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180 Cards in this Set

  • Front
  • Back
Apprehension over an anticipated problem is known as what?
Anxiety
What is fear?
reaction to an immediate situation
While fear is immediate, anxiety is what?
anticipated
What emotion activates the 'fight or flight' reaction?
fear
Fear triggers changes in what system?
sympathetic nervous system
What is the positive aspect of anxiety?
it is adaptive as it helps people notice things and plan for future threats
Yerkes and Dodson three broad levels of anxiety and the effects?
Absence - problem, little - adaptive, too much - detrimental
Define anxiety
Negative mood state characterised by bodily symptoms of physical tension & apprehension about the future
What are the three categories of Anxiety Disorders proposed for the DSM-5?
1. Anxiety Disorders;
2. Obsessive-Compulsive Related Disorders;
3. Trauma- and Stressor-Related Disorders
The DSM-5 proposes to split panic diosrder in the DSM-IV-TR into what two disorders?
Panic Disorder & Agoraphobia
What is Social Disorder in the DSM-IV-TR being renamed to in the DSM-5?
Social Anxiety Disorder
Which disorder in the DSM-IV-TR is described as a discrete period of intense fear or discomfort in which 4 of a list of symptoms develop abruptly & peak within 10 minutes?
Panic Attack
What are the three types of Panic Attack outlined in the DSM-IV-TR?
1. Cued (Situationally bound);
2. Uncued (unexpected);
3. Situationally predisposed
What three brain structures are implcated in the HPA axis?
Hypothalamus, pituitary gland, & adrenal gland
What does HPA stand for in the HPA Axis?
Hypothalamic-pituitary-adrenocortical
What are the two parts of the autonomic nervous system?
sympathetic and parasympathetic
What are some common physical symptoms of a panic attack?
laboured breathing, heart palpitations, upset stomach, chest pain, feelings of choking aand smothering, dizziness, lightheadedness, sweating, chills, heat sensations, and trembling
What are some common psychological symptoms of a panic attack
depersonalisation, derealisation, fear of losing control, going crazy, and dying
The first two signs of a panic attack are usualy what?
significant increase in HR and muscle tension
Activation of the HPA Axis results in an increases of which steroidal hormone?
cortisol
Which two neurotransmitters are excreted by the hypothalmus in the HPA Axis?
vasopressin and corticotropin releasing factor (CRF)
Vasopressin and CRF regulate pituitary gland which is stimulated to produce what hormone?
Adrenocorticotropic hormone (ACTH)
Which gland is stimulated by ACTH to produce cortisol?
Adrenal Gland
What two effects does cortisol have on the body?
Initially to produce the alarm response, and acts on the pituary gland and hypothalamus to supress the alarm system and restore calm
Protracted stress makes the system vulnerable to immune system disorders and also results in what effect on the hypocampus?
atrophy
What medication is preferred when treating anxiety SSRI's or Benzos?
SSRI's
The fear of objects or situations that is out of proportion to any real danger describes which disorder?
speciifc phobia
What are the three DSM-5 criteria for a specific phobia?
1. Marked and disproportionate fear consistently triggered by specific objects or situations;
2. The object or situation is avoided or else endured with intense anxiety;
3. Symptoms persist for at least 6 months
Claustrophbia is the fear of what?
closed spaces
Acrophobia is the fear of what?
heights
The fear of unfamiliar people or social scrutiny describes with disorder?
Social Anxiety Disorder
Anxiety about recurrent panic attacks describes which disorder?
Panic Disorder
Anxiety about being in places where escaping or getting help would be difficult if anxiety symptoms occurred describes which disorder?
Agoraphobia
Uncontrollable worry for at least 3 months describes which disorder?
Generalised Anxiety Disorder
A person with a specific phobia is likely to have what else?
another specific phobia
What are three criteria in DSM-5 that must be met for all anxiety disorders?
1. Impaired functioning or cause marked distress;
2. Symptoms are not caused by a drug or medical condition;
3. The fear & anxieties are distinct from the symptoms of another disorder
What are the four major subtypes of specific phobias?
