Anxiety Disorders: Aetiology and Treatment (ps2008- week 3)
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Questions and Answers

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?

  • 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?

  • Acetylcholine stability
  • GABA deficiency (correct)
  • Serotonin overactivity
  • Dopamine underactivity
  • Which cognitive-behavioral therapy (CBT) technique is identified as most effective for treating panic disorder?

    <p>Cognitive restructuring and interoceptive exposure</p> Signup and view all the answers

    What behavioral approach can help but ultimately encourages avoidance in anxiety sufferers?

    <p>Safety behaviors that reduce immediate anxiety</p> Signup and view all the answers

    What mechanism is implicated in individuals with GAD that contributes to their difficulty in disengaging from threatening stimuli?

    <p>Overactivity of the Amygdala</p> Signup and view all the answers

    Which of the following is a feature of the Integrated Cognitive model of worry?

    <p>Interaction between bottom-up and top-down processes</p> Signup and view all the answers

    What is one of the primary goals of stimulus control treatment in managing GAD?

    <p>To identify worrisome thoughts from pleasant ones</p> Signup and view all the answers

    During the scheduled worrying period suggested in stimulus control treatment, clients are encouraged to do what?

    <p>Engage in problem solving related to their worries</p> Signup and view all the answers

    What type of therapy uses both medications and psychological interventions for anxiety disorders?

    <p>Combination therapies</p> Signup and view all the answers

    Which psychological theory describes the link between bodily sensations and anxiety-provoking situations in panic disorders?

    <p>Classical Conditioning</p> Signup and view all the answers

    Which statement best describes the nature of panic attacks?

    <p>They are characterized by a sudden surge of fear or discomfort</p> Signup and view all the answers

    In individuals with GAD, what cognitive bias contributes to the reinforcement of worry?

    <p>Interpretation bias</p> Signup and view all the answers

    What is the heritability percentage related to anxiety as found in twin studies?

    <p>30%</p> Signup and view all the answers

    Which neurotransmitters are indicated to be imbalanced in individuals with GAD?

    <p>Serotonin, Norepinephrine, and GABA</p> Signup and view all the answers

    According to the Metacognitive Model, what type of worry is defined as functional and allows one to come to solutions?

    <p>Type 1</p> Signup and view all the answers

    Which type of environment is suggested to contribute to a child's development of GAD according to Bowlby's attachment theory?

    <p>Disorganised and uncaring</p> Signup and view all the answers

    The Contrast Avoidance model suggests that individuals with GAD engage in worrying to do what?

    <p>Prepare for worst-case scenarios</p> Signup and view all the answers

    What cognitive phenomenon is characterized by a negativity towards ambiguity and uncertainty, often leading to GAD?

    <p>Intolerance of uncertainty</p> Signup and view all the answers

    Which brain region is associated with emotional regulation and is found to be overactive in anxiety sufferers?

    <p>Amygdala</p> Signup and view all the answers

    What behavior model describes worry as a cognitive avoidance response to threatening material?

    <p>Cognitive Avoidance Model</p> Signup and view all the answers

    What is a key characteristic that differentiates anxiety from fear?

    <p>Fear is a reaction to immediate threats.</p> Signup and view all the answers

    What does Yerkes & Dodson's 'inverted U curve' suggest about anxiety?

    <p>There is an optimal level of anxiety for task performance.</p> Signup and view all the answers

    How does avoidance behavior affect anxiety according to the cycle of anxiety?

    <p>It reinforces anxiety through negative reinforcement.</p> Signup and view all the answers

    What components comprise Mowrer's two-factor model of fear conditioning?

    <p>Classical conditioning and operant conditioning.</p> Signup and view all the answers

    What is a common characteristic of anxiety disorders regarding their occurrence?

    <p>They are more frequently diagnosed in women.</p> Signup and view all the answers

    What role does classical conditioning play in anxiety disorders?

    <p>It establishes a fear response to a neutral stimulus.</p> Signup and view all the answers

    Which of the following best describes the secondary problem created by anxiety?

    <p>Flawed informational processing that complicates anxiety.</p> Signup and view all the answers

    Which factor is NOT part of the aetiology of Generalised Anxiety Disorder (GAD)?

    <p>Political environment.</p> Signup and view all the answers

    Study Notes

    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)

    • 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.

    • 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).

    • 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.

    • 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: 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).
    • 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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    Explore the intricacies of anxiety disorders through this focused quiz. Learn about the differences between fear and anxiety, their adaptive responses, and the cycle of anxiety that can lead to emotional disorders. Additionally, delve into fear conditioning and Mowrer's two-factor model.

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