Exam 2
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| Anxiety | ~Apprehension about a future threat
~Ambigous threat
~worry
~Increases prepardness
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| Fear | ~Response to an immediate threat
~clear threat
~phobia
~triggers fight or flight (may save life)
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| Anxiety vs Fear | ~Related
~Both can be adaptive
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| "U-shaped" curve | ~absence of anxiety interferes with performance
~moderate levels of anxiety improve performance
~high levels of anxiety are detrimental to performance
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| DSM-5 Anxiety Disorders | ~Specific phobias
~Social anxiety disorder
~panic disorder
~Agoraphobia
~Generalized anxiety disorder
25-30% will have some form of anxiety disorder (prevalence)
~most common are phobias
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| Phobias | ~Disruptive fear of a particular object or situation
~Fear out of proportion to actual threat
~Awareness that fear is excessive
~must be severe enough to cause distress or interfere with job or social life
~Avoidance
~most prevalent/least impairin
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| Specific phobia | ~Disproportionate fear of a particular object or situation
~Fear of spiders, snakes etc
~Fear out of proportion to actual threat
~Clusters around few objects and situations
~high comorbidity
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| DSM-5 Criteria for a specific phobia | ~Marked and disproportionate fear consistently triggered by specific objects or situations
~the object or situation is avoided or else endured with intense anxiety
~symptoms persist for at least 6 months
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| Social anxiety disorder | ~Previously called social phobia
~Causes more life disruption than other phobias
~more intense than shyness
~persistent, intense fear and avoidance of social situations
~Fear of negative evaluation or scrunity
~Humiliation
~Onset often adolescence
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| DSM-5 Criteria for social anxiety disorder | ~Marked and disproportionate fear consistently triggered by exposure to potential social scrunity
~intense anxiety about being evaliated negatively
~Trigger situations are avoided or else endured with intense anxiety
~Symptoms persist atleast 6 months
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| Panic disorder | ~Frequent panic attacks unrelated to specific situation
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| Panic attacks | ~Sudden, intense episode of fright, unease, discomfort, intense urge to flee
~symptoms reach peak intensity within 10 minutes
~unexpected
~25% of people will experience a single panic attack
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| uncued panic attacks | ~occur unexpectaedly without warning
~panic disorder diagnoses requires recurrent uncued attacks
~causes worry about future attacks
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| DSM-5 Criteria for panic disorder | ~Recurrent unexpected panic attacks
~Atleast 1 month of concern about the possibility of more attacks, worry about the consequences of an attack, or maladaptice behaviorla changes because of attacks
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| Agoraphobia | ~Anxiety about inability to flee anxiety- provoking situations, e.g. crows, stores, malls, churches, trains, etc.
~Causes significant impairment
~Atleast half of algoraphobics do not suffer panic attacks
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| DSM-5 criteria for agoraphobia | ~Fear or anxiety about at least 2 situations where it would be difficult to escape or receive help in the event of incapacitation or panic-like symtoms, such as being outside
~Shela lol
~these situations consistently provoke fear or anxiety
~6 mots
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| Generalized Anxiety Disorder (GAD); worry disorder | ~Chronic, excessive, generalized, uncontrollable worry
~6 months
~interferes w/daily life
~often cannot decide on a solution or course of action
symptoms: restlessness, poor concentration, fatigue
~common worries: relationships, health
~adolescence
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| DSM-5 GAD | ~Excessive anxiety and worry most days about atleast 2 life domains (e.g. family, healthy, finances, work, and school)
~The person finds it hard to control the worry
~The worry is sustained for atleast 6 mots
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| DSM-5 GAD (2) | ~ Marked avoidance of situations in which negative emotions could occur, time might have a negative outcome, procrastination, difficulty making decisions, due to worries, or repeate seeking reassurance due to worries.
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| Comorbidity | ~50% of those with anxiety disorder meet criteria for another anxiety disorder.
~75% of those with anxiety disorder meet criteria for another psy disorder
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| disorder commonly comorbid with anxiety | ~60% with anxiety also have depression
~substance abuse
~personality disorders
~medical disorder e.g. coronary heart disease
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| Gender differences | ~women are 2 as likely as men to have anxiety disorder
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| social explanations | ~women may be more liekly to report symptoms
~gender sterotype women are "more emotional"
~men are more likely to be encouraged to face fears
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| biological explanations | ~differences in brain structure and function
~sex hormones
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| Cultural factors | rate of anxiety disorders varies by culture, but ratio or somatic to psychological symptoms appears similar.