1. Blood, injection, or injury;
2. Situational;
3. Animals & insects;
4. Natural Environments
What persentage of the population have a specific phobia?
12.50%
What are three ways in which a phobia could be conditioned?
by direct trauma, modeling, or verbal instruction
Using the example of little Albert and the rat describe how the two-factor model of behavioural conidtioning can lead to a specific phobia.
Little Albert had no fear of rat but when rat was associated with a load noise little albert would cry when he saw the rat. This phobia would be then maintained by avoiding rats therefore operant conditioning maintains the fear. No rat = no fear.
What percentage of people with a specific phobia don't recall any conditioning experience as put forward by the two-factor behavioural model?
50%
An evolutionary view of specific phobias suggests that people have an inherent fear of what three things?
snakes, heights and angry people
The idea that our fear circuit may have been prepared by evolution is known as what type of learning?
prepared learning
Fear of associated non dangerous stimuli fades quickly, however associated fear of dangerous stimuli doesn't. This is illustrated by what example using rhesus monkeys?
Four monkeys taught to fear toy snake, toy crocodile, fowers and toy rabbit. Toy snkae and toy crocodile fear maintained but not flowers or monkey.
It is easier to condition fear of what type of stimuli more than neutral stimuli?
life-threatening
Experiencing a false alarm in a specific situation can cause people to develop what?
a phobia
Being repeatedly warned about a partuclar danger can cause the development of what?
a phobia
Which type of phobia is highly heritable?
blood, injection and injury
What is the main treatment for specific phobias?
exposure-based therapy
Which type of exposure therapy is more effective in the treament of specific phobias, in vivo exposure or systematic desensitisation?
in vivo exposure
Exposure based therapies are known to rewire what?
the brain
What are the four criteria for social anxiety disorder?
1. Marked & disproportionate fear consistently triggered by exposure to a potential social scrutiny;
2. Exposure to the trigger leads to intense anxiety about being evaluated negatively;
3. Trigger situations are avoided or else endured with intense anxiety;
4. Symptoms perist for at least 6 months
Prevalence of Social Anxiety Disorder?
3-13%
What is the gender ratio of socail anxiety disorder?
50 50
What is the primary fear in social anxiety disorder?
fear of evaluation
Why is social anxiety disorder being singled out as a phobia in the DSM-5?
it is pervasive and more often interferes with normal acitivities
What are the four most common types of specific fears in social anxiety disorder?
1. public speaking;
2. speaking in meetings or classes;
3. meeting new people;
4. talking to people in authority
What percentage of people with social anxiety disorder have comorbid avoidant personality disorder?
30%
Onset of social anxiety disorder
adolescence
Social anxiety disorder can range in severity from a realtively few specific fears to what?
generalised host of fears
In social anxiety disorders a larger number of fears is correlated with what?
comorbid depression and alcohol abuse, and increased neagtive effects of social and occupational acitvities
Individuals with Social Anxiety Disorder tend to negatively evaluate what?
their social performance
Rather than focusing on external stumuli people with social anxiety disorders tend to be busy monitoring what?
their own anxiety levels
What effect does early tendency to social anxiety disorder have on the ascquisition of social skills?
they avoid social situations and this retards social skill development
Behaviours used to avoid negative feeedback such as avoiding eye contact, disengaging from conversaiton and standing apart form others are what type of behaviours?
safety behaviours
What risk factor is thought to be at the heart of anxiety disorders?
classical conditioning of a fear response
What are the 5 types of common risk factors associated with anxiety disorders?
1. Conditioned fear response;
2. Genetics;
3. Neurobiological factors;
4. Personality Traits;
5. Cognitions
Explain Mowrer's two-factor model.
1. through classical conditioning a perosn elarns to fear a neutral stimulus (US) with an instrinsicallly aversive stimulus (UCS);
2. through operant conditioning a perosn gains relief by avolding the CS. This avoidance ismaintained because it is reduces fear (reinforcing)
What type of theory is Mowrer's two-factor model of conditiong?
behavioural
What role does operant conditioning play in Mowrer's two-factor model?
maintainence of the fear
What role does classical conditioning play in Mowrer's two-factor model?
development of the fear
People with anxiety disorders seem to acquire fears more readily through classical conditioning and slower what?
extinction of fears once they are acquired
In the study involving the pairing of rorschard card and electric shock what differences were found in the conditioning and extinction of the fear response between people with and without panic disorder?
