question

a state of immediate alarm in response to a serious, known threat to one's well being

answer

fear

question

a state of alarm in response to a vague sense of being in danger

answer

anxiety

question

experiences of fear and anxiety are often useful when

answer

they prepare us for action -- for fight or flight -- when danger threatens

question

when discomfort is too severe or too frequent, lasts too long, or is triggered too easily

answer

people most likely have anxiety

question

what is the most common mental disorder in US

answer

anxiety disorder

question

in any given year ____% of the adult US pop. experiences one of anxiety disorders... ____% develop at least one within their lifetime

answer

18% . 29%

question

one _____ of those with anxiety seek treatment

answer

1/5

question

most individuals with one anxiety disorder also have

answer

a second disorder

question

what other disorder is common with anxiety?

answer

depression

question

how many anxiety disorders are there?

answer

5

question

name the 5 anxiety disorders

answer

generalized anxiety disorder phobias agoraphobia social anxiety disorder panic disorders

question

what is GAD?

answer

Excessive or ongoing anxiety and worry, for at least six months, about two or more activities or events

question

another name for GAD

answer

free floating anxiety

question

how many symptoms are needed to be diagnosed with GAD?

answer

3

question

what are the symptoms of GAD?

answer

Feeling restless Keyed up, or on edge Fatigue and/or sleep problems Difficulty concentrating Muscle tension

question

GAD: The Sociocultural Perspective says

answer

People faced with truly dangerous social conditions are at risk

question

One of the most powerful forms of societal stress is

answer

poverty

question

As would be predicted by the sociocultural model, there are higher rates of GAD in ______ groups

answer

lower SES

question

GAD: The Psychodynamic Perspective from Freud says

answer

all children experience anxiety: Realistic anxiety when they face actual danger Neurotic anxiety when they are prevented from expressing id impulses Moral anxiety when they are punished for expressing id impulses

question

GAD: The Psychodynamic Perspective says that GAD developed for children who

answer

Who experience particularly high levels of anxiety Who's defense mechanisms are inadequate

question

Today's psychodynamic theorists often disagree with specific aspects of Freud's explanation of GAD... Researchers have found some support for the psychodynamic perspective:

answer

People with GAD are particularly likely to use defense mechanisms (especially repression) Adults, who as children suffered extreme punishment for expressing id impulses, have higher levels of anxiety later in life

question

GAD: The Humanistic Perspective says

answer

When people stop looking at themselves honestly and acceptingly they develop GAD

question

GAD the Humanistic perspective is illustrated by Carl Rogers:

answer

Lack of "unconditional positive regard" in childhood leads to "conditions of worth" They have negative thoughts about themselves when they are unable to meet these standards

question

Practitioners using humanistic "client-centered" approach try to show

answer

unconditional positive regard for their clients and to empathize with them

question

little research support for

answer

humanistic treatment for GAD

question

GAD: The Cognitive Perspective looks at two types of assumptions

answer

irrational and silent

question

GAD: Behavior is influenced by irrational assumptions:

answer

It is a dire necessity for an adult human being to be loved or approved of by virtually every significant person in his community It is awful and catastrophic when things are not the way one would very much like them to be

question

GAD: Silent assumptions imply imminent danger:

answer

A situation/person is unsafe until proven safe It is always best to assume the worst

question

GAD cognitive perspective: what is the metacognitive theory?

answer

The most problematic assumptions in GAD are the individual's worry about worrying (meta-worry)

question

GAD cognitive perspective: Intolerance of uncertainty theory

answer

It is unacceptable that negative events may occur, even if the possibility is very small They worry in an effort to find "correct" solutions

question

GAD cognitive perspective: Avoidance theory

answer

Worrying serves a "positive" function for those with GAD by reducing unusually high levels of bodily arousal

question

GAD: Two kinds of cognitive treatment approaches:

answer

Changing maladaptive assumptions Helping clients understand the role that worrying plays, and changing their views and reactions to it

question

for GAD cognitive theory, changing maladaptive assumptions is done by:

answer

Ellis's rational-emotive therapy (RET) (Point out irrational assumptions Suggest more appropriate assumptions Assign related homework Studies suggest at least modest relief from treatment)

question

for GAD cognitive theory, changing reaction to worrying: treatments

answer

Educate pts about the role of worrying in GAD and have them observe their bodily arousal and cognitive responses across life situations Pt's learn to identify their worrying and their attempts to control their lives by worrying Pt's learn to see the world as less threatening, to adopt more constructive ways of coping, and to worry less

question

GAD: The Biological Perspective says

answer

GAD is caused by biological factors

question

"GAD is caused by biological factors" is supported by

answer

pedigree studies (Biological relatives more likely to have GAD (~15%) than general population (~6%)) The closer the relative, the greater the likelihood. There is, however, a competing explanation of shared environment

question

GAD: The Biological Perspective says GAD is caused by

answer

GABA inactivity

question

in 1950s _______ were found to reduce anxiety

answer

Benzodiazepines

question

Benzodiazepines work because....

