96 Questions
Which factor makes individuals more or less vulnerable to anxiety in later life?
Sense of control
What is anxiety sensitivity?
A personality trait
What do most psychological accounts of panic invoke?
Conditioning and cognitive explanations
What are external cues in the context of panic attacks?
Places or situations similar to where the initial panic attack occurred
What brain circuits are involved in anxiety and its disorders?
Limbic system and prefrontal cortex
Which brain system is activated by signals from the brain stem and cortex, leading to freezing, anxiety, and evaluation of danger?
Behavioral inhibition system (BIS)
What is the role of the amygdala in activating the behavioral inhibition system (BIS)?
It provides a boost to the BIS
Which brain circuit is involved in panic and differs from the behavioral inhibition system (BIS)?
Fight/flight system (FFS)
What type of genetic contributions make individuals vulnerable to anxiety and panic disorders?
Collections of genes in several areas on chromosomes
What is the role of psychological and social factors in the development of anxiety and panic disorders?
They interact with genetic vulnerability
Which of the following is a similarity between fear and panic?
Both fear and panic are experienced suddenly
What are some symptoms of a panic attack?
All of the above
What is one possible cause of anxiety and related disorders?
Biological, psychological, and social contributors interact to produce anxiety and related disorders
What does increasing evidence suggest about anxiety and related disorders?
Anxiety and related disorders have a genetic component
What is the main purpose of the physiological surge recorded during a panic attack?
To prepare the body for an instantaneous reaction to impending danger
Which of the following is NOT a symptom of a panic attack?
Chest pain
What is the relationship between fear and panic attack?
Fear triggers panic attack
Which neurotransmitter system is NOT implicated in anxiety?
GABA–benzodiazepine system
Which area of the brain is most often associated with anxiety?
Limbic system
What is the function of the septal-hippocampal system in the limbic system?
Relaying danger signals to higher cortical processes
Which of the following is NOT a psychological contribution to anxiety?
Anxiety as a result of biological abnormalities
According to the text, what is the relationship between anxiety and panic?
Anxiety increases the likelihood of panic
What are the three vulnerabilities to anxiety mentioned in the text?
Generalized, specific, and social vulnerabilities
What triggers our biological and psychological vulnerabilities to anxiety?
Social and interpersonal stressors
What is the most likely reason why cues or triggers of severe fear may be unconscious?
They bypass the cortex and go directly to the amygdala
According to the triple vulnerability theory, which of the following is NOT one of the vulnerabilities that contribute to the development of anxiety disorders?
Generalized genetic vulnerability
Which vulnerability is described as a tendency to be uptight or high-strung that might be inherited?
Generalized biological vulnerability
What does the finding that other members of a family probably have panic attacks if one member does suggest?
A possible genetic contribution to initial panic attacks
Which vulnerability is described as a sense that events are uncontrollable/unpredictable and a tendency toward lack of self-confidence and low self-esteem?
Generalized psychological vulnerability
According to the text, what is the first vulnerability (or diathesis) described in the triple vulnerability theory?
Generalized biological vulnerability
Which of the following is NOT a treatment option for generalized anxiety disorder (GAD)?
Antipsychotics
Which vulnerability is described as a tendency to be uptight or high-strung that might be inherited?
Generalized biological vulnerability
According to the text, what is the second vulnerability (or diathesis) described in the triple vulnerability theory?
Generalized psychological vulnerability
Which neurotransmitter system is implicated in anxiety?
Norepinephrine
Which of the following is a symptom of generalized anxiety disorder (GAD)?
Excessive worry
What brain circuit is involved in panic and differs from the behavioral inhibition system (BIS)?
Amygdala
What does increasing evidence suggest about anxiety and related disorders?
They are caused by a combination of genetic and environmental factors
What is anxiety sensitivity?
The tendency to experience anxiety symptoms as dangerous
What is the function of the septal-hippocampal system in the limbic system?
Regulating emotions
According to the triple vulnerability theory, which of the following is NOT one of the vulnerabilities that contribute to the development of anxiety disorders?