Both groups were equally conditioned but the group with a panic disorder showed little drop in the fear during the extinction phase
People with anxiety disorders have a greater propensity to develop fears through classical conditiing and slower what?
extinction of fears once they are acquired
The heritability of panic disorder?
50%
The heritability of specific phobias, social anxiety disorder, GAD and PTSD?
20-40%
Having a family member with a phobia increases the risk of what?
developing an anxiety disorder
When is the fear circuit involved?
when people feel anxious or fearful
In what part of the brain is the amygdala?
temporal lobe
Which area of the brain is important for helping regulate the amygdala?
medial prefrontal cortex
The medial prefrontal cortex is involved in what related to fear and emotions?
it helps extinguish fears and regulate emotions
People with anxiety disorders show less activity in which part of the brain involved in regulating emotions?
Medial Prefrontal Cortex
Which three neurotransmitters are thought to be involved in anxiety disorders?
Serotonin, norepinephrine, and GABA
What differences in serotonin system, norpinephrine, and GABA have been found in people with anxiety?
Poor functioing of the serontonin system, higher than normal levels of norepinephrine, and poor GABA functioning
What role is GABA thought to play in anxiety?
GABA inhibitis brain acitivty resulting in decresed anxiety, poor GABA functioning increases anxiety
How do infants display the trait of behavioural inhibition?
tend to become agitated and cry when faced with novel toys, people, and other stimuli
What is the earliest age that infants tend to show the trait of behavioural inhibition?
4 months
What is the link between behavioural inhibition trait and anxiety?
behavioraul inhibition trait may predispose people to the development of anxiety disorders
Behavioural inhibiition is a strong predictor of which anxiety disorder?
Social Anxiety Disorder
What percentage of infants displaying the trait of behavioural inhibition developed social anxiety disorder by adolescence?
30%
Neuroticism is the personality trait defined by a tendency to do what?
react to events with greater than average negative affect
Neuroticism is a major correlate of which two mental health disorders?
anxiety and depression
What are three cogntive risk factors for the development of an anxiety disorder?
1. sustained negative beliefs about the future;
2. a perceived lack of control;
3. attention to signs of threat
How do safety behaviours allow a person with an anxiety disorder to sustain negative beliefs about the future?
To protect against feared consequences they engage is saftey behaviours. Then they believe it is the safety behaviours that protects them and not that the feared consequence is irrational.
People who think they lack control over their environment appear to be at a greater risk of what than people who do not have that belief?
developing an anxiety disorder
What sort of childhood experiences promote the view that life is not controllable?
trauma, punitive and restrictive parenting, and abuse
Anxiety disorders often develop after serious life events that threaten what in a person?
sense of control over their life
What percentage of people report a severe life event before the onset of an anxiety disorder?
70%
Explain the animal study, using monkeys, demonstrating the effect of a sense of control during childhood.
group of monkeys who had no control over when they received treats during childhood behaved in ways that looked anxious when facing new situations and interacting with other monkeys.
People with anxiety disorders have been found to pay attention to what sort of cues in the environment more than people without anxiety disorders?
negative or threat cues
People with social anxiety disorders have been found to selectively attend to what sort of faces?
angry faces
What differences in the training of positive bias were found between the control group and the GAD group?
No systematic pattern with the control and no change in anxiety levels after 240 trials. GAD group were trained with positive bias and 50% no longer met the criteria for GAD after the trial.
What is the most effective treatment for Social Anxiety Disorder?
Combination of exposure and cognitive therapy
Is exposure therapy or cognitive therapy more effective for the treatment of Social anxiety disorder?
exposure therapy
The effects of exposure treatment is enhanced when people with Social Anxiety Disorder are taught to stop using what type of behaviours?
safety behaviours
Role play or practicing with the therapists in small groups before going out in public is a type of exposure treatment for which anxiety disorder?
