Anxiety Disorders and Obesessive-Compulsive and Related Disorders

Meghan's fears of flying will likely be treated with __________ therapy, because it may be difficult to arrange real-life exposure.

virtual reality

People with high levels of __________ misattribute __________ signs of anxiety to dire underlying causes which intensify their anxiety reactions.

anxiety sensitivity; bodily

Anxiety is a generalized state of __________.

apprehension or foreboding

Anxiety disorders are more common in __________.

women than men

People with social anxiety often turn to __________ when preparing for social interactions.

tranquilizers and alcohol

Agoraphobia

Excessive, irrational fear of open or public places.

GAD treatment

The two major treatment approaches are CBT and drug therapy (typically paroxetine).

Maria wants the treatment for her panic disorder that will lead to the best long-term results. Her therapist advises a course of therapy involving __________.

cognitive behavioral therapy

For most sufferers, generalized anxiety disorder first becomes apparent in __________.

the mid-teens to mid-20s

Medications that specifically target the neurotransmitter GABA are effective in treating some people with generalized anxiety disorder because they __________.

tone down the central nervous system

Gradual exposure

A behavior therapy technique for overcoming fears through direct exposure to increasingly fearful stimuli; In behavior therapy, a method of overcoming fears through a stepwise process of exposure to increasingly fearful stimuli in imagination or in real-life situations.

Systematic desensitization

A behavior therapy technique for overcoming phobias by means of exposure to progressively more fearful stimuli (in imagination or by viewing slides) while remaining deeply relaxed.

Flooding

A behavior therapy technique for overcoming fears by means of exposure to high levels of fear-inducing stimuli.

Anxiety disorder

A class of psychological disorders characterized by excessive or maladaptive anxiety reactions. --Characterized by disturbed patterns of behavior in which anxiety is the most prominent feature. --Physical symptoms such as jumpiness, sweaty palms, and a pounding or racing heart --Behavioral features such as avoidance behavior, clinging or dependent behavior, and agitated behavior --Cognitive features such as worry or a sense of dread or apprehension about the future and fear of losing control.

Cognitive restructuring

A cognitive therapy method that involves replacing irrational thoughts with rational alternatives.

Virtual reality therapy (VRT)

A form of exposure therapy involving the presentation of phobic stimuli in a virtual reality environment.

Specific phobia

A phobia that is specific to a particular object or situation. Mice, spiders, tight places, heights

Body dysmorphic disorder (BDD)

A psychological disorder characterized by preoccupation with an imagined or exaggerated physical defect in appearance. --classified within the OCD spectrum because people with BDD typically experience obsessive thoughts related to their physical appearance and show compulsive checking behaviors and attempts to correct or cover up the problem.

Which of the following statements regarding antidepressants is true?

Antidepressants can be used for a variety of disorders, not just depression.

Hoarding disorder

A psychological disorder characterized by strong needs to acquire, and resistance to discarding, large collections of seemingly useless or unneeded possessions. --to a point of causing personal distress or significantly interfering with a person's ability to maintain a safe and habitable living space --shares characteristics with obsessive-compulsive disorder, such as obsessive thinking about acquiring objects and fears over losing them, as well as compulsive behaviors involving rearranging possessions and rigidly resisting efforts to discard them

Obsession

A recurring thought, image, or urge that the individual cannot control.

Compulsion

A repetitive or ritualistic behavior that the person feels compelled to perform.

Two-factor model

A theoretical model that accounts for the development of phobic reactions on the basis of classical and operant conditioning.

Generalized anxiety disorder (GAD)

A type of anxiety disorder characterized by general feelings of dread and foreboding and heightened states of bodily arousal. --anxiety that seems to be free floating or not tied to specific situations. The key features are worry and emotional distress.

Obsessive-compulsive disorder (OCD)

A type of anxiety disorder characterized by recurrent obsessions, compulsions, or both.

Panic disorder

A type of anxiety disorder characterized by repeated episodes of intense anxiety or panic.

anxiety

An emotional state characterized by physiological arousal, unpleasant feelings of tension, and a sense of apprehension or foreboding. May occur with panic disorder

Fear-stimulus hierarchy

An ordered series of increasingly fearful stimuli.

Which of the following statements regarding anxiety disorders and ethnic groups is true?

European Americans tend to have the highest rates of generalized anxiety disorder.

