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Questions and Answers
Which factor makes individuals more or less vulnerable to anxiety in later life?
Which factor makes individuals more or less vulnerable to anxiety in later life?
- Sense of control (correct)
- Anxiety sensitivity
- External cues
- Conditioning process
What is anxiety sensitivity?
What is anxiety sensitivity?
- A fear response
- A response to anxiety symptoms
- A personality trait (correct)
- A learned or false alarm
What do most psychological accounts of panic invoke?
What do most psychological accounts of panic invoke?
- Fearful response to anxiety symptoms
- Dangerous situations in the environment
- Conditioning and cognitive explanations (correct)
- External and internal cues
What are external cues in the context of panic attacks?
What are external cues in the context of panic attacks?
What brain circuits are involved in anxiety and its disorders?
What brain circuits are involved in anxiety and its disorders?
Which brain system is activated by signals from the brain stem and cortex, leading to freezing, anxiety, and evaluation of danger?
Which brain system is activated by signals from the brain stem and cortex, leading to freezing, anxiety, and evaluation of danger?
What is the role of the amygdala in activating the behavioral inhibition system (BIS)?
What is the role of the amygdala in activating the behavioral inhibition system (BIS)?
Which brain circuit is involved in panic and differs from the behavioral inhibition system (BIS)?
Which brain circuit is involved in panic and differs from the behavioral inhibition system (BIS)?
What type of genetic contributions make individuals vulnerable to anxiety and panic disorders?
What type of genetic contributions make individuals vulnerable to anxiety and panic disorders?
What is the role of psychological and social factors in the development of anxiety and panic disorders?
What is the role of psychological and social factors in the development of anxiety and panic disorders?
Which of the following is a similarity between fear and panic?
Which of the following is a similarity between fear and panic?
What are some symptoms of a panic attack?
What are some symptoms of a panic attack?
What is one possible cause of anxiety and related disorders?
What is one possible cause of anxiety and related disorders?
What does increasing evidence suggest about anxiety and related disorders?
What does increasing evidence suggest about anxiety and related disorders?
What is the main purpose of the physiological surge recorded during a panic attack?
What is the main purpose of the physiological surge recorded during a panic attack?
Which of the following is NOT a symptom of a panic attack?
Which of the following is NOT a symptom of a panic attack?
What is the relationship between fear and panic attack?
What is the relationship between fear and panic attack?
Which neurotransmitter system is NOT implicated in anxiety?
Which neurotransmitter system is NOT implicated in anxiety?
Which area of the brain is most often associated with anxiety?
Which area of the brain is most often associated with anxiety?
What is the function of the septal-hippocampal system in the limbic system?
What is the function of the septal-hippocampal system in the limbic system?
Which of the following is NOT a psychological contribution to anxiety?
Which of the following is NOT a psychological contribution to anxiety?
According to the text, what is the relationship between anxiety and panic?
According to the text, what is the relationship between anxiety and panic?
What are the three vulnerabilities to anxiety mentioned in the text?
What are the three vulnerabilities to anxiety mentioned in the text?
What triggers our biological and psychological vulnerabilities to anxiety?
What triggers our biological and psychological vulnerabilities to anxiety?
What is the most likely reason why cues or triggers of severe fear may be unconscious?
What is the most likely reason why cues or triggers of severe fear may be unconscious?
According to the triple vulnerability theory, which of the following is NOT one of the vulnerabilities that contribute to the development of anxiety disorders?
According to the triple vulnerability theory, which of the following is NOT one of the vulnerabilities that contribute to the development of anxiety disorders?
Which vulnerability is described as a tendency to be uptight or high-strung that might be inherited?
Which vulnerability is described as a tendency to be uptight or high-strung that might be inherited?
What does the finding that other members of a family probably have panic attacks if one member does suggest?
What does the finding that other members of a family probably have panic attacks if one member does suggest?
Which vulnerability is described as a sense that events are uncontrollable/unpredictable and a tendency toward lack of self-confidence and low self-esteem?
Which vulnerability is described as a sense that events are uncontrollable/unpredictable and a tendency toward lack of self-confidence and low self-esteem?
According to the text, what is the first vulnerability (or diathesis) described in the triple vulnerability theory?
According to the text, what is the first vulnerability (or diathesis) described in the triple vulnerability theory?
Which of the following is NOT a treatment option for generalized anxiety disorder (GAD)?
Which of the following is NOT a treatment option for generalized anxiety disorder (GAD)?
