Term
| What two behavioural tendencies are common to all anxiety disorders? |
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Definition
| All anxiety disorders share common avoidance behaviours and a desire to escape. |
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Term
| Differentiate between fear, anxiety and panic. |
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Definition
| Fear is an emotion with a sympathetic nervous system component (Present warning state).Anxiety is another negative mood state but is typically not involved with SNS (Future oriented state). • Panic is a sudden overwhelming sense of fear. |
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Term
| Describe a Panic Attack, both in duration and in typically symptoms. |
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Definition
| Symptoms typically associated with SNS arousal: increase heart rate, sweating, trembling, nausea, dizziness, paresthesias numbness or tingling), derealization (feeling of unreality), feeling of dying. Usually lass about 5-10 minutes. |
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Term
| What is the integrative view of anxiety? |
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Definition
| Biological and genetic vulnerability interact with psychological, experiential, and social variables. Involves the diathesis-stress model and inherited biological vulnerabilities. |
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Term
| Describe the Behavioural inhibition system (BIS). |
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Definition
| Brain stem monitors physiological state, relays this to cortex through the limbic system. The septal-hippocampal system (within the limbic system) is activated by Corticotropin releasing factor and regulates serotonergic and noradrenergic pathways. This system, when activated by cortex, causes us to freeze and assess our situation. |
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Term
| Describe the fight/flight system. |
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Definition
| The fight/flight system is essentially referring to the sympathetic nervous system. |
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Term
| Describe behaviouristic causes of anxiety. |
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Definition
| Anxiety and fear result from direct classical and operant conditioning and modelling |
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Term
| Describe psychological causes about anxiety. |
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Definition
| Early experiences with uncontrollability and unpredictability. For example: ○ Panic attacks/anxiety can become paired to stimuli in environment such that those stimuli evoke panic/anxiety. |
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Term
| Describe social contributions to anxiety. |
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Definition
| Stressful life events as triggers of biological/psychological vulnerabilities. Stressors can be familial and interpersonal. |
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Term
| Anxiety disorders have a high comorbidity with what other type of disorder? |
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Definition
| 55% comobidity with other psychological disorders at time of diagnosis, 76% will eventually experience a second diagnosis. High comorbidity with depression. Major depressive disorder is the most common secondary diagnosis. |
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Term
| Give a clinical description of specific phobia. |
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Definition
| Extreme, irrational fear in the presence of a phobic stimulus.Characterized by avoidance and significant impairment. Typical age of onset: between 7 – 11 years.Chronic course. 75% have a second phobia (average=3). |
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Term
| What is the prevalence of specific phobia in general population? In Canada? |
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Definition
| About 11% of the general population meet diagnostic criteria for specific phobia.6.4% of Canadians; 9% women, 4% men—Lifetime prevalence 2x’s higher for women. |
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Term
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Definition
Blood-Injection-Injury
Natural Environment
Situational
Animal
Other (fear of situations that may lead to choking or vomiting, costumed characters or loud noises in children). |
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Term
| Give DSM-5 diagnostic criteria of specific phobia. |
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Definition
| Marked fear or anxiety about a specific object or situation.The phobic object or situation almost always provokes immediate fear or anxiety and is actively avoided or endured with intense fear and anxiety.The fear, anxiety or avoidance is persistent (6+ months), causes significant impairment or distress, and cannot be explained by another mental disorder. |
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Term
| What learned responses may contribute to specific phobia? |
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Definition
| Direct experience (a personally traumatic experience with the object or situation), a vicarious experience (seeing it happen to someone else), or life stress (typically a false alarm, i.e. someone experiences panic in the presence of a dog and develops fear of dogs). |
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Term
| What are some treatments for specific phobia? |
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Definition
| Usually exposure based: Graduated, structured and consistent exposure to the feared stimulus paired with relaxation techniques. This is a type of cognitive behavioural therapy. |
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Term
| Give a clinical description of social anxiety disorder. |
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Definition
| Extreme, irrational fear or anxiety in social situations. Fears acting in a way that will be humiliating or embarrassing; being negatively evaluated by others. Often avoid social situations or endure them with great distress. |
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Term
| Give DSM-5 criteria for social anxiety disorder. |
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Definition
| Marked fear or anxiety about 1 or more social situations in which the person is exposed to possible scrutiny by others. The social situations provoke fear or anxiety that is out of proportion to the actual threat posed by the situation. Has to be persistent (last 6 months or more), and cause clinic distress or impairment. It cannot be attributed to another mental disorder or substance use. |
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Term
| List some causes of social anxiety disorder. |
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Definition
| Can be due to a tragic event, but not always. Sometimes results from observing someone else go through a traumatic event, or through false alarms. |