answer

Benzodiazepine receptors ordinarily receive gamma-aminobutyric acid (GABA, a common neurotransmitter in the brain) and GABA makes the neuron stop firing

question

Malfunctions such has ______ and _______ in the feedback system are believed to cause GAD

answer

To few GABA receptors AND Ineffective receptors

question

Research conducted in recent years indicates that the root of GAD is probably more complicated than a

answer

single neurotransmitter (GABA)

question

GAD: Biological Treatments

answer

drug therapy Relaxation training Biofeedback

question

drug therapy for GAD

answer

Early 1950s: Barbiturates (sedative-hypnotics) Late 1950s: Benzodiazepines More recently: Antidepressant and antipsychotic medications

question

facts about relaxation training as GAD treatment

answer

Research indicates that relaxation training is more effective than placebo or no treatment Best when used in combination with cognitive therapy or biofeedback

question

Biofeedback uses

answer

electrical signals from the body to train people to control physiological processes

question

Electromyograph (EMG) provides

answer

feedback about muscle tension

question

biofeedback found to have its greatest impact when used as an

answer

adjunct to other methods for treatment of certain medical problems (headache, back pain, etc.)

question

phobia is From the Greek word for ____

answer

fear

question

a phobia is a

answer

Persistent and unreasonable fears of particular objects, activities, or situations

question

People with a phobia often avoid

answer

the object or thoughts about it

question

phobias compared to common fears....

answer

phobias are .... More intense and persistent fear Greater desire to avoid the feared object or situation Distress that interferes with functioning

question

Most phobias technically are categorized as "specific" which is.....

answer

an intense and persistent fear of a specific object or situation

question

with phobias When exposed to the object or situation, sufferers experience

answer

immediate fear

question

most common phobias

answer

animals or insects heights enclosed spaces thunderstorms blood

question

Each year close to ______% of all people in the U.S. have symptoms of specific phobia More than _____% develop such phobias at some point in their lives

answer

9% and 12%

question

are women or men more likely to have phobia

answer

women 2:1

question

Vast majority of people with a specific phobia (do/do not) seek treatment

answer

DO NOT

question

Each model offers explanations for what causes specific phobias, but evidence tends to support the ________ explanations

answer

behavioral

question

Phobias develop through

answer

conditioning

question

Other behavioral explanations for What Causes Specific Phobias

answer

Phobias develop through modeling Phobias are maintained through avoidance Phobias may develop into GAD when a person acquires a large number of them

question

What Causes Specific Phobias? A behavioral-evolutionary explanation

answer

Theorists argue that there is a species-specific biological predisposition to develop certain fears Called "preparedness" because we are theoretically more "prepared" to acquire some phobias than others Model explains why some phobias (snakes, spiders) are more common than others (meat, houses)

question

How Are Specific Phobias Treated?

answer

Systematic desensitization Flooding Modeling

question

two types of systematic desensitization

answer

In vivo desensitization (live) Covert desensitization (imaginal)

question

what is Flooding

answer

Forced non-gradual exposure

question

what is Modeling

answer

Therapist confronts the feared object while the fearful person observes

question

the key to success for phobia treatments is

answer

ACTUAL contact with the feared object or situation

question

People with agoraphobia are

answer

afraid of being in public places or situations where escape might be difficult, should they experience panic or become incapacitated

question

In any given year, about ____% of adults experience agoraphobia, women twice as frequently as men

answer

2%

question

Explanations for Agoraphobia

answer

Although broader than specific phobias, agoraphobia is often explained in ways similar to specific phobias Many also are prone to experience extreme and sudden explosions of fear - called "panic attacks" - and may receive a second diagnosis of panic disorder

question

How is Agoraphobia Treated?

answer

Behavioral therapy with an exposure approach is the most common and effective treatment for agoraphobia

question

Between _______% of clients with agoraphobia who receive exposure treatment find it easier to enter public places and the improvement lasts for years

answer

60-80%

question

Social Anxiety Disorder is a

answer

Severe, persistent, and irrational fears of social or performance situations in which scrutiny by others and embarrassment may occur

question

People judge themselves as performing less competently than they actually do either ______ or ______

answer

narrow or broad

question

ex. of narrow for Social Anxiety Disorder

answer

talking, performing, eating, or writing in public

question

ex. of broad for Social Anxiety Disorder

answer

general fear of functioning poorly in front of others

question

What Causes Social Anxiety Disorder?

