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Questions and Answers
What distinguishes agoraphobia from simple phobias?
What distinguishes agoraphobia from simple phobias?
Which of the following is a commonly avoided situation for those with agoraphobia?
Which of the following is a commonly avoided situation for those with agoraphobia?
What is a common misconception about social anxiety disorder's prevalence?
What is a common misconception about social anxiety disorder's prevalence?
What is the relationship between panic attacks and agoraphobia according to Barlow?
What is the relationship between panic attacks and agoraphobia according to Barlow?
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At what age is the onset of social anxiety disorder most commonly observed?
At what age is the onset of social anxiety disorder most commonly observed?
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Which of the following is a characteristic symptom of social phobia/social anxiety disorder?
Which of the following is a characteristic symptom of social phobia/social anxiety disorder?
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What unique cultural influence on anxiety is noted in the content?
What unique cultural influence on anxiety is noted in the content?
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What differentiates the subtype of social phobia known as performance anxiety?
What differentiates the subtype of social phobia known as performance anxiety?
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Which subtype of panic attack is characterized by attacks that can occur in specific situations but not in others?
Which subtype of panic attack is characterized by attacks that can occur in specific situations but not in others?
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What theory suggests that individuals have a hypersensitivity to detecting carbon dioxide, leading to panic attacks?
What theory suggests that individuals have a hypersensitivity to detecting carbon dioxide, leading to panic attacks?
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Which cognitive factor contributes to the spiraling of anxiety leading to a panic attack?
Which cognitive factor contributes to the spiraling of anxiety leading to a panic attack?
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What percentage of the population is estimated to meet the criteria for panic disorder?
What percentage of the population is estimated to meet the criteria for panic disorder?
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Which treatment method is primarily recommended for panic attacks, despite potential side effects?
Which treatment method is primarily recommended for panic attacks, despite potential side effects?
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What is the association between hikikomori and social phobia in men?
What is the association between hikikomori and social phobia in men?
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Which cultural group shows a higher prevalence of anxiety disorders in Canada?
Which cultural group shows a higher prevalence of anxiety disorders in Canada?
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What is a common characteristic of social anxiety disorder as compared to other anxiety disorders?
What is a common characteristic of social anxiety disorder as compared to other anxiety disorders?
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What percentage of individuals with social anxiety disorder (SAD) are at risk of substance abuse regarding marijuana?
What percentage of individuals with social anxiety disorder (SAD) are at risk of substance abuse regarding marijuana?
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Which of the following statements accurately reflects social anxiety disorder's impact on personal relationships?
Which of the following statements accurately reflects social anxiety disorder's impact on personal relationships?
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According to studies, what was the 12-month prevalence of social anxiety disorder (SAD) in the USA?
According to studies, what was the 12-month prevalence of social anxiety disorder (SAD) in the USA?
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Which of the following disorders has a higher comorbidity than social anxiety disorder?
Which of the following disorders has a higher comorbidity than social anxiety disorder?
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What common issue complicates research on social anxiety across different cultures?
What common issue complicates research on social anxiety across different cultures?
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What is a noted trend in the prevalence of anxiety disorders in affluent countries?
What is a noted trend in the prevalence of anxiety disorders in affluent countries?
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Which of the following conditions is noted for having a substantial comorbidity with anxiety disorders?
Which of the following conditions is noted for having a substantial comorbidity with anxiety disorders?
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What is a characteristic feature of panic attacks according to the diagnostic criteria?
What is a characteristic feature of panic attacks according to the diagnostic criteria?
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Which of the following best describes the role of cognitive interpretations in fear according to contemporary models?
Which of the following best describes the role of cognitive interpretations in fear according to contemporary models?
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What kind of anxiety disorder is characterized by feelings of unreality and detachment from oneself during panic attacks?
What kind of anxiety disorder is characterized by feelings of unreality and detachment from oneself during panic attacks?
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What term describes the behaviors adopted by individuals with anxiety to prevent negative outcomes, even if unnecessary?
What term describes the behaviors adopted by individuals with anxiety to prevent negative outcomes, even if unnecessary?
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Which mechanism is hypothesized to be responsible for reducing the emotional connections associated with fear memories during treatment?
Which mechanism is hypothesized to be responsible for reducing the emotional connections associated with fear memories during treatment?
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What is the first-line treatment approach for panic disorder that focuses on changing maladaptive thought processes?
What is the first-line treatment approach for panic disorder that focuses on changing maladaptive thought processes?
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What is a common erroneous belief about worry among individuals with Generalized Anxiety Disorder (GAD)?
What is a common erroneous belief about worry among individuals with Generalized Anxiety Disorder (GAD)?
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What treatment strategy emphasizes exposure to the feared outcome in treating anxiety disorders?
What treatment strategy emphasizes exposure to the feared outcome in treating anxiety disorders?
