Psych review exam 2 Anxiety Disorders 1 What is anxiety anxiety is the condition experience of being afraid Anxiety is immediate fearful reaction to a perceived threat Anxiety is also anxious anticipation 2 What are the four types of symptoms associated with anxiety a Physiological or Somatic Symptoms b Cognitive Symptoms c Behavioral Symptoms d Emotional symptoms 3 When is anxiety considered adaptive vs maladaptive its considered adaptive vs maladaptive when a are concerns realistic given the circumstances b is the amount of fear in proportion to the threat c does the concern persist in the absence of the threat 4 What two factors should be considered when making an anxiety diagnosis a when it s severe enough to lower quality of life b chronic frequent enough to interfere with functioning 5 How does culture play a role in anxiety disorders differ across cultures context environment influences the content of fears 1 What are the main criteria for diagnosing GAD Generalized Anxiety Disorder a anxiety and worry occurring more days than not for at least 6 months About a number of events or activities restlessness or feeling keyed up or on edge b Worry is difficult to control c Associated with 3 of the following more days than not for past 6 months i ii easily fatigued iii difficulty concentrating or mind going blank iv irritability v muscle tension vi sleep disturbance d Focus is not confined to features of axis 1 disorders e f Not due to substance use GMC or does not occur exclusively during Impairment or distress mood psychotic or pervasive developmental disorders 2 What are the proposed changes of the DSM V a New name Generalized Anxiety Worry Disorder b Changes to Criteria Length of time reduced from 6 to 3 month Must show BOTH restlessness muscle tension c Other symptoms listed in Criterion C will be dropped d New criteria spend inordinate amount of time and energy preparing for feared situations or avoiding those situations Immobilized by procrastination and indecision Seek reassurance 3 What is the prevalence course of GAD a 3 5 of general population b Highly comorbid with other anxiety disorders c Also associated with depression and substance use disorders d 50 report onset in childhood or adolescence e Course is chronic but fluctuating and often worse during time of stress f WOMEN ARE AT GREATER RISK 4 How is GAD explained by a Cognitive theory People with GAD think about threat constantly The function of worry Worry is an attempt at suppression of negative images Worry prevents bad things from happening Worrying is dangerous to your health b Biological theory GABA Theory Indivduals with GAD have deficiency in GABA receptors resulting in excessive firing in the limbic system Genetic Theory Biological vulnerability to GAD is inherited 5 What are psychological biological treatments for GAD Psychological treatments a Cognitive Behavioral Therapy CBT I Some Techniques Therapist works with client to identify and alter negative automatic thoughts Self monitor worrying and schedule worry time b Relaxation Techniques Progressive Muscle Relaxation Deep Breathing Biological treatments a Benzodiazepines Short term relief from anxiety very addictive many b Tricyclic Antidepressants Tofranil and SSRIs Paxil Paxil reduces anxiety better than benzodiazepines c Serotonin Norepinephrine Reuptake Inhibitor effexor Better than side effects placebo 1 What are the main components of panic disorder and agoraphobia Panic Disorder A Panic Disorder recurrent unexpected panic attacks At least one panic attack has been followed by 1 month of I II III persistent concern of additional attacks worry about the implications of the attacks a significant change in behavior B Agoraphobia Anxiety about being in places or situations for fear of having a panic attack or panicky feelings I II III IV Situations include waiting in line Traveling on public transportation Using elevators Being away from home Some people avoid these situations completely Others force themselves into feared situations but feel anxious and panicky throughout 2 How do biology and cognitions play a role in panic disorder Biology A Support from family history studies First degree relatives of someone diagnosed with PD are more likely to develop PD compared to relatives of someone without PD B Support from twin studies Suggest 30 40 of variation due to genetics Cognitions C Panic is not inherited like eye color Pay close attention to bodily sensations Misinterpret bodily sensations Engage in snowballing catastrophic interpretations 3 What treatments are used to treat panic disorder A Drug Treatments Tricyclic Antidepressants I II III I II Selective Serotonin Reuptake Inhibitors SSRIs Ex Prozac Paxil Zoloft Celexa etc Benzodiazepines Downers Suppress the central nervous system mute alarm response Disadvantages Physically Addictive need increasing dosage Interfere with cognitive motor functioning Panic attacks when you quit B Cognitive Behavioral Therapy CBT for Panic Disorder and ALL anxiety conditions involves 1 Cognitive restructuring 2 EXPOSURE of some kind I EXPOSURE alters maladaptive fear anxiety by Provides evidence against irrational thoughts Habituation to anxiety C Components of Treatment Relaxation exercises based on the idea that you cant be both relaxed and scared at the same time Progressive Muscle Relaxation PMR D Interoceptive Exposure Given that PD is a fear of bodily sensations what exactly would EXPOSURE for PD clients entail What does the data say about their effectiveness Interoceptive Exposure techniques are better than pharmacological treatments Combination of CBT and meds may actually decrease success of treatment PTSD Related Stress Disorders 1 Know the diagnostic criteria for the 3 stress disorders a Combat and War Related Traumas Combat fatigue syndrome b Disasters Tornadoes floods earthquakes fires c Abuse Physical emotional sexual d Common Traumatic Events Car accidents sudden deaths of shell shock loved ones e DIAGNOSTIC CRITERIA Exposed to trauma with both of the following present Event involving actual or threatened death serious injury or threat to physical integrity of self or others Response involving fear helplessness or horror DSM V will drop this requirement f Traumatic event is reexperienced in 1 of the following ways g Avoidance of stimuli associated with the trauma numbing of general responsiveness as indicated by 3 of the following Intrusive images thoughts or perceptions Distressing dreams Active
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