answer

People with this disorder hold a group of social beliefs and expectations that consistently work again them, including: Unrealistically high social standards or Views of themselves as unattractive and socially unskilled

question

Cognitive theorists hold that, because of these beliefs, people with social anxiety disorder anticipate that social disasters will occur and they perform "________" and "_______" behaviors to prevent them

answer

avoidance or safety

question

In addition for ______________, after a social event, they review the details and overestimate how poorly things went or what negative results will occur

answer

social anxiety disorder

question

Treatments for Social Anxiety Disorder: Two components must be addressed:

answer

Overwhelming social fear: (Address fears behaviorally with exposure) Lack of social skills: (Social skills and assertiveness trainings have proved helpful)

question

Social fears are often reduced through

answer

medication (antidepressants)

question

social fears are treated through

answer

medication psychotherapy social skills training

question

psychotherapy is where

answer

People treated with psychotherapy are less likely to relapse than people treated with drugs alone One psychological approach is exposure therapy, either in an individual or group setting Cognitive therapies have also been widely used

question

Social skills training is where

answer

Therapists provide feedback and reinforcement Allows pt to practice skills with other group members

question

Panic

answer

________, an extreme anxiety reaction, can result when a real threat suddenly emerges

question

_______ are periodic, short bouts of panic that occur suddenly, reach a peak, and pass

answer

panic attacks

question

Sufferers of _______ often fear they will die, go crazy, or lose control

answer

panic attacks

question

panic Attacks happen in the absence of a

answer

real threat

question

More than _______ of all people have one or more panic attacks at some point in their lives, but some people have panic attacks repeatedly, unexpectedly, and without apparent reason

answer

1/4

question

_______ are when people have panic attacks repeatedly, unexpectedly, and without apparent reason

answer

panic disorders

question

example 0f ____________: they may worry persistently about having an attack or plan their behavior around possibility of future attack

answer

panic disorder

question

with panic disorders, women are _____ as likely to as men to be affected

answer

twice

question

Poor people are ______% more likely than wealthier people to experience these disorders

answer

50%

question

The prevalence for panic disorders is (the same/different) across cultural and racial groups in the U.S. and seems to occur in cultures across the world

answer

the same

question

Approximately ______ of those with panic disorder are in treatment

answer

1/3

question

Panic disorder often (but not always) accompanied by

answer

agoraphobia

question

Panic Disorder: The Biological Perspective: In the 1960s, clinicians discovered that people with panic disorder were not helped by benzodiazepines, but were helped by ____

answer

antidepressants

question

Researchers worked ________ from their understanding of antidepressant drugs

answer

backward

question

What biological factors contribute to panic disorder?

answer

Neurotransmitter brain circuits amygdala genetic factors

question

which neurotransmitter is a factor that contributes to panic disorder

answer

norepinephrine

question

norepinephrine is irregular in people with

answer

panic attacks

question

It is possible that some people with panic disorder inherit a predisposition to abnormalities in the _____ and ______

answer

brain circuits and amygdala

question

Genetics as a factor of panic disorder: Among monozygotic (MZ, or identical) twins, the rate is as high as ____% Among dizygotic (DZ, or fraternal) twins, the rate is only ____%

answer

31% 11%

question

biological treatment for panic disorders

answer

drug therapy

question

antidepressants function at the _______ receptors in the panic brain circuit

answer

norepinephrine

question

antidepressents Bring at least some improvement to_____% of patients with panic disorder

answer

80%

question

Some _________ (especially Xanax [alprazolam]) work for panic disorders

answer

benzodiazepines

question

Panic Disorder: The Cognitive Perspective: Cognitive theorists recognize that biological factors are only part of the cause of panic attacks

answer

full panic reactions are experienced only by people who misinterpret bodily events

question

Cognitive treatment is aimed at

answer

correcting misinterpretation of bodily events

question

Panic-prone people may be very sensitive to certain bodily sensations and may misinterpret them as

answer

signs of a medical catastrophe

question

why do people experience misinterpretations?

answer

Experience more frequent or intense bodily sensations Have experienced more trauma-filled events over the course of their lives They focus on bodily sensations much of the time, are unable to assess the sensations logically, and interpret them as potentially harmful

question

Panic Disorder: The Cognitive Perspective: the cognitive therapy tries to

answer

Tries to correct people's misinterpretations of their bodily sensations

question

what are the 3 steps for cognitive therapy for panic disorders?

answer

Step 1: Educate clients Step 2: Teach clients to apply more accurate interpretations (especially when stressed) Step 3: Teach clients skills for coping with anxiety (relaxation, breathing)

question

cognitive therapy for panic disorders may also use _________ procedures to induce panic sensations

answer

biological challenge

question

OCD Made up of two components

answer

obsessions and compulsions

question

obsessions are

answer

Persistent thoughts, ideas, impulses, or images that seem to invade a person's consciousness

question

compulsions are

answer

Repetitive and rigid behaviors or mental acts that people feel they must perform to prevent or reduce anxiety

question

Diagnosis of OCD is called for when symptoms:

answer

Feel excessive or unreasonable Cause great distress Take up much time Interfere with daily functions

question

Between ____% and _____% of U.S. population suffer from OCD in a given year

answer

1% and 2%

question

OCD is _____ common in men and women and among different racial and ethnic groups

answer

equally

question

OCD usually begins by

answer

young adulthood and typically persists for many years, although symptoms may fluctuate over time

question

It is estimated that more than ____% of those with OCD seek treatment

answer

40%

question

What Are the Features of Obsessions and Compulsions?

