Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
36 Cards in this Set
- Front
- Back
|
Panic Attack (PA) |
- not a disorder - intense fear/discomfort - sudden onset and peak rapidly (<10 min) - accompanied by 4+ physical symptoms: sweating, increased heart rates, gastrointestinal distress, muscle tension cued v.s. uncued - prevalence: female > male |
|
|
Panic Disorder (PD) |
- recurrent and unexpected PA - followed by 1+ month of at least one from the following: persistence concern about having another PA, persistence concern about implications of PA, significant change in behaviors - prevalence: female > male |
|
|
Agoraphobia |
- anxiety about places / situations where they can't escape and help may not be available - may caused by PD - situation avoided or endured with distress - e.g. being in crowd, on a subway, being or leaving the house alone - prevalence: female > male |
|
|
Separation anxiety disorder |
- excessive anxiety concerning the separation from primary caregiver or home - 4+ weeks (6 months for adults) - duration of the symptoms, abnormality in behaviours and physical impairment can serve as key indications of the disorder - e.g. kids acting sick so they don't have to leave their parents for going to school - prevalence: female > male |
|
|
Selective Mutism |
- consistent failure to speak in social situations - interfere with achievement - duration > or = 1 months - other disorders need to be ruled out so such behaviour can be considered to be "selective mutism" - prevalence: female = male; lowest |
|
|
Specific phobia |
- marked and persistent fear - exposure triggers fear and anxiety - situation avoided / endured with distress - fear/anxious object is not an actual danger - has subtypes e.g. animal, blood-injection-injury, situational, natural/environmental |
|
|
Social Anxiety Disorder (social phobia in DSM-4) |
- fear of being focus of the attention / scrutiny - fear of being humiliated - exposure triggers fear and anxiety - fear is persistent (6+ months) - prevalence: female> male in community setting, female=male in clinical setting (patients reaching help); highest |
|
|
Generalized anxiety disorder (GAD) |
- chronic / exaggerated worry / tension (6+ months) - unable to control worry - 3+ physical symptoms for adults and 1+ for children (restlessness, easily fatigued, difficulty concentration, irritability, muscle tension, sleep disturbance) |
|
|
Order of Age of Onset (early to late) |
Separation anxiety (~ preschool) Selective Mutism (<5) Specific Phobia (7-11) Social Anxiety (8-15) Agoraphobia (17) Panic Disorder (20-24) Generalized Anxiety (<30) |
|
|
Internalizing disorder |
- comorbidity of anxiety disorder and depression in kids - the difference between anxiety and depression in children is quite ambiguous so it's usually address under the umbrella of internalizing disorder |
|
|
Biological Approaches of Anxiety Etiology Structural theory: Dual Pathway Model of Fear |
stimulus --> thalamus --> amygdala (reflexives / store emotional info) or cerebral cortex (slow though processing / cognition)
|
|
|
Biological Approaches of Anxiety Etiology Psychophysiological Theory |
- poorly regulated fight or flight - overreactive autonomic nervous system (either the body respond too sensitively or paying to much attention to those normal body response) |
|
|
Biological Approaches of Anxiety Etiology Genetic Theory |
- you are more likely to have anxiety disorder if your family has it - gene candidate: serotonergic system (5-HT, SLC6A4), dopaminergic system (DRD4, DRD2), modulation of monoamine metabolism (MAOA, COMT) - serotonergic for negative emotion, dopaminergic for positive emotion, monoamine for degradation of serotonin |
|
|
Biological Approaches of Anxiety Etiology Neurotransmitter Theory |
Poor regulation of NT: high NE (stimulating), low 5-HT(mood regulating), GABA (inhibitory so calm body down / GAD deficient in GABA and GABA receptor) |
|
|
Personality Trait Theory |
- Neuroticism / negative affectivity - Behavioral inhibition in early stages increase risk getting social phobia |
|
|
Psychological Approaches of Anxiety Etiology Cognitive Theory |
- high anxiety sensitivity: catastrophic interpretation to body response or event - - hyper-vigilant to potential threat - cognitive self-evaluation model (social phobia) e.g. too sensitive in social rejection, have high standards of social values about themselves |
|
|
Triple Vulnerability Model |
- Biological vulnerability - Specific Psychological vulnerability: maladaptive interpretation on events of response - Generalized psychological vulnerability: external locus of control |
|
|
Psychological Approaches of Anxiety Etiology Behavioural Theory |
- acquired through classical conditioning (can be via observation), maintained by operant conditioning
|
|
|
Biological Treatments to Anxiety |