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| General vulnerabilities for anxiety disorders | ~genetic (inherited)
~psy (unpredictable and uncontrollability overestiamtion of threat, exxaggertaion of consequences)
~specific psy vulnerability through learning (classical and operant)
~behavioral inhibition
~neuroticism
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| Risk factors | Occurs before disorder occurs
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| correlates | things we can see at that moment that are related to current disorder. Don't know if it caused, just know it's related
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| Genetic | ~twin studies suggest heritability
~Shared genes for GAD panic agoraphobia vs. specific phobia
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| Neurobiological | ~Fear circuit over activity
~Amygdala
~Prefrontal cortext deficits
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| Neurotransmitters | ~Poor functioning of serotonin and GABA
~Higher levels of norephine
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| Behavioral inhibition- temperament | ~Tendency to be agitated, distress, avoidant and cry in unfamiliar or novel settings
~observed in infants as youngs as 4 months
~may be inherited
~predicts anxiety in childhood ad social anxiety in adolescence
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| Neuroticism | ~Tendency to react with frequent negative emotion
~Linked to anxiety and depression
~Double the liklihood of developing anxiety disorders
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| Sustained negative beliefs about future | ~Bad things will happen
~If bad things do happen, it will be devastating
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| Belief that one lacks control over environment | ~more vulnerable to developing anxiety disorder
~Childhod trauma or punitive parenting may foster beliefs
~Serious life events can threaten sense of control
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| Attention to threat | ~Tendency to notice negative environment cues
~Selective attention to certain cues
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| Mower's to factor model | ~pairing of stimulus with aversive UCS leads to fear (classical conditioning)
~avoidance maintained though negative reinforcement (operant conditioning)
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| modeling | seeing another person harmed by the stimulus
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| verbal instruction | parent warning a child about a danger
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| hose with anxeity tend to acquire fear more readily | and to be more resistant to extinction
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| risk factors act as diatheses | vulnerabilities influences development of phobias
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| prepared learning | ~evolutionary preparation to fear certain stimuli
~potentially life-threatening (heights, snakes, etc).
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| behavioral factors | ~factors similar to specific phobia (i.e., classical operant conditioning)
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| cognitive factors | ~unrealistic negative beliefs about consequences of behaviors
~excessive attention to internal cues
~fear of negative evaluation by others
~Expect other to dislike them
~negative self-evaluation
~harsh, punitive self-judgement
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| Eitiology of panic disorder Behavioral factors | ~interoceptive conditioning
~classical conditioning of panic in response to internal bodily sensations
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| Etiology of panic disorder Cognitive factors | ~Catastrophic misinterpretations of somatic changes
~interpreted as impending doom; I must be having a heart attack
~beliefs increase anxiety and arousal
~Creates vicious cycle
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| Anxiety sensitivity index | ~High scores predict development of panic
~unusual body sensations scare me
~When I notice that my heart is beating rapidly; I worry that I might have a heart attack
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| Etiology of panic disorder Neurobiological factors | ~locus coerules
~Major source of noreponephrine
~A trigger for nervous system activity
~People with panic disorder more sensative to drugs that trigger the release of norepinephrine
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| Etiology of Agoraphhobia | ~Fear of fear hypothesis
~Expectations about the catastrophic consequences of having a public panic attack
~New research consistent with more of a fear disorder than anxiety/ distress disorder i.e. more like a phobia
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| Etiology of GAD | ~The excessive worry of GAD may be an attempt to avoid intense emotions
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| Borkovee's cognitive model | ~Worry reinforcing because it distracts from negative emotions+images
~Allows avoidance of more disturbing emotions
~E.g. distress of previous trauma
~Worrying decreases psychophysiological arousal
~Avoidance prevents extinction of underlying anxiety
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| Psychological treatments emphasize exposure | ~Face the situation or object that triggers annxiety
~should include as many features of the trigger as possible
~should be conducted in as many settings as possible
~70-90% effective (~50% reduction)
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| Treatments of the anxiety disorders cognitive approaches | ~increases belief in ability to cope with the anxiety
~challenge/test expectations about negative outcomes
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| phobias exposure | in vivo (real-life) exposure more effective than systematic desensitization
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| social anxiety disorder exposure | role playing or small group interaction
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| social anxiety disorder social skill training | reduce use of safety behavior
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| social anxiety disorder cognitive therapy | Clark's (2003) cognitive therapy more effective than medication or exposure
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| Panic control therapy (PCT) | ~Exposure to somatic sensations associated with panic attack in a safe setting; increased heart rate, rapid breathing, dizziness
~Use of coping stategies to control symptoms; relaxation/deep breathing
~PCT benefits maintained after treatment ends
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| Psychological treatment of GAD | ~Relaxation training
~Cognitive behavioral methods;
~Challenge and modify negative thoughts
~increase ability to tolerate uncertainty
~Worry only during "scheduled" times
~Exposure to "contrasts"
~mindfulness
~Acceptance of commitment therapy
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| Medications | ~Anxiolytics: drugs that reduce anxiety
~Benzodaiepenes= quick acting
~Antidepressants= slower acting
~Side effects can be problematic w/continuing medication
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| Combined treatment | ~Combination of medication and CBT does not lead to best outcomes.
~Withdrawal of medications after CBT + meds may actually increase relapse.
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