Specific biological vulnerability
Which of the following is a common treatment for generalized anxiety disorder (GAD)?
Antidepressants
What physiological measure consistently distinguishes individuals with generalized anxiety disorder (GAD) from nonanxious individuals?
Muscle tension
What is the term used to describe individuals with GAD who are highly sensitive to threat, particularly to a threat that has personal relevance?
Autonomic restrictors
Which of the following is NOT a risk associated with benzodiazepines, a common treatment for generalized anxiety disorder (GAD)?
Increased heart rate
Which brain system is activated by signals from the brain stem and cortex, leading to freezing, anxiety, and evaluation of danger?
Amygdala
What is the term used to describe the physiological measure that consistently distinguishes individuals with generalized anxiety disorder (GAD) from nonanxious individuals when compared using the Stroop color-naming task?
Muscle tension
What is the second vulnerability (or diathesis) described in the triple vulnerability theory of anxiety and panic disorders?
Generalized psychological vulnerability
What is the term used to describe individuals with generalized anxiety disorder (GAD) who show less responsiveness on most physiological measures, such as heart rate, blood pressure, skin conductance, and respiration rate?
Autonomic restrictors
What is the first vulnerability (or diathesis) described in the triple vulnerability theory of anxiety and panic disorders?
Biological vulnerability
Which of the following is NOT a symptom of generalized anxiety disorder (GAD)?
Panic attacks
Which type of treatment for generalized anxiety disorder (GAD) involves helping patients process threatening information on an emotional level using images?
Cognitive-behavioral treatment (CBT)
In a major study, a brief adaptation of the cognitive-behavioral treatment (CBT) for GAD was successfully used to decrease anxiety and improve quality of life in which type of healthcare setting?
Primary care office
Which type of treatment for generalized anxiety disorder (GAD) has been found to have large treatment effects, primarily consisting of cognitive-behavioral therapy (CBT)?
Cognitive-behavioral therapy (CBT)
What is the prevalence of panic disorder (PD) in the population?
Approximately 2.7%
What is agoraphobia characterized by?
Both avoiding and enduring certain situations
What is interoceptive avoidance?
Avoiding internal physical sensations
What percentage of individuals with agoraphobia identified in population surveys do not have panic attacks?
Approximately 50%
What is the term used to describe the fear of going to certain places or neglecting duties for fear of an attack?
Agoraphobia
What is the term used to describe the fear of the marketplace, which is an appropriate term for agoraphobia?
Agoraphobia
Which of the following is a common stressful place for individuals with agoraphobia?
Shopping mall
What is the main reason for agoraphobic avoidance behavior?
Severe, unexpected panic attacks
Which type of treatment for generalized anxiety disorder (GAD) has shown the highest success rates in a clinical trial?
Combination of drug and psychological treatments
Which disorder is often accompanied by panic disorder (PD) and is characterized by fear and avoidance of situations in which a person feels unsafe or unable to escape?
Agoraphobia
Which type of medication is NOT associated with impairments in alertness and cognitive functioning?
Antidepressants
What is the recommended duration for prescribing benzodiazepines for the short-term relief of anxiety associated with a temporary crisis or stressful event?
A week or two
Which of the following disorders is NOT mentioned as having symptoms similar to agoraphobia?
Obsessive-compulsive disorder
During which stage of sleep do nocturnal panic attacks typically occur?
Delta sleep
Which racial group has a higher prevalence of panic disorder and posttraumatic stress disorder in relation to isolated sleep paralysis?
African Americans
What are the three contributing factors mentioned in the text that are involved in the development of panic disorder?
Biological, psychological, and social
Which of the following is a symptom of generalized anxiety disorder (GAD)?
Muscle tension, mental agitation, irritability, sleeping difficulties, and susceptibility to fatigue.
What is the relationship between anxiety and panic?
Panic attacks can occur in individuals with anxiety disorders, but not all individuals with anxiety disorders experience panic attacks.
What is the term used to describe individuals with generalized anxiety disorder (GAD) who show less responsiveness on most physiological measures, such as heart rate, blood pressure, skin conductance, and respiration rate?