Ethnic Differences in rates of Anxiety Disorder

Evidence from nationally representative samples of U.S. adults showed generally lower rates of some anxiety disorders among ethnic minorities as compared to (non-Hispanic) White Americans.

Social anxiety disorder

Excessive fear of social interactions or situations. Also called social phobia. --> involves an intense fear of being judged negatively by others

Alan has GAD and often worries about just about everything each day. He has concerns about his life in general and cannot shake the idea that something bad will eventually happen. Which of the following is likely true about Alan?

He has lower levels of GABA than other individuals without GAD. or potentially under-active amygdala?

Raquita worries a great deal. She has a general sense of dread and fears bad events happening. These experiences are examples of __________ features of anxiety.

cognitive

People with panic disorder tend to have low levels of the neurotransmitter __________ in certain regions of the brain.

GABA

Omar experienced panic attacks on several different occasions, all when he was away from home. He now hardly ever ventures away from his home. Which of the following statements about Omar is true?

His form of panic disorder is less common than panic disorder without agoraphobia.

Development of Phobias

Learning theorists explain that phobias are learned behaviors acquired based on conditioning and observational learning. Mowrer's two-factor model incorporates both classical and operant conditioning in the explanation of phobias. Phobias appear to be moderated by cognitive factors, such as oversensitivity to threatening cues, overprediction of dangerousness, and self-defeating thoughts and irrational beliefs. Genetic factors also appear to increase proneness to development of phobias. Some investigators believe we are genetically predisposed to acquire certain types of phobias that may have had survival value for our prehistoric ancestors.

Which of the following statements regarding body dysmorphic disorder (BDD) is true?

People with BDD have lower self-esteem and are less likely to seek help for their disorder.

GAD theoretical perspective

Psychodynamic theorists view anxiety disorders as attempts by the ego to control the conscious emergence of threatening impulses. Feelings of anxiety are seen as warning signals that threatening impulses are nearing awareness. Learning-based models focus on the generalization of anxiety across stimulus situations. Cognitive theorists seek to account for generalized anxiety in terms of faulty thoughts or beliefs that underlie worry. Biological models focus on irregularities in neurotransmitter functioning in the brain.

Which of the following statements regarding generalized anxiety disorder is true?

Roughly 6 in 100 individuals will suffer from generalized anxiety disorder.

Which of the following statements regarding anxiety disorders is true?

Specific phobia is more common than social anxiety. GAD is more common than panic disorder agoraphobia does NOT have the greatest prevelance GAD does NOT have the least prevalence

What does research from epidemiological studies suggest about children from ethnic minority groups that face extreme hardship early in life?

The children learn coping skills to deal with stressors later in life.

OCD Treatment

The major contemporary treatment approaches include learning-based models (exposure with response prevention), cognitive therapy (correction of cognitive distortions), and use of SSRI-type antidepressants.

Treating Panic Disorder

The most effective methods of treatment are cognitive behavioral therapy and drug therapy. --CBT for panic disorder incorporates techniques such as self-monitoring; controlled exposure to panic-related cues, including bodily sensations; and development of coping responses for handling panic attacks without catastrophic misinterpretations of bodily cues. --Biomedical approaches incorporate use of antidepressant drugs, which have antianxiety and antipanic effects as well as antidepressant effects.

Treatment for Phobic Disorders

The most effective methods of treatment are learning-based approaches, such as systematic desensitization and gradual exposure, as well as cognitive therapy and drug therapy, such as the use of antidepressants (e.g., Zoloft, Paxil) for treating social anxiety.

Conceptual model of panic disorder

The prevailing model today conceptualizes panic disorder in terms of a combination of cognitive factors (e.g., catastrophic misinterpretation of bodily sensations, anxiety sensitivity) and biological factors (e.g., genetic proneness, increased sensitivity to bodily cues). --In this view, panic disorder involves physiological and psychological factors interacting in a vicious cycle that can spiral into full-blown panic attacks.

OCD theories

Within the psychodynamic tradition, obsessions represent leakage of unconscious urges or impulses into consciousness, and compulsions are acts that help keep these impulses repressed. Research on biological factors highlights roles for genetics and for brain mechanisms involved in signaling danger and controlling repetitive behaviors. Research shows roles for cognitive factors, such as over-focusing on one's thoughts, exaggerated perceptions of risk of unfortunate events, and perfectionism. Learning theorists view compulsive behaviors as operant responses that are negatively reinforced by relief from anxiety produced by obsessional thinking.

