chapter 8

compulsion

A repetitive and seemingly purposeful behavior performed in response to uncontrollable urges or according to a ritualistic or stereotyped set of rules.

panic disorder

An anxiety disorder in which an individual has panic attacks on a recurrent basis or has constant apprehension and worry about the possibility of recurring attacks.

acute stress disorder

An anxiety disorder that develops after a traumatic event, and lasts for up to 1 month with symptoms such as depersonalization, numbing, dissociative amnesia, intense anxiety, hypervigilance, and impairment of everyday functioning.

trauma informed care

An approach to treatment that acknowledges the role that trauma can have on the mental health of individuals.

trichotillomania (hair-pulling disorder)

An impulse-control disorder involving the compulsive, persistent urge to pull out one's own hair.

specific phobia

An irrational and unabating fear of a particular object, activity, or situation.

obsession

An unwanted thought, word, phrase, or image that persistently and repeatedly comes into a person's mind and causes distress.

categories of specific phobias

Animal type Natural environment type Situational type Blood-injection-injury type

Phobias that are acquired through learning, in which people come to associate a specific stimulus with fear, may be involved with which brain structure?

the amygdala

fear

The emotional response to real or perceived imminent threat.

post-traumatic growth

The personal growth that can occur following exposure to a traumatic experience.

reasons that clinicians may not wish to prescribe benzodiazepines

They may produce dependency. They may lead to abuse.

behaviorist view of how specific phobias develop

A person generalizes an appropriate fear reaction to all stimuli in that category, even harmless ones.

graded in vivo

A procedure in which clients gradually expose themselves to increasingly challenging anxiety-provoking situations.

The rate of selective mutism ranges from ____ to ____

0.2 to 2 percent

post-traumatic stress disorder (PTSD)

A disorder in which an individual exposed to a traumatic event continues to experience a range of distressing symptoms for more than a month that include reexperiencing the traumatic event, avoidance of reminders of the trauma, numbing of general responsiveness, and increased arousal.

What is the lifetime prevalence of OCD in the US?

1.6%

What is the approximate lifetime prevalence of social anxiety disorder?

12%

The lifetime prevalence of specific phobia in the US is

12.5 percent

What is the lifetime prevalence for specific phobia in the US?

12.5%

body dysmorphic disorder (BDD)

A disorder in which individuals are preoccupied with the idea that a part of their body is ugly or defective.

hoarding disorder

A disorder in which people have persistent difficulties discarding things, even if they have little value.

selective mutism

A disorder originating in childhood in which the individual consciously refuses to talk.

virtual reality exposure therapy (VRET)

A method of exposure therapy that uses virtual reality, in which clients become immersed in computer-generated environments that resemble the situations they fear.

panic attack

A period of intense fear and physical discomfort accompanied by the feeling that one is being overwhelmed and is about to lose control.

About what percent of the population experience panic attacks?

20%

Anxiety disorders have a lifetime prevalence of about

29 percent.

Selective mutism develops between the ages of

3 and 6 years old

The prevalence of anxiety disorders peaks between ages

30 and 44.

From 2001-2003, what age group was most susceptible to developing an anxiety disorder?

30-34 years old

Worldwide, epidemiologists estimate that ____ percent of individuals experience separation anxiety disorder at some point in life.

5.3 percent

What percent of individuals, worldwide, are likely to experience separation anxiety disorder sometime in their lives?

5.3%

The lifetime prevalence of generalized anxiety disorder is about

6%

What is the approximate 12-month incidence of social anxiety disorder?

7%

reactive attachment disorder (RAD)

A diagnosis given to children involving a consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers along with minimal responsiveness to others and limited positive affect.

obsessive-compulsive disorder (OCD)

A disorder characterized by recurrent obsessions or compulsions that are inordinately time consuming or that cause significant distress or impairment.

in vivo flooding

A behavioral technique in which the client is immersed in the actual feared situation.

flooding

A behavioral technique in which the client is immersed in the sensation of anxiety by being exposed to the feared situation in its entirety.

imaginal flooding

A behavioral technique in which the client is immersed through imagination into the feared situation.

relaxation training

A behavioral technique used in the treatment of anxiety disorders that involves progressive and systematic patterns of muscle tensing and relaxing.

separation anxiety disorder

A childhood disorder characterized by intense and inappropriate anxiety, lasting at least 4 weeks, concerning separation from home or caregivers.

anxiety

A future-oriented and global response, involving both cognitive and emotional components, in which an individual is inordinately apprehensive, tense, and uneasy about the prospect of something terrible happening.

conditioned fear reactions

Acquired associations between an internal or external cue and feelings of intense anxiety.

generalized anxiety disorder

An anxiety disorder characterized by anxiety and worry that is not associated with a particular object, situation, or event but seems to be a constant feature of a person's day-to-day existence.

social anxiety disorder

An anxiety disorder characterized by marked, or intense, fear or anxiety in social situations in which the individual may be scrutinized by others.

which country has the lowest prevalence rates of specific phobia?

China

disinhibited social engagement disorder

Diagnosis given to children who engage in culturally inappropriate, overly familiar behavior with people who are relative strangers.

complex post-traumatic stress disorder

Diagnosis in ICD-11 used to apply to individuals who suffer prolonged exposure to severe stressors or multiple and repeated adverse events from which they cannot escape.

anxiety disorders

Disorders characterized by excessive fear and anxiety, and related disturbances in behavior.