Hyporesponsive
What is the main purpose of the physiological surge recorded during a panic attack?
To prepare the body for a fight-or-flight response.
Which of the following is NOT a reason why some people think something terrible is going to happen when they have a panic attack?
They have a history of panic disorder
What is the term used to describe events that occur during sleep and resemble nocturnal panic?
Sleep disturbances
Which of the following is NOT a risk associated with benzodiazepines, a common treatment for generalized anxiety disorder (GAD)?
Increased risk of panic attacks
Which of the following is NOT a way of dealing with a phobia, according to the text?
Seeking therapy
According to the text, what is the major characteristic of phobias?
Marked fear and anxiety about a specific object or situation
According to the text, how many phobias are there?
As many as there are objects and situations
What does Table 5.4 in the text show?
Phobias beginning with the letter 'a'
What is the purpose of the long list of phobias mentioned in the text?
To show the extent of named phobias
What is the DSM-5 criterion for phobias?
Marked fear and anxiety about a specific object or situation
What do Judy and Madden have in common, according to the text?
Marked fear and anxiety about a specific object or situation
What is the main difference between Judy and Madden, according to the text?
The specific object or situation of their phobia
What is the purpose of discussing other ways of dealing with phobias at the end of the chapter, according to the text?
To provide additional strategies for overcoming phobias
What does the text say about the variety of Greek and Latin names for phobias?
It stuns the imagination
What is the average age of onset for specific phobias?
Approximately 7 years
What is the main difference between situational phobia and panic disorder?
Situational phobia never experiences panic attacks outside the context of their phobic object or situation
What is the prevalence of specific phobias in different cultures?
Hispanics are two times more likely to report specific phobias than white non-Hispanic
What is the median age of onset for specific phobias?
Approximately 9 years
What is the main difference between situational phobia and panic disorder?
Situational phobia never experiences panic attacks outside the context of their phobic object or situation
What are the four major subtypes of specific phobia?
Blood–injection–injury type, situational type, natural environment type, and animal type
What is the fifth category of specific phobia?
Fear of choking, fear of vomiting, fear of contracting an illness, and fear of loud sounds
How do people with blood–injection–injury phobias differ from people with other types of phobia in terms of their physiological reaction?
They experience a marked drop in heart rate and blood pressure and may faint
What is one major difference between Judy and Madden in terms of their physiological reaction to their phobias?
Judy experienced a marked drop in heart rate and blood pressure, while Madden experienced an increased heart rate and blood pressure
What do we know about most people who suffer from phobia in terms of the number and types of phobias they have?
They tend to have multiple phobias of several types
Study Notes
Anxiety Disorders: Comorbidity and Features
- Anxiety disorders share common features of anxiety and panic, with biological and psychological vulnerabilities contributing to their development.
- Comorbidity rates among anxiety disorders are high, with approximately 55% of patients having at least one additional anxiety or depressive disorder at the time of assessment.
- The most common additional diagnosis for anxiety disorders is major depression, which occurs in 50% of cases over the course of a patient's life.
Generalized Anxiety Disorder (GAD)
- GAD is characterized by excessive anxiety and worry (apprehensive expectation) about everyday life events, with difficulty controlling the worry process.
- The disorder is associated with muscle tension, mental agitation, fatigue, irritability, and difficulty sleeping.
- GAD is distinguished from other anxiety disorders by its focus on minor, everyday life events.
- Adults with GAD typically worry about family health, job responsibilities, and minor things, while children worry about competence in academic, athletic, or social performance, and family issues.
Statistics and Demographics
- Approximately 3.1% of the population meets criteria for GAD during a given year, and 5.7% at some point during their lifetime.
- The one-year prevalence of GAD is lower in adolescents (1.1%).
- Women are more likely to be diagnosed with GAD than men, with a sex ratio of about 2:1 in epidemiological studies.
- The prevalence of GAD is significantly lower among Asian, Hispanic, and Black adults compared to Whites in the United States.
