psych 2621 midterm 2 chapter 5

anxiety disorders

anxiety

the unpleasant feeling of fear and apprehension

what are the three components of anxiety?

physiological, cognitive, behavioural

what is physiological anxiety?

heightened level of arousal and physiological activation (heart rate, shortness of breath, dry mouth)

what is cognitive anxiety?

subjective perception of anxious arousal and associated cognitive processes (worry and ruminations)

what is behavioural anxiety?

‘safety behaviours’, avoidance used to reduce perceived threat

when does anxiety become a clinical problem?

when it is chronic, relatively intense, associated with role impairment and causing significant distress for self or others

what are the most common psychological disorders?

anxiety disorders are among the most common psychological disorders

what was the pooled one-year prevalence of anxiety disorders in international studies?

10.6%, according to Somers and colleagues (2006)

which anxiety related disorders often begin early?

specific phobias and separation anxiety

what is a specific phobia?

an unwanted fear of a specific object or situation, disproportionate to its actual danger

what is claustrophobia?

fear of closed spaces

what is acrophobia?

fear of heights

what is ergasiophobia?

fear of working

what is pnigophobia?

fear of choking

what is taphephobia?

fear of being buried alive

what is erythrophobia?

fear if blushing

what is triskaidekaphobia?

fear of the number 13

what is ornithophobia?

fear of birds

situational factors

a tendency to perceive treat and to be concerned/worried when there is no objective threat

what are the most common specific phobia categories?

animals, heights, closed spaces, flying, water, dentists, blood or injections and storms

how can culture influence specific phobias?

different cultures may emphasize different fears and express anxiety in different ways

what is social anxiety disorder (SAD)

persistant fear of being judged or negatively evaluated by other people

what are the 3 main types of social anxiety?

public performance, social interaction and being observed in public

what does the performance-only specifier for SAD refer to?

fear limited to speaking or performing in public

when does SAD commonly begin?

often during adolescence. reported an average onset at age 13

what is taijin kyofusho?

a Japanese culture-related fear of offending or making others uncomfortable through ones appearance or behaviour

what is separation anxiety in adults?

intense worry about losing contact with loved ones and difficulty being alone

what is selective mutism?

not speaking in a particular setting, often school, while being able to speak in other settings

what is avoidance conditioning?

learning to avoid a feared stimulus or situation

how does classical conditioning contribute to phobias?

a previously neutral stimulus becomes associated with a frightening experience

how does operant conditioning maintain avoidance?

avoidance reduced anxiety, reinforcing the behaviour and making future avoidance more likely

what is modelling in fear learning?

learning fear by observing and imitating another persons fearful responses

what is prepared learning?

a tendency to learn certain fears more easily then others

what does the behavioural model of SAD propose?

poor or unlearned social skills can contribute to uncomfortable social interactions and anxiety

what do cognitive theories say about phobias and SAD?

threat-focused thoughts and interpretations can increase vulnerability to anxiety and maintain fear

what is attentional bias?

a tendency to focus on threatening or negative stimuli

how many anxious people interpret ambiguous situations?

they may interpret them negatively and see them as evidence of personal shortcomings

what is post-event processing in SAD?

replaying and critically reviewing a social interaction after it has ended

what core fear is associated with SAD in cognitive theories?

fear of negative evaluation or having a perceived personal flaw exposed

which brain areas show greater activity in some anxiety disorders?

the amygdala and insula, which are associated with negative emotional responses

what is autonomic lability?

a tendency for the autonomic nervous system to become easily aroused

what is behavioural inhibition?

an early temperament involving shyness or strong reactions to unfamiliar stimuli

how does psychoanalytic theory explain specific phobias?

anxiety from repressed impulses is displaced onto a symbolic object or situation

what is a panic attack?

a sudden episode of intense fear with physical symptoms and feelings of impending doom

4 physical symptoms of a panic attack

rapid heartbeat, breathing difficulty, dizziness and sweating

what is depersonalization?

feeling as if you are outside your own body

what is derealization?

feeling as if the outside word is unreal

what is uncued panic attacks?

an unexpected attack without an obvious trigger

what is required for a diagnosis of panic disorder?

recurrent unexpected panic attacks and worry about having future attacks

how can panic attacks differ from phobia fear?

attacks occurring exclusively in specific feared situations may indicate a phobia

what is agoraphobia?

fear of situations where escape or help may be difficult as a person becomes incapacitated

which 5 situations are associated with agoraphobia?

public transport, open spaces, enclosed spaces, crowds or lines and leaving home alone

how many types of situations are required for agoraphobia?

at least 2 of the 5

what is the fear-of-fear hypothesis?

agoraphobia may involve fear of having a panic attack in public, rather than the fear of public places themselves

what is kayak-angst?

a culture specific panic condition among inuit seal hunters alone at sea, involving intense fear, disorientation and fear of drowning

what biological factors are linked to panic disorder?

family and twin findings suggest genetic risk. some physical conditions can also cause panic like symptoms

what does the noradrenergic theory of panic propose?

excessive activity in the noradrenergic system may contribute to panic attacks

how does GABA generally affect noradrenergic activity?