True or false: Research has shown that separation anxiety is passed down from parents to children through genetic mechanisms.

False

Methods of exposure used in behavioral therapy of specific phobias

Imagery (systematic desensitization, imaginal flooding) Live (graded in vivo, in vivo flooding)

agoraphobia

Intense anxiety triggered by the real or anticipated exposure to situations in which individuals may be unable to get help should they become incapacitated.

positive reinforcement

When a therapist supports and praises the client for successes

reasons people with social phobia are particularly challenging to treat

They have fewer opportunities to engage in challenging situations. They isolate themselves socially. Their poorer social skills may lead them to receive negative reactions from others.

excoriation (skin-picking) disorder

Recurrent skin picking resulting in skin lesions

trauma

Response experienced by an individual to an event that is harmful or life threatening that can have lasting adverse effects on the individual's functioning and mental health.

Which medications are regarded as being the most effective in treating social anxiety disorders?

SSRIs or SNRIs

_____ factors play a role in predispositioning an individual to developing separation anxiety disorder.

Sociocultural

anxiety sensitivity theory

The belief that panic disorder is caused in part by the tendency to interpret cognitive and somatic manifestations of stress and anxiety in a catastrophic manner.

True or False: A clinician would prescribe antianxiety medication only if a specific phobia interferes with the individual's ability to carry out everyday activities.

True

Researchers believe the anxiety associated with specific phobias may relate to abnormalities in the

anterior insular cortex

To be diagnosed, a specific phobia must be present

at least 6 months

Children most frequently exhibit selective mutism where?

at school

The ____ approach emphasizes that specific phobias occur because the response is learned.

behavioral

What medication is sometimes used to treat social anxiety disorders has the most potential for abuse?

benzodiazapines

The most effective antianxiety medications for treating panic disorder and agoraphobia are

benzodiazepines.

What is the lifetime prevalence of panic disorder?

between 3 and 5 percent

According to the DSM-5-TR, specifiers for panic attacks include

chest pain. palpitations. nausea. trembling.

Prior to the DSM-5, the condition of separation anxiety disorder was considered specific to

children

Which approach is considered the treatment of choice for generalized anxiety disorder?

cognitive-behavioral therapy

Which therapy approach coaches the client on learning to challenge their irrational beliefs about perceived threatening situations?

cognitive-behavioral therapy

The ______ perspective posits that people with specific phobias misinterpret harmless stimuli as being dangerous.

cognitive-behavorial

A technique where parents and teachers minimize pressure placed on the child to speak is called

defocused communication

When looking at panic disorders through a classical conditioning perspective, panic disorders result from conditioned ___ reactions.

fear

Research has shown that VRET can successfully treat which types of phobias?

fear of heights fear of spiders fear of blood

How many major dimensions does OCD have?

four

Gradually exposing a client to stimuli that present greater and more intense feelings of anxiety is referred to as a procedure called

graded in vivo exposure.

Virtually exposing a client to the feared situation is considered which behavorial technique?

imaginal flooding

If a client is afraid of heights, a clinician may bring the client to the top of a tall building. This is an example of

in vivo flooding

The symptoms of separation anxiety disorder seem to be more severe in countries that promote a(n) ______ set of cultural norms.

individualistic

Performance type social anxiety disorder

intense fear and anxiety during speaking or performing in public but not in other types of more general social situations

Virtual reality exposure therapy is (more/less/equally) effective in the treatment of social phobia than it is in the treatment of specific phobia.

less

Which neurotransmitter helps prepare the body to react to stressful situations?

norepinephrine

To be diagnosed with a panic disorder, panic attacks have to occur______ and be accompanied by fear of having another one.

on a repeated basis

What is the term used to describe an irrational fear associated with a particular object or situation?

phobia

Which is a behavioral technique that helps individuals gain control over the bodily reactions involved in panic attacks?

relaxation

symptoms of generalized anxiety disorder

restlessness, fatigue, concentration problems, irritability, muscle tension, sleep disturbance

According to anxiety ___ theory, people who develop panic disorder have heightened responsiveness to the presence of carbon dioxide in the blood.

sensitivity

Of all 12-month prevalence cases of anxiety disorders, almost 23% are classified as

severe

For how long must one experience the symptoms of agoraphobia before it can be officially diagnosed?

six months

What techniques are used in relaxation training?

slow breathing intentional hyperventilation

Social phobia was renamed what in the DSM-4-TR?

social anxiety disorder

____ ______ ____ is when an individual has marked or intense fear of public situations in which the individual may be embarrassed in front of others.

social anxiety disorder

If someone has an excessive fear of spiders, this would be considered a(n)

specific phobia

Storms, heights, fires, seeing blood, having medical procedures, and engaging in specific activities such as flying are all categories of

specific phobias

For treating specific phobias, which method suggests the client learn to substitute relaxation for fear through a series of graduated steps?

systematic desensitization

People with generalized anxiety disorder tend to have an inability to tolerate

uncertainty

In which technique are clients immersed in computer-generated environments that resemble the situations they fear?

virtual reality exposure therapy

From 2001-2003, it was more likely for men or women to have anxiety disorders?

women

Those with OCD may experience impaired

work family life social life