Causes of GAD
- There is a generalized biological vulnerability to GAD, reflected in studies examining a genetic contribution to the disorder.
- Anxiety sensitivity, or the tendency to become distressed in response to arousal-related sensations, is a heritable trait that may contribute to the development of GAD.
Treatment and Clinical Description
- GAD is often treated in primary care settings, and relatively few people with GAD seek help from anxiety clinics.
- Treatment of GAD can be challenging, as it is a chronic disorder with a high rate of comorbidity with other anxiety and depressive disorders.Here are the study notes in bullet points:
Generalized Anxiety Disorder (GAD)
- Definition: Excessive and persistent worry about everyday things, such as work, finances, and relationships, even when there is no apparent reason to worry.
- Diagnostic criteria: At least 6 months of excessive anxiety and worry, accompanied by at least 3 of the following symptoms:
- Restlessness or feeling keyed up or on edge
- Easily fatigued
- Difficulty concentrating or mind going blank
- Irritability
- Muscle tension
- Sleep disturbance (difficulty falling or staying asleep or restless, unsatisfying sleep)
- Epidemiology:
- 3.1% of the population meets criteria for GAD in a given year
- 5.7% experience GAD at some point in their lifetime
- Adolescents: 1.1% prevalence
- GAD is one of the most common anxiety disorders
- Demographics:
- Women are more likely to be affected than men (except in some developing countries)
- Prevalence is lower among Asian, Hispanic, and Black adults compared to Whites
- Onset:
- Often begins in early adulthood
- Gradual onset, with symptoms persisting over time
- Course:
- Chronic course, with symptoms waxing and waning over time
- 8% probability of becoming symptom-free after 2 years
- 45% of those who recover will relapse later
Anxiety and Age
- Older adults:
- More likely to experience GAD, with prevalence rates as high as 10%
- Frequently prescribed minor tranquilizers, which may not be intended for anxiety
- Younger adults:
- Less likely to experience GAD
- Less likely to be prescribed minor tranquilizers
Biological and Psychological Factors
- Genetic contribution:
- Generalized biological vulnerability to anxiety
- Inherited trait of anxiety sensitivity
- Brain function:
- Restrictive autonomic arousal, accompanied by intense cognitive processing
- Lack of attentional capacity for creating images of potential threats, leading to chronic worrying
Let me know if you want me to clarify or expand on any of these points!### Generalized Anxiety Disorder (GAD)
- Approximately 1 in 10 older adults suffer from GAD
- Individuals with GAD are autonomic restrictors, meaning they show intense cognitive processing in the frontal lobes, but restricted peripheral autonomic arousal
- This may be due to frantic, intense thought processes or worry without accompanying images
- Avoiding images associated with the threat may prevent individuals with GAD from working through their problems and arriving at solutions
Treatment of GAD
- Medication: benzodiazepines, selective-serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs) are effective in treating GAD
- SSRIs are currently the indicated drug for GAD, but sexual dysfunction is a common side effect
- Benzodiazepines are widely used, but can lead to physical and psychological dependence and addiction
Panic Disorder
- Treatment options: medication, psychological interventions, and a combination of both
- Medication: high-potency benzodiazepines, SSRIs, and SNRIs are effective in treating panic disorder
- Psychological treatments: cognitive-behavioral therapy (CBT), panic control treatment (PCT), and situation-exposure tasks
- CBT is highly effective for treating panic disorder, with most patients remaining better after at least 2 years
Combined Psychological and Drug Treatments
- A major study sponsored by the National Institute of Mental Health found that combined treatment was no better than individual treatments
- However, a slight advantage for combined treatment was found after 6 additional months of maintenance treatment
- Booster sessions after therapy can help prevent relapse and offset disorder recurrence
Specific Phobia
- A specific phobia is an irrational fear of a specific object or situation that markedly interferes with an individual's ability to function
- Psychological treatments like CBT are highly effective for treating specific phobia
Test your knowledge on the psychological factor of control and its impact on individuals. This quiz will cover various studies and evidence supporting the development of a sense of control and its effects on our well-being.
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