GABA generally inhibits or reduces noradrenergic activity

what is anxiety sensitivity?

fear of anxiety symptoms because they are believed to be dangerous or harmful

what is generalized anxiety disorder (GAD)?

persistant, excessive, difficult-to-control worry across many areas of life

4 features of GAD

difficulty concentrating, fatigue, restlessness, irritability and muscle tension

what can contribute to the onset of GAD?

stressful life events, psychological processes, and possible biological or genetic factors

how do learning theories explain GAD?

anxiety becomes conditioned to a broad range of external stimuli

what role does perceived control play in anxiety?

a lack of perceived control can contribute to anxiety

what is intolerance of uncertainty?

difficulty coping with unpredictable or ambiguous situations, which can increase worry

predictable events produces less anxiety than unpredictable events do

what is approach-avoidance conflict in GAD?

wanting certainty while avoiding anxiety. which creates a conflict that can increase worry

how can worry negatively reinforce GAD?

worry may distract from negative emotions and block emotional processing, helping maintain anxiety

what are positive metacognitive beliefs about worry?

beliefs that worrying is useful, such as believing it helps solve problems

what are negative metacognitive beliefs about worry?

beliefs that worrying is dangerous and uncontrollable

what biological findings are linked to GAD?

possible genetic influences, increased dorsal amygdala activation and involvement of the GABA system

how does psychoanalytic theory explain GAD?

unconscious conflict produces anxiety without the person knowing its source

what is systematic desensitization?

imagining increasingly frightening scenes while deeply relaxed

what is in vivo exposure?

facing feared objects or situations in real life

what is virtual reality exposure?

using a immersive virtual environment to face feared situations in real time

what is flooding?

exposure to the feared stimulus at full intensity

what is modelling therapy for phobias?

watching someone interact calmly with the feared object or situation

why is blood-injection phobia treated differently in modelling therapy

relaxation may worsen reactions, so applied muscle tension may be used instead

what can help people with SAD improve their social skills?

role-play, social skills training and social effectiveness therapy

what is panic control therapy?

a treatment combining relaxation, cognitive behavioural techniques and exposure to panic related bodily sensations

what are the 3 components of panic control therapy?

relaxation training, cognitive restructuring and interoceptive exposure

what is interoceptive exposure?

facing physical sensations that trigger or resemble panic symptoms

what does CBT stand for?

cognitive behavioural therapy

what is cognitive restructuring?

identifying and changing unhelpful or inaccurate thoughts

what is the B in CBT?

behavioural practice, including exposure and learning between sessions

why is CBT homework important?

completing exposure exercises and attending sessions are associated with greater improvement

what is the goal of mindfulness and acceptance-based treatments?

become more aware of and accepting toward anxious thoughts and feelings instead of avoiding them

what is self compassion?

treating yourself with kindness and extending that kindness to others

what are anxiolytics?

medications used to reduce anxiety

what are barbiturates?

an early class of anxiety medications with high addiction and potentially fatal overdose risk

what is benzodiazepines?

anti-anxiety medications that act on brain systems linked to GABA

what are MOA inhibitors?

antidepressant medications as a treatment option for social anxiety

what are SSRIs?

selective serotonin reuptake inhibitors, used for many anxiety disorders but not typically specific phobias

what are possible limitations of anxiety medications?

side effects can include nausea, dizziness, drowsiness, memory problems and dependence with some medications

startle response

a rapid, unconscious defence reflex triggered by a sudden or unexpected stimuli

gender difference

16% women, 9% men

early age of onset, typically during:

childhood

seperation anxiety

people who cannot stand to be alone and who are cognitively preoccupied with losing contact with loved ones

panic disorder

recurrent panic attacks involving sudden onset of physiological symptoms, such as dizziness rapid heart rate and trembling, accompanied by terror and feelings of impending doom

agoraphobia

fear of being in public places (unable to escape)

generalized anxiety disorder

persistent, uncontrollable worry often about minor things