Social Anxiety Disorder
What two cogntive therapy techniques are most effective for the treatment of Social Anxiety Disorder?
teaching the person not to focus internally and heloing them to combat their negative images of how others with react to them
What types of anit depressants have been found to be most effective in treating Social Anxiety disorder?
Tricyclic AD's and MAO inhibitors
Adding what drug to CBT significantly enhances the treatment outcome for Social Anxiety Disorder?
d-cycloserine (an antibiotic)
What is the DSM-5 criteria for Panic Disorder?
Recurrent uncued panic attacks, and for at least one month concern about the possibility of more attacks, worry about the consequences of an attack, or maladaptive behavioural changes because of the attacks
Can panic disorder be diagnosed if panic attacks are cued?
no
People with panic disorder do what to avoid panic attacks?
1. abuse drugs and alcohol and
2. interoceptive avoidance such as removal from sitautions thatn might produce physiological arousal like exercise, saunas, and watching sport
Onset of Panic Disorder
Adolescence
What proportion of people with panic disorder report being unemployed for more than 5 years?
one quarter
What percentage of people with panic disorder experience nocturnal attacks? And in what stage of sleep does this occur?
60% and during delta or SWS sleep
Which particular part of the fear circuit plays an important role in panic disorder?
locus coeruleus
The locus coeruleus is the major source of which neurotransmitter that plays a major role in triggering the sympathetic nervious system?
norepinephrine
Panic attacks are often trieggered by internal bodily sensations of what?
arousal
Classical conditioning of panic attacks in response to bodily sensations has been called what?
interoceptive conditioning
What is interoceptive conditioning?
when a perosn experiences somatic signs of anxiety, which are followed by the person's first panic attack, the panic attack then becpomes the conditioned repsonse to the somatic changes
Cognitive perspectives of panic disorder focus on the catastrophic misinterpretation of what changes?
somatic
Catastrophic interpretations of the what seem to be important in triggering panic attacks in panic disorder?
bodily sensations
What Index measures the extent to which people respond fearfully to their bodily sensations?
Anxiety Sensitivity Index
Unexplained physiological arousal in someone who is fearful of such sensations leads to what?
panic attacks
The anxiety sensitivity indiex has been shown to predict the onset of what in long term studies?
panic attacks
What is the most widely used drug to treat panic disorder?
Benzodiazepines
What three types of medications are used to treat panic disorder?
SSRI's, SNRI's and Benzodiazepines
SNRI's stand for what?
serotonin-norepinephrine reuptake inhibitors
What percentage of people prescribed with medication for panic disorder are panic free?
60%
What percentage of people with panic disorder relapse once medication is stopped?
50 to 90%
What does the psychodynamic treatment for panic disorder involve?
24 sessions focessed on identifyiing the emotions and meaning surrounding panic attacks
What treatment is most successful for treating panic disorder?
CBT, particularly exposure therapy
What treatment for panic disorder is described as inducing bodily sensations in a safe environment, creating symptoms themselves, and then practicing tactics for managing or reducing symptoms and therefore increasing a sense of control over the bodily symptoms?
Panic-Control Therapy
What disorder is described in the DSM-5 as a disproportionate and marked fear or anxiety about at least 2 situation where it would be difficult to escape or receive help in the event of incapacitation or panic-like symptoms? And what are the other three criteria in the DSM-5 for this disorder?
Agoraphobia
1. these situations consistently provoke fear;
2. these situations are avoided, require the presences of a companion, or are endured with intense fear and anxiety;
3. symptoms last for at least 6 months.
How is agoraphobia coded in the DSM-IV-TR and how will it appear in the DSM-5?
Coded in DSM-IV as a subtype of panic disorder and will appear in DSM-5 as a separate diagnosis.
