Podcast
Questions and Answers
What primarily exacerbates anxiety sensitivity according to the theory?
What primarily exacerbates anxiety sensitivity according to the theory?
- Excessive reliance on medication
- Overexposure to social situations
- Catastrophic misinterpretation of bodily sensations (correct)
- Active engagement in physical activity
What is a consequence of the body's response to hyperventilation during a panic attack?
What is a consequence of the body's response to hyperventilation during a panic attack?
- Blood vessels constrict to restrict oxygen (correct)
- Metabolic demands increase dramatically
- The person experiences heightened relaxation
- The body increases oxygen intake
Which neurotransmitter activity is associated with increased panic disorder symptoms?
Which neurotransmitter activity is associated with increased panic disorder symptoms?
- Acetylcholine stability
- GABA deficiency (correct)
- Serotonin overactivity
- Dopamine underactivity
Which cognitive-behavioral therapy (CBT) technique is identified as most effective for treating panic disorder?
Which cognitive-behavioral therapy (CBT) technique is identified as most effective for treating panic disorder?
What behavioral approach can help but ultimately encourages avoidance in anxiety sufferers?
What behavioral approach can help but ultimately encourages avoidance in anxiety sufferers?
What mechanism is implicated in individuals with GAD that contributes to their difficulty in disengaging from threatening stimuli?
What mechanism is implicated in individuals with GAD that contributes to their difficulty in disengaging from threatening stimuli?
Which of the following is a feature of the Integrated Cognitive model of worry?
Which of the following is a feature of the Integrated Cognitive model of worry?
What is one of the primary goals of stimulus control treatment in managing GAD?
What is one of the primary goals of stimulus control treatment in managing GAD?
During the scheduled worrying period suggested in stimulus control treatment, clients are encouraged to do what?
During the scheduled worrying period suggested in stimulus control treatment, clients are encouraged to do what?
What type of therapy uses both medications and psychological interventions for anxiety disorders?
What type of therapy uses both medications and psychological interventions for anxiety disorders?
Which psychological theory describes the link between bodily sensations and anxiety-provoking situations in panic disorders?
Which psychological theory describes the link between bodily sensations and anxiety-provoking situations in panic disorders?
Which statement best describes the nature of panic attacks?
Which statement best describes the nature of panic attacks?
In individuals with GAD, what cognitive bias contributes to the reinforcement of worry?
In individuals with GAD, what cognitive bias contributes to the reinforcement of worry?
What is the heritability percentage related to anxiety as found in twin studies?
What is the heritability percentage related to anxiety as found in twin studies?
Which neurotransmitters are indicated to be imbalanced in individuals with GAD?
Which neurotransmitters are indicated to be imbalanced in individuals with GAD?
According to the Metacognitive Model, what type of worry is defined as functional and allows one to come to solutions?
According to the Metacognitive Model, what type of worry is defined as functional and allows one to come to solutions?
Which type of environment is suggested to contribute to a child's development of GAD according to Bowlby's attachment theory?
Which type of environment is suggested to contribute to a child's development of GAD according to Bowlby's attachment theory?
The Contrast Avoidance model suggests that individuals with GAD engage in worrying to do what?
The Contrast Avoidance model suggests that individuals with GAD engage in worrying to do what?
What cognitive phenomenon is characterized by a negativity towards ambiguity and uncertainty, often leading to GAD?
What cognitive phenomenon is characterized by a negativity towards ambiguity and uncertainty, often leading to GAD?
Which brain region is associated with emotional regulation and is found to be overactive in anxiety sufferers?
Which brain region is associated with emotional regulation and is found to be overactive in anxiety sufferers?
What behavior model describes worry as a cognitive avoidance response to threatening material?
What behavior model describes worry as a cognitive avoidance response to threatening material?
What is a key characteristic that differentiates anxiety from fear?
What is a key characteristic that differentiates anxiety from fear?