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Which of the following statements is true regarding the relationship between panic disorder and anticipatory anxiety?
Which of the following statements is true regarding the relationship between panic disorder and anticipatory anxiety?
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What factor contributes to situational avoidance in individuals with panic disorder?
What factor contributes to situational avoidance in individuals with panic disorder?
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Which of the following best describes panic as it relates to physiological symptoms?
Which of the following best describes panic as it relates to physiological symptoms?
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What characterizes Generalized Anxiety Disorder (GAD) in relation to its cognitive processing?
What characterizes Generalized Anxiety Disorder (GAD) in relation to its cognitive processing?
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Which statement accurately reflects the characteristics of agoraphobia?
Which statement accurately reflects the characteristics of agoraphobia?
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Which biological contribution is speculated to play a role in Generalized Anxiety Disorder?
Which biological contribution is speculated to play a role in Generalized Anxiety Disorder?
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What is a defining feature of social anxiety disorder compared to other anxiety disorders?
What is a defining feature of social anxiety disorder compared to other anxiety disorders?
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In cognitive-behavioral models of anxiety, what is considered a maintaining factor for individuals with GAD?
In cognitive-behavioral models of anxiety, what is considered a maintaining factor for individuals with GAD?
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Which factor significantly differentiates panic attacks from stress responses?
Which factor significantly differentiates panic attacks from stress responses?
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What is the lifetime prevalence of anxiety disorders in the general population, according to the relevant statistics?
What is the lifetime prevalence of anxiety disorders in the general population, according to the relevant statistics?
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Which of the following subtypes of panic can be identified based on the nature of their onset?
Which of the following subtypes of panic can be identified based on the nature of their onset?
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Which factor contributes to a generalized pattern of avoidance in individuals with anxiety disorders?
Which factor contributes to a generalized pattern of avoidance in individuals with anxiety disorders?
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Study Notes
Agoraphobia
- Anxiety about being in places or situations where escape might be difficult or embarrassing, or where help may not be available.
- It differs from simple phobias because it can occur in multiple situations.
- Common situations that are avoided include: buses, subways, bridges, enclosed spaces, crowds, malls, movie theatres, and standing in line-ups.
- There is controversy around whether agoraphobia always occurs with panic disorder, as 46-80% of those with agoraphobia do not report panic attacks.
Social Phobia/Social Anxiety Disorder (SAD)
- Marked or persistent fear of one or more social or performance situations.
- Individuals fear doing something humiliating or embarrassing and being negatively evaluated.
- Includes a performance-only subtype, where fears are limited to public performances like singing or eating in public.
Prevalence of Anxiety Disorders
- Anxiety disorders are the fourth most prevalent disorder after depression, alcoholism, and specific phobias.
- Prevalence rates are high in North America, especially in Canada (8.1%).
- Prevalence is lower in Europe (2.3%).
- Prevalence is similar across children, adolescents, and adults.
- Onset is typically at age 13, but can begin earlier.
Gender Differences
- Anxiety disorders are more prevalent in women in community populations.
- Men are more likely to seek treatment for anxiety disorders.
Cultural Influences
- Taijin kyofusho: a culture-bound syndrome in Japan, characterized by the fear of offending others through behaviour, body odour, or intense gaze.
- Different cultures may have varying interpretations of anxiety, with some cultures being more accepting of shyness or reserved behaviour.
Generalized Anxiety Disorder (GAD)
- Characterized by excessive worry and anxiety for at least 6 months.
- Individuals with GAD often worry about everyday things (e.g., finances, health, work).
- GAD involves a tendency towards:
- Intolerance of uncertainty
- Erroneous beliefs about worry
- Poor problem orientation
- Cognitive avoidance
- Worrying serves as a distraction from deeper fears.
- Safety behaviors include overpreparation.
Treatment for GAD
- Cognitive-behavioural therapy (CBT) is a common treatment approach for GAD.
- CBT techniques include:
- Worry discrimination: classifying worries into controllable (Type 1) and uncontrollable (Type 2).
- Exercise problem solving for Type 1 worries.
- Increasing tolerance for uncertainty for Type 2 worries.
- Engaging in actions without excessive preparation.
- Reducing reassurance-seeking.
- Exposure to the feared outcome.
Panic Disorder (PD)
- Characterized by unexpected panic attacks that are recurrent (occurring more than once).
- Panic attack symptoms include:
- Physiological symptoms: palpitations, chest pain, shortness of breath, dizziness, nausea, trembling, sweating, paresthesias (numbness or tingling), chills or hot flushes.
- Psychological symptoms: derealization (feelings of unreality), depersonalization (being detached from oneself), fear of losing control, fear of going crazy, and fear of dying.
- Panic attacks can be conditioned, meaning that fear can develop in certain situations due to a panic attack occurring in that specific situation.