Which vulnerability is described as a tendency to be uptight or high-strung that might be inherited?
Which vulnerability is described as a tendency to be uptight or high-strung that might be inherited?
According to the text, what is the second vulnerability (or diathesis) described in the triple vulnerability theory?
According to the text, what is the second vulnerability (or diathesis) described in the triple vulnerability theory?
Which neurotransmitter system is implicated in anxiety?
Which neurotransmitter system is implicated in anxiety?
Which of the following is a symptom of generalized anxiety disorder (GAD)?
Which of the following is a symptom of generalized anxiety disorder (GAD)?
What brain circuit is involved in panic and differs from the behavioral inhibition system (BIS)?
What brain circuit is involved in panic and differs from the behavioral inhibition system (BIS)?
What does increasing evidence suggest about anxiety and related disorders?
What does increasing evidence suggest about anxiety and related disorders?
What is anxiety sensitivity?
What is anxiety sensitivity?
What is the function of the septal-hippocampal system in the limbic system?
What is the function of the septal-hippocampal system in the limbic system?
According to the triple vulnerability theory, which of the following is NOT one of the vulnerabilities that contribute to the development of anxiety disorders?
According to the triple vulnerability theory, which of the following is NOT one of the vulnerabilities that contribute to the development of anxiety disorders?
Which of the following is a common treatment for generalized anxiety disorder (GAD)?
Which of the following is a common treatment for generalized anxiety disorder (GAD)?
What physiological measure consistently distinguishes individuals with generalized anxiety disorder (GAD) from nonanxious individuals?
What physiological measure consistently distinguishes individuals with generalized anxiety disorder (GAD) from nonanxious individuals?
What is the term used to describe individuals with GAD who are highly sensitive to threat, particularly to a threat that has personal relevance?
What is the term used to describe individuals with GAD who are highly sensitive to threat, particularly to a threat that has personal relevance?
Which of the following is NOT a risk associated with benzodiazepines, a common treatment for generalized anxiety disorder (GAD)?
Which of the following is NOT a risk associated with benzodiazepines, a common treatment for generalized anxiety disorder (GAD)?
Which brain system is activated by signals from the brain stem and cortex, leading to freezing, anxiety, and evaluation of danger?
Which brain system is activated by signals from the brain stem and cortex, leading to freezing, anxiety, and evaluation of danger?
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?
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?
What is the second vulnerability (or diathesis) described in the triple vulnerability theory of anxiety and panic disorders?
What is the second vulnerability (or diathesis) described in the triple vulnerability theory of anxiety and panic disorders?
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?
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?
What is the first vulnerability (or diathesis) described in the triple vulnerability theory of anxiety and panic disorders?
What is the first vulnerability (or diathesis) described in the triple vulnerability theory of anxiety and panic disorders?
Which of the following is NOT a symptom of generalized anxiety disorder (GAD)?
Which of the following is NOT a symptom of generalized anxiety disorder (GAD)?
Which type of treatment for generalized anxiety disorder (GAD) involves helping patients process threatening information on an emotional level using images?
Which type of treatment for generalized anxiety disorder (GAD) involves helping patients process threatening information on an emotional level using images?
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?
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?
Which type of treatment for generalized anxiety disorder (GAD) has been found to have large treatment effects, primarily consisting of cognitive-behavioral therapy (CBT)?
Which type of treatment for generalized anxiety disorder (GAD) has been found to have large treatment effects, primarily consisting of cognitive-behavioral therapy (CBT)?
What is the prevalence of panic disorder (PD) in the population?
What is the prevalence of panic disorder (PD) in the population?
What is agoraphobia characterized by?
What is agoraphobia characterized by?
What is interoceptive avoidance?
What is interoceptive avoidance?
What percentage of individuals with agoraphobia identified in population surveys do not have panic attacks?
What percentage of individuals with agoraphobia identified in population surveys do not have panic attacks?
What is the term used to describe the fear of going to certain places or neglecting duties for fear of an attack?
What is the term used to describe the fear of going to certain places or neglecting duties for fear of an attack?
What is the term used to describe the fear of the marketplace, which is an appropriate term for agoraphobia?
What is the term used to describe the fear of the marketplace, which is an appropriate term for agoraphobia?
Which of the following is a common stressful place for individuals with agoraphobia?
Which of the following is a common stressful place for individuals with agoraphobia?
What is the main reason for agoraphobic avoidance behavior?
What is the main reason for agoraphobic avoidance behavior?