What does Yerkes & Dodson's 'inverted U curve' suggest about anxiety?
What does Yerkes & Dodson's 'inverted U curve' suggest about anxiety?
How does avoidance behavior affect anxiety according to the cycle of anxiety?
How does avoidance behavior affect anxiety according to the cycle of anxiety?
What components comprise Mowrer's two-factor model of fear conditioning?
What components comprise Mowrer's two-factor model of fear conditioning?
What is a common characteristic of anxiety disorders regarding their occurrence?
What is a common characteristic of anxiety disorders regarding their occurrence?
What role does classical conditioning play in anxiety disorders?
What role does classical conditioning play in anxiety disorders?
Which of the following best describes the secondary problem created by anxiety?
Which of the following best describes the secondary problem created by anxiety?
Which factor is NOT part of the aetiology of Generalised Anxiety Disorder (GAD)?
Which factor is NOT part of the aetiology of Generalised Anxiety Disorder (GAD)?
Flashcards
Genetic Component of Anxiety
Genetic Component of Anxiety
The tendency for a trait to be passed down from parents to offspring.
Twin Studies
Twin Studies
A study comparing identical twins (MZ) to fraternal twins (DZ) to determine the heritability of a trait.
Amygdala and Prefrontal Cortex
Amygdala and Prefrontal Cortex
Brain regions associated with emotional processing and decision-making.
Amygdala Overactivity and Prefrontal Underactivity
Amygdala Overactivity and Prefrontal Underactivity
A state of excessive activity in the amygdala and reduced activity in the prefrontal cortex, potentially contributing to the development of GAD.
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Neurotransmitter Imbalance in GAD
Neurotransmitter Imbalance in GAD
An imbalance in neurotransmitters like serotonin, norepinephrine, and GABA, potentially contributing to GAD.
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Cognitive Avoidance Model of Worry
Cognitive Avoidance Model of Worry
The avoidance of emotional processing and control of negative emotions through worry.
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Contrast Avoidance Model of Worry
Contrast Avoidance Model of Worry
The belief that worrying is a way to prepare for the worst-case scenario and avoid distress.
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Superstitious Beliefs and Worry Reinforcement
Superstitious Beliefs and Worry Reinforcement
The belief that avoiding worry will lead to negative consequences, reinforcing the habit of worrying.
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Fear
Fear
A basic emotion triggered by an immediate threat, motivating quick and adaptive responses. It's like a 'fight or flight' system.
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Anxiety
Anxiety
Apprehension about a future threat, involving cognitive connections between emotions, events, and responses. It's less instinctive than fear and can vary greatly.
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Classical Conditioning (in fear)
Classical Conditioning (in fear)
A learning process where a neutral stimulus becomes associated with an aversive stimulus, leading to a fear response.
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Operant Conditioning (in avoidance)
Operant Conditioning (in avoidance)
A learning process where avoiding a feared stimulus leads to relief, reinforcing the avoidance behavior.
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Cycle of Anxiety
Cycle of Anxiety
The cycle of anxious thoughts, fear, physiological arousal, and avoidance that reinforces itself.
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Informational Processing Bias
Informational Processing Bias
The tendency to interpret incoming information in a negative or threatening way, even when evidence suggests otherwise.
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Generalized Anxiety Disorder (GAD)
Generalized Anxiety Disorder (GAD)
A mental health disorder characterized by excessive and persistent worry, difficulty controlling worry, and physical symptoms like restlessness or fatigue.
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Aetiology
Aetiology
The study of the factors that contribute to the development of a disorder. It's about the roots of a problem.
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Anxiety Sensitivity
Anxiety Sensitivity
The tendency to focus excessively on bodily sensations, often misinterpreting them as dangerous or threatening, leading to anxiety and worry about losing control, often manifesting in panic attacks and creating a cycle of fear.