answer

obsessions compulsions

question

obsessions are

answer

Thoughts that feel both intrusive and foreign Attempts to ignore or resist them trigger anxiety

question

compulsions are

answer

"Voluntary" behaviors or mental acts

question

performing behaviors for OCD reduce anxiety by

answer

only for a short time

question

with OCD, behaviors often develop into

answer

rituals

question

common forms of compulsions:

answer

Cleaning Checking Order or balance Touching, verbal, and/or counting

question

Compulsive acts often occur in response to

answer

obsessive thoughts

question

Compulsions seem to represent a yielding to

answer

obsessions

question

Compulsions also sometimes serve to help control

answer

obsessions

question

Many with OCD are concerned that they will act on their

answer

obsessions

question

Compulsions usually do not lead to

answer

violence or "immoral" conduct

question

OCD: The Behavioral Perspective: Behaviorists have concentrated on explaining and treating

answer

compulsions rather than obsessions

question

OCD: The Behavioral Perspective: In a fearful situation, they happen to perform a particular act (washing hands) When the threat lifts, they associate the improvement with

answer

the random act

question

OCD: Behavioral perpective: After repeated associations, they believe the compulsion is

answer

changing the situation

question

OCD: The Behavioral Perspective: Treatment

answer

behavioral therapy:

question

example of behavioral therapy for OCD:

answer

Exposure and response prevention (ERP)

question

Exposure and response prevention (ERP) is where

answer

Clients are repeatedly exposed to anxiety-provoking stimuli and are told to resist performing the compulsions

question

Between ____ and _____ percent of clients have been found to improve considerably with ERP, and improvements often continue indefinitely

answer

55 and 85

question

with OCD, as many as _____% fail to improve at all from ERP, and the approach is of limited help to those with obsessions but no compulsions

answer

25

question

OCD: The Cognitive Perspective: Cognitive theorists begin by pointing out that everyone has

answer

repetitive, unwanted, and intrusive thoughts

question

OCD: The cognitive perspective: People with OCD blame themselves for normal (although repetitive and intrusive) thoughts and expect that

answer

terrible things will happen as a result

question

OCD: The Cognitive Perspective: To avoid such negative outcomes, they attempt to "_______" their thoughts with actions (or other thoughts)

answer

neutralize

question

Neutralizing thoughts/actions may include:

answer

Seeking reassurance Thinking "good" thoughts Washing Checking

question

People with OCD tend to:

answer

Be more depressed than others Have exceptionally high standards of conduct and morality Believe thoughts are equal to actions and are capable of bringing harm Believe that they can, and should, have perfect control over their thoughts and behaviors

question

Cognitive therapists focus on the

answer

cognitive processes that help to produce and maintain obsessive thoughts and compulsive acts

question

Cognitive-Behavioral Therapy (CBT) with OCD:

answer

psychoeducation as well as exposure and response prevention exercises

question

Research suggests that a combination of the ______ and _______ models is often more effective than either intervention alone for OCD

answer

cognitive and behavioral

question

Family pedigree studies provided the earliest clues that OCD may be linked in part to _______

answer

biological factors

question

Studies of twins found a ______% concordance rate in identical twins, versus _______% in fraternal twins

answer

53% and 23%

question

OCD: The Biological Perspective: biological therapies

answer

Serotonin-based antidepressants Research suggests that combination therapy (medication + cognitive behavioral therapy approaches) may be most effective

question

Serotonin-based antidepressants for OCD

answer

Clomipramine (Anafranil), fluoxetine (Prozac), fluvoxamine (Luvox) Bring improvement to 50-80% of those with OCD Relapse occurs if medication is stopped

question

In recent years, a growing number of clinical researchers have linked some excessive behavior patterns (e.g., hoarding, hair pulling, shopping, sex) to

answer

OCD

question

DSM-5 has created the group name "Obsessive-Compulsive-Related Disorders" and assigned four patterns to that group:

answer

hoarding disorder, hair-pulling disorder, excoriation (skin-picking) disorder, and body dysmorphic disorder

question

Theorists typically account for obsessive-compulsive-related disorders by using the same kinds of explanations that have been applied to

answer

OCD

question

clinicians typically treat clients with these disorders by applying the kinds of treatment used with OCD, particularly

answer

antidepressant drugs, exposure and response prevention, and cognitive therapy

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