Chapter 5 (Anxiety, Fear, and Vulnerabilities)

What are the three characteristic traits of anxiety?

1) future-oriented mood state characterized by marked negative affect 2) somatic (bodily) symptoms of physical tension 3) apprehension about future danger or misfortune

What are the four characteristic traits of fear?

1) present-oriented mood state marked by negative affect 2) immediate fight/flight response to danger or threat 3) strong avoidance/escapist tendencies 4) involves abrupt activation of the sympathetic NS

What is the suicide rate associated with panic disorder? (hint: its high)

20%.

About ______% of patients have two or more diagnoses.

50.

How does the behavioural inhibition system work? (activation and working)

Activated by signals that arise from the brain stem or descend from the cortex; our tendency is to freeze, experience anxiety, and apprehensively evaluate the situation to confirm that danger is present.

Explain how parents who provide a "secure home base" for their children can reduce their risk of panic/anxiety

Allow their children to explore their world and develop the necessary skills to cope with diversity, which enables them to develop a healthy sense of control.

What is a panic attack?

An abrupt experience of intense fear or discomfort, accompanied by several physical symptoms (ie. chest pain, breathlessness, etc.)

What is the main difference between fear and anxiety?

Anxiety = future-oriented; fear = present-oriented

What were the behaviouristic views regarding the origins of anxiety? What did it say of panic?

Anxiety and fear resulted from classical/operant conditioning and modelling. Stated that account of panic were really just "learned false alarms" to various internal/external cues.

As per Freud, what was anxiety and why did it occur?

Anxiety was deemed a psychic reaction to danger, caused by the reactivation of an infantile fear situation.

What two "systems" are involved in the response to danger?

Behavioural inhibition system and the flight/flight system.

What characterizes a specific psychological vulnerability to an anxiety disorder?

Belief that situations/objects are dangerous, when in fact they are not (ie. hypochondriasis).

What is the integrative view of the cause of anxiety?

Biological vulnerability interacts with psychological, experiential, and social variables to produce an anxiety disorder. (consistent with diathesis-stress model)

What is the psychological view on the reason behind panic/aniexty?

Caused by early experiences with uncontrollability and unpredictability.

_________ and __________ are critical to the expression of anxiety. (hint: think biological contributions)

Corticotropin-releasing factor (CRF), HPA axis

What is the most common secondary diagnosis related to anxiety disorders?

Depression.

What are the two sub-types of panic attacks?

Expected (cued) -- expected and bound to certain situations. Unexpected (uncued) -- happens "out of the blue" without warning.

T/F. Anxiety is always a negative thing.

False -- in moderate amounts, anxiety can enhance physical and intellectual performance.

True/false. Anxiety is typically general.

False -- though it can be general, it is usually focused in one area (ie. social evaluations, grades in school, etc).

Many environmental stressors inducing anxiety are __________ and ______________. Give some examples.

Familial and interpersonal. (ie. marriage, divorce, death of a loved one, pressure to do well in school)

In what situations does physical comorbidity exist?

GI diseases, respiratory disease, migraines.

What characterizes a generalized psychological vulnerability to an anxiety disorder?

Growing up believing the world is dangerous or out of your control, and that you might not be able to cope with adversity (tendency towards lack of self-confidence, low self-esteem, inability to cope.

What are internal cues for panic attacks?

Increases in heart rate or respiration that were associated with the initial panic attack, even if occurring under normal circumstances (ie. exercise).

Explain the brain circuits of people with increased anxiety.

Less GABA; noradrenergic and serotonergic neurotransmitter systems are associated.

What two brain circuits help to signal danger?

Limbic system (amygdala) and the septal-hippocampal system (connects limbic system to prefrontal cortex).

Explain the diathesis-stress model as it relates to anxiety and panic.

People can inherit a vulnerability for anxiety snd panic, but NOT for an anxiety disorder itself. Stress and life circumstances activate the underlying vulnerability.

What can be said of an additional diagnosis of depression or alcohol/drug abuse?

Person is less likely to recover from anxiety disorder. Also makes it hard to determine presence of anxiety disorder in the first place.

Psychological disorders are _______________ symptoms of ___________________.

Pervasive and persistent, anxiety and fear.

What are external cues for panic attacks?

Places or situations similar to the one where the initial panic attack happened.

How do social contributions play a role in panic/anxiety?

Stressful life events can trigger biological and psychological vulnerabilities.

What is comorbidity?

The co-occurence of two or more disorders in a single individual.

What characterizes a generalized biological vulnerability to an anxiety disorder?

The heritable contribution to negative affect (tendency to be uptight or high-strung might be inherited); "glass half empty", irritable, driven.

How do we know that there might be a possible genetic contribution to panic attacks?

The particular way we react to stress seems to run in families.

What is required of symptoms and avoidance in order to be classified as an anxiety disorder?

They must cause clinically significant distress and impairment.

True/false. Environmental factors can likely change the sensitivity of the brain circuits involved in the anxiety and fear responses.

True -- can make people more/less susceptible.

True/false. Comorbidity is common across the anxiety disorders.

True -- many share the same vulnerabilities for development.

True/false. People with certain physical conditions are more likely to have an anxiety disorder.

True -- something about having the anxiety disorder may cause the physical symptoms.

True/false. A healthy sense of control (or lack thereof) makes one more or less susceptible to anxiety later in life.

True.

True/false. Stressful life events can trigger physical reactions.

True. (headaches, hypertension, emotional reactions)