Test 2 Study Guide Ch 5 Anxiety and Panic 1 Anxiety a Anxiety is a negative mood characterized by physical tension and apprehension about the future We get anxious because it is an adaptive alarm system that prepares our body for a fight or flight reaction i ii iii iv v vi vii viii ix x xi xii xiii Panic Disorder Specific Phobia Social Anxiety Disorder Generalized Anxiety Disorder Post Traumatic Stress Disorder 1 Trauma and stressor related disorders Obsessive compulsive disorder Hoarding Disorder Excessive acquisition of things difficulty discarding anything and living with excessive clutter under conditions best characterized as gross disorganizations Treatment is not very successful Body dysmorphic disorder A person who looks normal but is obsessively preoccupied with an imagined defect in appearance or imagined ugliness Some seek plastic surgery as a remedy Trichotillomania Hair pulling Excoriation Skin picking Emetophobia Fear of vomiting Adjustment Disorders Developing anxiety or depression in response to a stressful but not traumatic event Anxiety prone individuals are more likely to experience this Attachment Disorders Common in children experiencing inadequate abusive or absent caregiving and fail to develop normal relationships with caregivers This results in two different disorders 1 Reactive attachment disorder is when children that are inhibited emotionally withdrawn and unable to form attachment with caregivers 2 Disinhibited social engagement disorder describes children who inappropriately approach all strangers as if they had a strong and loving relationship xiv Many more 2 There are 3 Components of Anxiety i ii iii i ii iii iv i ii iii Cognitive Symptoms Behavioral Symptoms Physiological or Somatic Symptoms b Adaptive vs Maladaptive Fears Are the concerns realistic given the circumstances Is the amount of fear in proportion to the threat Does the concern persist in absence of the threat Anxiety disorders involve maladaptive fear c Fear vs Diagnosis of Anxiety Disorder Anxiety is a future oriented state where a person focuses on the possibility of uncontrollable danger misfortune while fear is a present oriented state in response to current danger Distress and Impairment is Present for Anxiety Disorders 1 Severe enough to lower quality of life 2 Chronic and frequent enough to interfere with functioning Anxiety is a mood state of apprehension because we can not control the future fear is an immediate emotional reaction to current danger 3 Features of Anxiety Disorders i Prevalence Commonness 1 25 lifetime prevalence 31 in females 19 in males 2 Some recent estimates put lifetime prevalence at 49 5 ii Chronicity 1 70 80 of people do not seek professional help a Reasons 2 17 30 experience spontaneous remission iii High Rates of Comorbidity 1 Comorbidity is the simultaneous presence of more than one disorder 2 55 76 iv Linked to Suicide Attempts 1 Rates similar to depression in PTSD and MDD 4 Vulnerabilities i Generalized Biological Vulnerability 1 We inherited a tendency to be tense and uptight Panic seems to run in families 2 Multiple genes contribute to making us more vulnerable 3 Stress factors in environment turn on these vulnerable genes to cause anxiety panic 4 Specific brain circuits and neurotransmitter systems are associated with increased anxiety GABA 5 Noradrenergic system has also been implicated in anxiety 6 Heredity contributed to negative affect 7 8 9 CRF system 10 The limbic system is the area of the brain that is most related to Glass is half empty Irritable Driven anxiety 11 Behavioral inhibition system involved in apprehensively evaluating a situation with potential danger ii Generalized Psychological Vulnerability 1 Sense that events are uncontrollable and unpredictable 2 Tendency toward lack of self confidence 3 Low self esteem 4 Inability to cope 5 Early life experiences Actions of parents affect whether a child develops a sense of control iii Specific Psychological Vulnerability 1 Focused on particular events or circumstances 2 Development of specific anxiety disorders 3 Specific focus of stress and anxiety that leads to a specific diagnosis a ie Social Phobia 5 Panic Disorders a Panic Attack i ii iii Discrete period of intense fear and discomfort Represents the alarm response of real fear but there is not actually any danger Four or more of these symptoms develop and peak within 10 minutes 1 Pounding Heart 2 Sweating 3 Trembling Shaking 4 Shortness of Breath 5 Feeling of Choking 6 Chest Pain 7 Nausea or Abdominal Distress 8 Dizziness 9 Derealization or depersonalization 10 Fear of losing control 11 Fear of Dying 12 Numbness or Tingling 13 Chills or Hot Flashes 28 3 Lifetime prevalence 2 3x more common in women Onset late adolense to mid 30 s iv v vi i ii iii iv v i ii iii iv b Panic Disorder Recurrent unexpected panic attacks At least one panic attack has been followed by one month of any of these 1 Persistent concern of additional attacks 2 Worry about the implications of the attacks 3 Significant change in behavior 4 7 Lifetime prevalence 2 3x more common in women Onset late adolense to mid 30 s 6 Cognitive Perspective Panic disorders are a misinterpretation of bodily senses They involve maladaptive beliefs including cardiac loss of control going crazy social consequences Trigger stimulus Perceived threat Apprehension Body sensations Interpretation of sensations as catastrophic Cycle repeats Safety Behaviors 1 Avoiding anxiety provoking situations 2 Maintain fear by avoiding disconfirming evidence or having a false attribution of evidence 3 Slow breathing sit down drink water grab hold of something or distract themselves during a panic attack 7 Treatments i ii iii 4 Taking Xanax Tricyclic Antidepressants SSRI s Benzodiazepines downers 1 These suppress the central nervous system to mute the alarm 2 They are addictive and interfere with cognitive and motor 3 They are a form of avoidance and panic attacks occur when you response functioning stop taking them iv Cognitive Behavioral Therapy v Interoceptive Exposure Includes cognitive restructuring and exposure treatment 1 2 Exposure reduces maladaptive fear anxiety by providing evidence against irrational thoughts and allowing new associations to form between the feared context and safety 1 Controlled exposure to the symptoms in order to show the patient that the symptoms are tolerable 2 Brings on symptoms carefully and then reduces them through techniques 3 Decreases the cognitive
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