- Tricyclic antidepressant: increase level of NTs (NE, don't work with PD but work with GAD) - SSRI: increase serotonin (less neg emotion) - Benzodiazepine: suppress CNS and influence NT (NE, 5-HT, GABA / addictive) |
|
|
Behavioural treatments to Anxiety |
- Modelling: therapist model appropriate behaviour - Implosive therapy (flooding/ intense exposures) - systematic desensitization (gradual exposure) |
|
|
Systematic Desensitization |
- Fear hierarchy development --> teach relaxation --> practice with gradual exposure --> practice relaxation while experiencing panic symptoms (behavioural) - identify maladaptive cognition --> challenge catastrophic thoughts (cognitive) |
|
|
Treatment effectiveness for Anxiety |
GAD: short term, CBT > pharmacotherapy Panic disorder: remain improved at follow up, CBT = pharmacotherapy (but pharm. has higher rate of relapse) |
|
|
Obsessive-Compulsive Disorder (OCD) |
- either obsession or compulsion - time consuming symptoms ( > 1 hour/day) - cause distress and impairment - recurrent cycle of OCD: stimulus (internal/external) --> obsession <--> distress/anxiety --> ritual behaviours <--> temporary relief (reinforcement of behaviour)
|
|
|
Obsession |
- unwanted, anxiety-causing, recurrent and persistent urge, thoughts or images e.g germ contamination --> thoughts are not worries to real life problems (GAD) --> not delusional thoughts (use reality-testing) --> may show attempt to suppress or to neutralize with actions/thoughts |
|
|
Compulsions |
- repeated behaviours or mental acts - aim to reduce distress (e.g. neutralizing obsessive thoughts or reduce anxiety) |
|
|
Biological Theory of OCD |
- brain dysfunction = lack of control in primitive behaviours - linked to 5-HT - genetic predisposition |
|
|
Cognitive-Behavioural Theory of OCD |
- can not turn off the obsessive thought as their brain wired differently |
|
|
Psychodynamic Theory of OCD |
- Obsessions and compulsions represent symbolic conflicts - formulation example: feel guilty of the past mistake leads her attempt to undo feelings of shame through cleansing rituals |
|
|
Biological Treatments for OCD |
- 5-HT enhancing / antidepressant drugs (e.g. prozac, zoloft, paxil) - psychosurgery used for severe cases (anterior cingulotomy/capsulotomy) - Treat the pathway from stimuli to obsession/distress |
|
|
Behavioural Treatments for OCD |
- Exposure and response prevention --> preventing from engaging rituals hen exposed with obsessive thoughts stimuli - Treat the pathway from obsession<--> distress & ritual behaviours <--> temporary relief |
|
|
Cognitive therapy for OCD |
- Encourage change in thinking--> accepting the brain wire differently - Treat the pathway from obsession <--> distress |
|
|
Posttraumatic Stress Disorder (PTSD) |
- experienced traumatic events with actual/threatened death or injury -intrusive symptoms (nightmares/flashbacks) - avoidance of stimuli - negative alteration in mood/cognition (sudden change e.g. dropout of uni) - marked alteration in arousal/activity (panic/difficulty in sleeping) - fear/anxiety persisting after trauma (> 4 weeks) - if <4 weeks = Acute Stress Disorder - Cortisol level peak slow in stress --> not responsive to stress management |
|
|
Other Stressor related disorder |
Adjustment disorder - distress in major transition in life but not necessarily traumatic / within 3 months of stressor / youth diagnosis Acute stress disorder - same symptoms as PTSD but <4 weeks |
|
|
Treatments of PTSD |
CBT: systematic desensitization (extinguish fear) / cognitive strategy (challenge irrational thoughts) Stress management: problem solving to reduce stress / use of "thought stopping" to treat intrusive thoughts Biological therapies: antidepressant/antianxiety drugs Eye movement desensitization: side to side eye movements while the patient attends and react to traumatic stimuli (belief: once traumatize, you are not processing the thoughts in the right way and RAM sleep recovery can help that) --> not proven more effective compare to exposure tech. |
|
|
PTSD Vulnerability |
determined by - sociocultural factors (proximity, duration, severity, social support) - psychological factor (personal assumption, distress,coping styles) -biological factors (physiological hyperactivity, genetics, epigenetics affect DNA methylation to decrease capability in regulating stress hormone, HPA axis hypoactivity, developmental stages that are more susceptible or not) |
|
|
Summary of Major Anxiety Disorders |
Phobia: fear avoidance of harmless objects or situations Panic Disorder: sudden physiological symptoms + recurrent panic attacks Generalized Anxiety Disorder: persistent, uncontrollable worry Separation Anxiety: worry about losing contact/proximity, esp. significant others (common in youth) Agoraphobia: fear of being in public places (comorbid with PD) Substance induced anxiety e.g. caffeine overdose |