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Term
| What treatments are used for people with social anxiety disorder? |
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Definition
| Exposure exercises/virtual reality therapy. Medications are available as well, such as antidepressents (tricyclics, MAO inhibitors, SSRIs). |
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Term
| Give a clinical description of panic disorder. |
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Definition
| Experience of unexpected panic attack (i.e., a false alarm).Develop anxiety, worry, or fear about having another attack or its implications. May involve agorophobia (Fear or avoidance of situations/events associated with panic). |
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Term
| What are nocturnal panic attacks? |
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Definition
| Nocturnal panic attacks – 60% experience panic during deep non-REM sleep. |
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Term
| DSM-5 diagnostic criteria for panic disorder. |
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Definition
| Recurrent unexpected panic attacks (see definition, next slide). At least 1 attack has been followed by 1 month + of either persistent concern or worry about additional panic attacks or their consequences or a significant change in their behavior related to the attacks. |
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Term
| Which anxiety disorder has the worst prognosis? |
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Definition
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Term
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Definition
| Marked or intense, persistent fear or anxiety triggered by anticipated exposure to situations associated with developing panic-like symptoms or other incapacitating or embarrassing symptoms. Fear/anxiety centers around being in places where escape might be difficult or help may not be available . |
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Term
| Diagnostic criteria for agorophobia? |
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Definition
Marked fear or anxiety about 2 or more of the following for a period of 6 months or more:
1) using public transportation (e.g., traveling in a bus, train or automobile)
2)being in open spaces (e.g., parking lots, marketplaces, bridges)
being in enclosed places (e.g., shops, theatres)
3)standing in a line or being in a crowd
4)being outside the home alone
Agoraphobic situations almost invariably provoke fear or anxiety; and are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety |
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Term
| What are some treatments for panic disorder? |
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Definition
| SSRIs are sometimes prescribed. Psychological treatments like CBT work to help manage anxiety. Panic control treatment involves physiological elevation to mimic panic to habituate the patient. |
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Term
| Give clinical description for Generalized Anxiety Disorder? |
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Definition
| Excessive, uncontrollable apprehension and worry about numerous life events, often minor, everyday concerns. Strong, pronounced, persistent anxiety. Somatic symptoms (muscle tension, fatigue, irritability). Chronic course. |
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Term
| DSM diagnostic criteria for generalized anxiety disorder. |
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Definition
Excessive anxiety and worry, occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance). The individual finds it difficult to control the worry. Anxiety and worry are associated with 3+ of the following symptoms present for more days than not for the past 6 months :
Restlessness or feeling keyed up or on edge
Being easily fatigued
Difficulty concentrating or mind going blank
Irritability
Muscle tension
Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep). |
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Term
| What treatments are given for generalized anxiety disorder? |
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Definition
| Benzodiazapenes, antidepressents (tricyclics, SSRIs, MAO inhibitors). Psychological treatments like CBT. |
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Term
| Separation Anxiety Disorder DSM criteria |
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Definition
Developmentally inappropriate/excessive anxiety concerning separation from home or from those to whom one is attached, evidenced by 3 of the following:
1) Recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated
2) Persistent/excessive worry or fear: about losing, or about possible harm to major attachment figures / that an untoward event will lead to being alone or without being near a major attachment figure
3) Persistent reluctance or refusal to: go out, away from home, to school, to work or elsewhere sleep away from home or to go to sleep without being near a major attachment figure Repeated: nightmares involving the theme of separation complaints of physical symptoms
Lasts at least 4 weeks in kids or 6 months in adults |
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Term
| What are some new trauma & stressor related disorders in DSM-5 |
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Definition
| Reactive Attachment Disorder Disinhibited Social Engagement Disorder Adjustment Disorders Acute Stress Disorder PTSD |
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Term
| Clinical Description for PTSD |
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Definition
| Trauma exposure that leads to avoidance, intrusive symptoms (negative memories, etc.) emotional numbing, negative mood states, altered physiological arousal. |
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Term
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Definition
SSRIs
Cognitive behavioural therapy (usually through memory recall). |
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Term
| Obsessive compulsive disorder (new to DSM-5) Clinical Discription |
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Definition
| Characterized by obsessions (Repetitive and persistent thoughts), compulsions (Repetitive behaviours or mental acts driven to perform in response to an obsession, or according to rules which must be rigidly followed).Must be time-consuming or cause clinically significant distress or impairment. |
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Term
| What are the four types of compulsions? |
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Definition
| Checking, ordering, arranging, washing/cleaning. |
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Term
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Definition
| Medications like clomipramine and SSRIs are often prescribed (SSRIs more common). CBT is highly effective when it involves exposure and ritual prevention. In extreme cases cingulotomy is done. |
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