- The aetiology of panic disorder is likely due to an interaction of biological vulnerability (genetics or evolutionary factors) and learning experiences.
- Safety behaviours can reinforce the belief in the threat.
Treatment for Panic Disorder
- The first-line treatment for panic disorder is cognitive-behavioural therapy (CBT).
- CBT techniques for panic disorder include:
- Cognitive modification: changing maladaptive thought processes.
- In vivo exposure (in real life) - gradual exposure to feared situations.
- Virtual reality exposure.
- Mechanisms of how CBT for panic disorder works include:
- Reconsolidation: reactivating fear memories and storing them with fewer emotional connections.
- Extinction learning: developing new memories associated with the fear stimulus.
- Cognitive change: reducing selective attention to threat through safety learning.
- Although panic attacks may subside, feelings of anxiety may persist.
Diagnosis of Panic Disorder
- Diagnosis requires at least five symptoms of a panic attack, anticipatory anxiety, and significant behavioural change (e.g. avoiding situations associated with triggers).
Physiological Arousal
- A universal experience that is essential for survival.
- The innate fear system involves the activation of the hypothalamic-pituitary-adrenal (HPA) axis.
- The HPA axis affects multiple brain regions and all organ systems in the body.
Concepts Related to HPA Activation
- Stress: The response to perceived demands that exceed coping abilities.
- Fear: A present-oriented response to actual danger.
- Panic: A sudden rush of intense fear and physiological symptoms without objective danger.
- Anxiety: Future-oriented apprehension or concern about a possible future threat.
Anxiety vs Anxiety Disorders
- Anxiety disorders are characterized by:
- Intense, frequent, excessive, or unreasonable anxiety (exaggerated threat perception).
- Distress or impairment in daily life.
- It's important to acknowledge that anxiety is a normal human experience.
Importance of Anxiety Disorders
- They are the most prevalent mental health problems in North America.
- There is a high lifetime prevalence in the general population (24.9%).
Cognitive-Behavioural Models of GAD
- Maintaining factors often include cognitive avoidance.
- Studies have found that people with GAD have less physiological reactivity except for muscle tension compared to those with panic disorder.
- Worry often serves as a distraction from deeper fears.
Impairment Due to Anxiety Disorders
- Social: Social withdrawal, avoiding relationships, lower social support, fewer friends, increased loneliness.
- Education: Career choices may be impacted, leading to limited career opportunities.
- Occupational: Underemployment or limited career advancements.
- Comorbidity: Elevated risk for depression and substance abuse, especially marijuana.
Prevalence of Anxiety Disorders Across Cultures
- There are variations in prevalence rates across cultures:
- Europe: 8.4%
- USA: 22%
- Australia: 5.6%
- China: 13%
- Canada: 5.8% (PD, Agoraphobia, SAD only).
- Anxiety disorders are more common in European countries and those with Anglophone backgrounds.
- Prevalence rates may be influenced by access to mental health care.
Issues with Research on Cultural Influences
- There is a lack of consensus on the definition of culture and ethnic heritage.
Subtypes of Panic Attacks
- Cued (situationally bound): Occur in specific situations or with certain triggers.
- Situationally predisposed: More likely to occur in certain situations but not confined to them.
- Unexpected: Occur unexpectedly without a clear trigger.
- Limited symptom attacks: Some symptoms of panic but not enough to meet the diagnostic criteria for panic attacks.
Prevalence of Panic Attacks
- Approximately one in three people experiences a panic attack.
- Only 3% meet the criteria for panic disorder.
Biological Contributions to Panic Disorder
- Biological challenge studies (e.g., infusions of lactic acid, carbon dioxide inhalation) can trigger panic attacks.
- Biological theorists suggest a neurochemical disturbance and a genetic component to panic disorder.
- The suffocation false alarm theory suggests that panic disorder may be linked to hypersensitivity to carbon dioxide.
Cognitive Contributions to Panic Disorder
- Cognitive interpretations of physical sensations influence fear.
- Catastrophic misinterpretations of bodily sensations (fear of fear) can contribute to panic attacks.
Cognitive Model of Panic Attacks
- A trigger (internal or external) creates a perceived threat.
- This perceived threat leads to apprehension, bodily sensations, and anxiety.
- Catastrophic misinterpretations of these sensations escalate anxiety and contribute to panic attacks.
Treatment for Panic Disorder
- Medications may have side effects that can trigger panic attacks.
- CBT is the preferred first-line treatment.
- CBT techniques include:
- Education about panic disorder and its symptoms.
- Challenging catastrophic misinterpretations.
- Exposure therapy.
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Description
This quiz covers key concepts related to anxiety disorders, including agoraphobia and social anxiety disorder. Learn about the characteristics, prevalence, and common situations associated with these conditions. Test your knowledge and understand the nuances of anxiety disorders.