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Safety Behaviors
Safety Behaviors
A key feature of anxiety disorders, where individuals engage in behaviors aimed at reducing perceived threats or anxiety but often worsen the condition by reinforcing avoidance behaviors and creating a reliance on these strategies rather than directly facing anxieties.
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Superstitious Reinforcement in GAD
Superstitious Reinforcement in GAD
The belief that worrying is necessary to prevent negative outcomes, leading to a reinforcement cycle where worrying becomes a habit.
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Integrated Cognitive Model of Worry
Integrated Cognitive Model of Worry
A cognitive model that explains how involuntary and voluntary processes interact to create and sustain worry.
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Hyperventilation
Hyperventilation
A rapid breathing pattern characterized by ventilation exceeding metabolic demand, often triggered by anxiety or panic attacks, leading to low blood carbon dioxide levels, resulting in a series of physical symptoms such as dizziness and lightheadedness.
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Cognitive Behavioral Therapy (CBT) for GAD
Cognitive Behavioral Therapy (CBT) for GAD
A treatment approach for GAD that focuses on identifying and changing the way individuals think and behave in response to worrisome thoughts. This approach can involve techniques like stimulus control and exposure.
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Interoceptive Exposure
Interoceptive Exposure
A cognitive-behavioral therapy technique that helps individuals confront and challenge the negative thoughts associated with bodily sensations, gradually reducing fear and anxiety by creating a sense of safety and control.
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Stimulus Control Treatment for GAD
Stimulus Control Treatment for GAD
A therapy strategy for GAD that involves identifying worrisome thoughts and creating a specific time and place to worry. This helps individuals gain better control over their worrying habits.
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Cognitive Restructuring
Cognitive Restructuring
A core principle of CBT that involves identifying and challenging distorted or irrational thoughts that fuel anxiety, ultimately aiming to replace these negative thoughts with more realistic and balanced perspectives.
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Panic Attack
Panic Attack
The sudden onset of intense fear or discomfort that reaches a peak within minutes, characterized by physical and psychological symptoms.
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Attentional Bias in GAD
Attentional Bias in GAD
The tendency to focus attention on threatening stimuli, making it difficult to disengage from these stimuli. This can be influenced by factors like overactivity in the amygdala.
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Classical Conditioning in Panic Disorder
Classical Conditioning in Panic Disorder
A learning process where a neutral stimulus (e.g., bodily sensations) becomes associated with an anxiety-provoking situation.
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Combination Therapies for GAD
Combination Therapies for GAD
A combination of medication and therapy used to treat GAD. This approach aims to address both the biological and psychological aspects of the condition.
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Anxiety Disorders: Aetiology and Treatment
- Fear: A response to immediate threat, useful for quick adaptive reactions.
- Anxiety: Apprehension about a future threat, a future-focused cognitive response connecting basic emotions. It's less "hardwired" than fear and varies by individual and situation.
- Both are adaptive responses to threat, useful for preparedness. Anxiety increases preparedness (Yerkes & Dodson, 1908). Fear triggers the "fight or flight" response aiding survival.
- Maladaptive anxiety: Excessive intensity, frequency or duration can lead to emotional and anxiety disorders (Barlow, 2002).
- Cycle of Anxiety: Cognitive thoughts about the anxiety-provoking situation create an emotional fear response. This leads to a physiological response triggering avoidance behavior. This cycle repeats, reinforcing the anxiety and avoidance.
Fear Conditioning
- Mowrer's Two-Factor Model: A model consisting of classical and operant conditioning.
- Classical Conditioning: An individual learns a fear response to a neutral stimulus (CS) repeatedly paired with an intrinsically aversive stimulus (UCS).
Generalised Anxiety Disorder (GAD)
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DSM-5 criteria: Excessive anxiety and worry (apprehensive expectation) about two or more life domains. Occurs more days than not for 3+ months. Often associated with restlessness, muscle tension, avoidance of activities or events with possible negative outcomes. This includes time/effort preparing for such events, procrastination due to worries and seeking reassurance by others. Impairment in social, occupational, or other important areas of functioning. A key point is the disturbance is not caused or exacerbated by the direct physiological effects of a substance, or another medical condition, nor should it be attributed to another mental disorder.