Why is there a change in DSM-5 for agoraphobia?
because at least half of people with agoraphobia symptoms do not experience panic attacks
Agoraphobia is associated with significant impairment in what?
daily functioning
The principle cognitive model for the etiology of agoraphobia is the what?
fear-of-fear-hypothesis
What is the name of the hypothesis which suggests that agoraphobia is driven by negative thoughts about the consequences of experiencing anxiety in public?
fear-of-fear-hypothesis
What are the two ways to treat agoraphobia?
exposure therapy, particularly systematic exposure, and teaching the partner to stop enabling the behaviour
What is a central feature of GAD?
worry
The cognitive tendency to chew on a problem and to be unable to let go of it is known as what?
worry
What three features characterise worry that is associated with GAD?
the worries are excessive, unavoidable, and long-lasting
What are the 6 symptoms of GAD of which three are required to be present for a diagnosis
1. Restlesness or feeling keyed up or on edge;
2. Being easily fatigued;
3. Difficulty concentrating or mind going blank;
4. Irritability;
5. Muscle tension;
6. Sleep disturbance
How long must symptoms be present to qualify for a diagnosis of GAD in the DSM-5 and DSM-IV?
3 months in DSM-5 and 6 months in DSM-IV
Onset of GAD
Adolescence
People with GAD often recall a tendency to worry for how long?
all their lives
Deficits in the functioning of which neurotransmitter system are involved in GAD?
GABA
One theory suggests that worry may be reinforceing because it may being distracting people from what?
more powerful negative emotions and images
By worrying, people with GAD may be avoiding what unpleasant emotions that would be more powerful than GAD because worrying decreases what?
physiological signs of arousal
What childhood experience predicted a four fold increase in the risk of developing GAD?
malttreatment such as maternal rejection, harsh discipline, and childhood abuse
People with GAD have an intolerence of what experience?
amibiguity
What are two suggested reasons that people with GAD avoid emotions?
because they find it hard to understand and label their emotions and they find it difficult to regulate their negative emotions
What proportion of people with GAD are female? Why might this be?
2/3, may be due to reporting bias
A chronic course of GAD is characterised by what?
waxing and waning
Why might GAD be more prevalent in older adults?
diminished control over some aspects of their life
Does GAD tend to have a rapid or insidious onset?
insidious
What is the function of worry?
the vigilent anticipation of potential danger
People with GAD overpredict negative outcomes causing them to do what?
ruminate to avoid making a choice that may lead to failure
Worry in GAD is reinforced by what process?
anticipate the worst and then the castastrophe doesn't occur and this reinforces the belif that worrying was effective in the first place
Does GAD tend to run in families?
Yes
Are people with GAD more or less responsive on physiological measures of arousal?
less
People with GAD have restricted arousal but high levels of activity in which part of the brain?
frontal lobe
what medication is most commonly prescribed for relieving a temporary crisis in people with GAD?
Benzodiazepines
What is more effective in the long term treatment of GAD medication or psychological therapy?
psychological
What is the most common behavioural treatment for people with GAD?
relaxation training - particulary progressive
What are 5 cognitive streategies for treating people with GAD?
1. help people tolerate uncertainty;
2. challenge negative thoughts;
3. confronting anxiety-provoking thoughts;
4. scheduling time to worry;
5. focussing on present (mindfulness)
What do people often experience when they stop using benzos?
withdrawal symptoms
What are 4 common side effects of tricyclic AD's?
jitteriness, weight gain, elevated HR and high blood pressure
What are 4 common side effects of SSRI's?
restlessness, insomnia, headaches and diminished sexual functioning
D-cycloserine bolster's psychological treatment involving conditioning such as exposure therapy because of it's ability to enhance what?
learning
Which type of treatment is most effective for anxiety disorders in 70 to 90% of cases?
exposure treatment
Extinction involves what?
learning new adaptive associations to replace the maladaptive ones
Exposure treatment helps people correct their mistaken what?
beliefs
What percentage of people with an anxiety disorder meet the criteria for another anxiety disorder suring their lifetime?
50%
How many times more likely are people with GAD to develop another anxiety disorder compared to the general population?
four times
What percentage of people with GAD will meet the criteria for another anxiety disorder?
80%
What are two primary reasons for comorbidity within anxiety disorders?
Overlapping symptoms and share vulnerability
What percentage of people with an anxiety disorder meet the criteria for another disorder in the DSM? What percentage meet the criteria for major depression?
75% and 60% respectively
Different cultures express symptoms of anxiety in what?
different ways