Which type of treatment for generalized anxiety disorder (GAD) has shown the highest success rates in a clinical trial?
Which type of treatment for generalized anxiety disorder (GAD) has shown the highest success rates in a clinical trial?
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?
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?
Which type of medication is NOT associated with impairments in alertness and cognitive functioning?
Which type of medication is NOT associated with impairments in alertness and cognitive functioning?
What is the recommended duration for prescribing benzodiazepines for the short-term relief of anxiety associated with a temporary crisis or stressful event?
What is the recommended duration for prescribing benzodiazepines for the short-term relief of anxiety associated with a temporary crisis or stressful event?
Which of the following disorders is NOT mentioned as having symptoms similar to agoraphobia?
Which of the following disorders is NOT mentioned as having symptoms similar to agoraphobia?
During which stage of sleep do nocturnal panic attacks typically occur?
During which stage of sleep do nocturnal panic attacks typically occur?
Which racial group has a higher prevalence of panic disorder and posttraumatic stress disorder in relation to isolated sleep paralysis?
Which racial group has a higher prevalence of panic disorder and posttraumatic stress disorder in relation to isolated sleep paralysis?
What are the three contributing factors mentioned in the text that are involved in the development of panic disorder?
What are the three contributing factors mentioned in the text that are involved in the development of panic disorder?
Which of the following is a symptom of generalized anxiety disorder (GAD)?
Which of the following is a symptom of generalized anxiety disorder (GAD)?
What is the relationship between anxiety and panic?
What is the relationship between anxiety and panic?
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?
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?
What is the main purpose of the physiological surge recorded during a panic attack?
What is the main purpose of the physiological surge recorded during a panic attack?
Which of the following is NOT a reason why some people think something terrible is going to happen when they have a panic attack?
Which of the following is NOT a reason why some people think something terrible is going to happen when they have a panic attack?
What is the term used to describe events that occur during sleep and resemble nocturnal panic?
What is the term used to describe events that occur during sleep and resemble nocturnal panic?
Which of the following is NOT a risk associated with benzodiazepines, a common treatment for generalized anxiety disorder (GAD)?
Which of the following is NOT a risk associated with benzodiazepines, a common treatment for generalized anxiety disorder (GAD)?
Which of the following is NOT a way of dealing with a phobia, according to the text?
Which of the following is NOT a way of dealing with a phobia, according to the text?
According to the text, what is the major characteristic of phobias?
According to the text, what is the major characteristic of phobias?
According to the text, how many phobias are there?
According to the text, how many phobias are there?
What does Table 5.4 in the text show?
What does Table 5.4 in the text show?
What is the purpose of the long list of phobias mentioned in the text?
What is the purpose of the long list of phobias mentioned in the text?
What is the DSM-5 criterion for phobias?
What is the DSM-5 criterion for phobias?
What do Judy and Madden have in common, according to the text?
What do Judy and Madden have in common, according to the text?
What is the main difference between Judy and Madden, according to the text?
What is the main difference between Judy and Madden, according to the text?
What is the purpose of discussing other ways of dealing with phobias at the end of the chapter, according to the text?
What is the purpose of discussing other ways of dealing with phobias at the end of the chapter, according to the text?
What does the text say about the variety of Greek and Latin names for phobias?
What does the text say about the variety of Greek and Latin names for phobias?
What is the average age of onset for specific phobias?
What is the average age of onset for specific phobias?
What is the main difference between situational phobia and panic disorder?
What is the main difference between situational phobia and panic disorder?
What is the prevalence of specific phobias in different cultures?
What is the prevalence of specific phobias in different cultures?
What is the median age of onset for specific phobias?
What is the median age of onset for specific phobias?
What is the main difference between situational phobia and panic disorder?
What is the main difference between situational phobia and panic disorder?
What are the four major subtypes of specific phobia?
What are the four major subtypes of specific phobia?
What is the fifth category of specific phobia?
What is the fifth category of specific phobia?
How do people with blood–injection–injury phobias differ from people with other types of phobia in terms of their physiological reaction?
How do people with blood–injection–injury phobias differ from people with other types of phobia in terms of their physiological reaction?
What is one major difference between Judy and Madden in terms of their physiological reaction to their phobias?
What is one major difference between Judy and Madden in terms of their physiological reaction to their phobias?
What do we know about most people who suffer from phobia in terms of the number and types of phobias they have?
What do we know about most people who suffer from phobia in terms of the number and types of phobias they have?
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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
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