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Aetiology and Prevalence: More common in women, ages 35-59. Data from National Comorbidity Survey Replication (NCS-R) shows varying prevalence rates across different age groups (18-29, 30-44, 45-59, 60+). GAD etiology involves Biological (genes, brain areas, neurotransmitters) or Psychological theories (informational processing biases, beliefs, meta-beliefs, worrying function).
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Biological factors: Genetics play a role (Noyes et al., 1992). Twin studies (MZ vs DZ) show heritability around 30% (Dellava, Kendler & Neale, 2011). Amygdala (emotional regulation) and Prefrontal cortex (decision-making) may also be involved. Imbalance relating to Serotonin, Norepinephrine & GABA.
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Psychological Factors: Unpredictable and stressful events can increase GAD risk.
Worry
- Cognitive Avoidance Response (Borkovec & Newman): Worry distracts from distressing material, acts as a form of negative reinforcement.
- Intolerance of Uncertainty (Dugas, Marchand & Ladouceur 2005): A dispositional characteristic that makes people want to reduce ambiguity and uncertainty.
- Contrast Avoidance Model: People engage in worry to ensure they are ready a worst case scenario
- Metacognitive Model (Wells, 1995): Adaptive Worry (Type 1) is normal and functional; Meta-worry (Type 2) is pathological, worrying about worrying.
Parenting Styles and Psychological Factors related to GAD
- Parenting styles: Insecure attachment associated with uncaring environment may contribute to difficulties in dealing with difficult situations.
Treatment of GAD
- Pharmacological: Anxiolytics or Anti-depressants (SSRI).
- Psychological: Stimulus control and exposure, Cognitive Behavioral Therapy (CBT) includes self-monitoring, relaxation training, cognitive restructuring, behavioral rehearsal. Cognitive bias modification (CBM).
Panic Disorder and Agoraphobia
- Panic Attacks: An abrupt surge of intense fear or discomfort peaking within minutes. Can be "out-of-the-blue" or associated with specific situations.
- DSM-5 Panic Disorder criteria: Recurrent unexpected panic attacks for one month or more after the attack; persistent concern or worry about additional attacks; significant maladaptive changes in behavior; not due to substance or medical condition or another mental disorder (e.g., Social Anxiety, Specific Phobia, Obsessive-Compulsive Disorder, Posttraumatic Stress Disorder, Separation Anxiety).
- DSM-5 Agoraphobia criteria: Marked fear or anxiety about two or more situations leading to avoidance or needing a companion. Situations include public transportation, open spaces, shops, theaters, lines/crowds, outside of home alone, etc; fear out of proportion to actual danger; situations are actively avoided, require a companion, or endured with marked fear/anxiety; disturbance persists for 6+ months; causes significant impairment.
Psychological theories of Panic Disorder
- Classical Conditioning: Linking bodily sensations to panic attacks and anxiety-provoking situations.
- Interoceptive Conditioning: Conditioning panic in response to internal bodily sensations. (Panic is separate from anxiety. Anxiety is anticipatory preparedness for an attack and panic is when the attack is already happening).
Biological Factors related to Panic Disorder
- Hyperventilation: Rapid breathing exceeding metabolic demand leading to a reduction in CO2 levels, which can induce symptoms (dizziness, lightheadedness).
- Neurotransmitter Imbalance: Deficient GABA neurons, overactivity of Noradrenaline.
Treatment of Panic Disorder
- Pharmacological: Tricyclic Antidepressants, SSRIs (second-line NICE recommendation). Benzodiazepines are not recommended by NICE.
- Psychological: Cognitive Behavioral Therapy (CBT) including Interoceptive Exposure, Cognitive Restructuring, Relaxation, Breathing retraining.
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