What is the predominant treatment for generalized anxiety disorder?

a combination of psychiatric drugs and cognitive behavioral therapy

Compared to men, women are __________ likely to suffer from generalized anxiety disorder.

about twice as

Jonathan experienced several panic attacks over the course of a year which resulted in __________, which is an excessive fear of being in public places.

agoraphobia

Which brain structure produces fear responses to triggering stimuli without conscious thought?

amygdala

Cherita avoids people, places, and events that are likely triggers for a panic attack. These are examples of __________ features of anxiety.

behavioral

Michael spends several hours a day checking his face for blemishes and grooming his hair. He attempts to cover his perceived facial defects with makeup but is never satisfied. Although an attractive man, Michael sees only his physical imperfections. Michael would most likely be given a DSM-5 diagnosis of __________.

body dysmorphic disorder

When Grant attends his therapy sessions for panic disorder, his therapist has him engage in __________, a technique that aims at restoring a normal level of carbon dioxide in the blood by having clients breathe slowly and deeply from the abdomen.

breathing retraining

People with hoarding disorder show abnormal patterns of activation in parts of the brain involved in __________ when thinking about acquiring and discarding possessions.

decision making and self-regulation

Phobia

excessive, irrational fear --involve a behavioral component—the avoidance of the phobic stimulus—as well as physical and cognitive features of anxiety associated with exposure to the phobic stimulus.

Joshua has been diagnosed with obsessive-compulsive disorder because of his persistent thoughts about being contaminated and his repetitive washing behavior. He is currently in therapy that involves placing him in a situation that evokes the obsessive thoughts and then prevents him from performing the compulsive washing behavior. This is an example of __________ therapy.

exposure with response prevention

In her treatment for her phobia of travelling across bridges, Vera is led through scenarios in her imagination in which she crosses various different bridges until she can move to facing more fear-inducing stimuli. In this case, she is undergoing __________ therapy.

systematic desensitization

Compared to the emotional reaction in obsessive-compulsive disorder, those with hoarding disorder __________.

feel less distress when thinking about their possessions and collecting habits

Because people seem to carry it from situation to situation, the type of anxiety observed in GAD can be characterized as __________.

free-floating

For the past few years, Jesus has been unable to shake his feelings of anxiety. He constantly worries about his job, his marriage, and his health. Jesus' wife believes his concerns are blown out of proportion and gets frustrated because Jesus seems to worry about everything, all the time. He is most likely suffering from which disorder?

generalized anxiety disorder

Rhianna is a 25-year-old graduate student who frequently misses classes because she is afraid of being judged by her peers because of her appearance. Although all her friends tell her she looks just fine, Rhianna believes that her blemishes are unattractive, her hands are too chubby, and her feet are too big. She cannot stop thinking about what she considers to be serious flaws in her appearance. Compared to her friends, Rhianna is likely to __________.

have higher rates of suicidal thinking

Panic attack

intense physical or bodily symptoms, notably cardiovascular symptoms, that may be accompanied by feelings of sheer terror and fears of losing control, losing one's mind, or dying. --Panic attack sufferers often limit their outside activities for fear of recurrent attacks. This can lead to agoraphobia

According to Mowrer's two-factor model, the avoidance component of phobias is acquired and maintained through __________.

negative reinforcement

Alejandro cringes and feels panic-stricken every time he drives over a suspension bridge. Which cognitive factor associated with phobias best describes his fear reaction?

oversensitivity to threatening cues

Which of the following has a stronger bodily component than other anxiety disorders?

panic disorder

The DSM-5 recognizes which specific types of anxiety disorders?

panic disorder, phobic disorders, and generalized anxiety disorder

A cognitive factor linked to the development of OCD is __________.

perfectionism, or belief that one must perform flawlessly

Johan feels a tightness in the pit of his stomach, as well as nauseated and dizzy, when his feelings of anxiety begin. These are examples of __________ features of anxiety.

physical

One biological theory of OCD posits that the compulsive aspects of OCD result from abnormalities in brain circuits that normally constrain __________.

repetitive behaviors

When Juan even contemplates driving through the fast food lane at the restaurant, he feels instant anxiety about getting the order wrong and being judged negatively by others who witness his mistake. Juan most likely is experiencing __________.

social phobia