

Anxiety Cycle

Maintained by pervasive avoidance behaviors, which perpetuate anxiety. Includes anxiety-causing situations, pre-situational anxiety, decision to avoid, and temporary relief.

Epidemiology of Anxiety Disorders

Anxiety disorders are the most prevalent mental disorders, affecting up to 33.7% of the population during their lifetime. Prevalence is higher in people with chronic physical illnesses and groups vulnerable to stigma.

Co-morbidity of Anxiety Disorders

High overlap among anxiety disorders and between anxiety disorders and other mental conditions is a major criticism of the DSM 5. Anxiety and depression are particularly highly comorbid.

Medication for Anxiety

Anxiolytic drug therapy (e.g., Alprazolam, Chlordiazepoxide, Clonazepam) can help, but is best used alongside therapy.

Cognitive Behavioral Therapy (CBT)

Based on the idea that a person's perception of a situation impacts their reaction more than the situation itself. CBT helps identify distorted thinking and evaluate how real they are.

CBT Model

Situation triggers automatic thoughts that impact reactions, which can be viewed as how we think (cognition) impacts how we feel (emotion) and how we act (behavior).

Rational Emotive Behaviour Therapy (REMBT)

A type of CBT that focuses on resolving emotional and behavioral problems by changing irrational beliefs to more rational ones through reality testing.

Mindfulness

Focuses on paying attention to the present moment, helping people become more aware of thoughts, feelings, and body sensations to better manage them. Reduces anxiety by focusing on the present rather than fear of future threats.

Separation Anxiety Disorder

Characterized by persistent and excessive anxiety beyond that expected for the child's developmental level related to separation from attachment figures. Evidenced by distress, worry, reluctance to go out, fear of being alone, nightmares, and physical symptoms.

Physiology of Separation Anxiety Disorder

May be linked to early history of exposure to traumatic events altering infant-caregiver bonding and affecting the oxytocin receptor, potentially increasing future risk for mood disorders.

Aetiology of Separation Anxiety Disorder

Risk factors include family history of anxiety disorders/depression, early/traumatic separation from attachment figures, and interactive patterns with an over-protective or depressed parent.

Treatment of Separation Anxiety Disorder

Includes CBT and pharmacological treatments, though routine prescription is not recommended due to concerns about potential harm.

Specific Phobias

Include situational, natural environment, blood-injury-injection, animal, and other types. Symptoms persist for at least 6 months and impact functioning.

Stimulus Generalisation

The fearful reaction to specific objects or situations begins to be triggered by other similar stimuli.

Treatment of Phobias: CBT

A straightforward and systematic approach aimed at a specific phobia, focusing on the interaction between situation, thoughts, physical reactions, moods/feelings, and behavior.

Treatment of Phobias: Behavioral Exposure Therapy

The gradual exposure to feared objects or situations either in vivo (real life) or in imagination, creating a fear hierarchy from least to most scary.

Treatment of Phobias: Cognitive Behavioral Therapy

Can address cognitive distortions related to over-estimation of risk or harm associated with the feared object.

Trauma and Stressor-Related Disorders

Include Reactive Attachment Disorder, Disinhibited Social Engagement Disorder, PTSD, Acute Stress Disorder, and Adjustment Disorder, but are not anxiety conditions.

PTSD Diagnostic Criteria

Requires history of exposure to a traumatic event, intrusion symptoms, avoidance of trauma-related stimuli, negative thoughts/feelings that began/worsened after trauma, and alterations in arousal and reactivity. Symptoms must be present for a minimum of a month.

Brain Areas Implicated in PTSD

Three main areas are the (Medial) Prefrontal Cortex, Amygdala, and Hippocampus.

Treatment/Protection for PTSD

Psychological Debriefing aims to normalize feelings but may not always be effective. EMDR (Eye Movement Desensitization and Reprocessing) has shown positive results.