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Summary all practicals - Anxiety and Related Disorders (GGZ2024)
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All practicals of the course Anxiety and Related Disorders. summary of all relevant literature (2023/2024)
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All practicals of the courseAnxiety and Related disorders
Academic year 2023/2024
Author: R. Gillet
,Table of contents
Practical 1. Anxiety, panic disorders and hyperventilation.....................................3
Practical 2. Specific phobias and the learning theory...........................................14
Practical 3. Cognitive theory of anxiety................................................................23
Practical 4. Biological mechanisms of anxiety and pharmacotherapeutic
treatments............................................................................................................ 29
Practical 5. OCD.................................................................................................... 37
Practical 6. PTSD.................................................................................................. 48
,Practical 1. Anxiety, panic disorders and
hyperventilation
1. What are the symptoms of these disorders? (DSM-V, other literature)
a. generalized anxiety disorder (GAD)
Anxiety = innate, adaptive mechanism that readies body for action and protects
them from anticipated threat.
Diagnostic criteria generalized anxiety disorder (DSM-V)
A. Excessive anxiety and worry, occurring more days than not for at least 6
months, about different events or activities.
B. Individual finds it difficult to control the worry
C. Anxiety and worrying are associated with 3(+) of the following symptoms
(note: for children only 1 item is required, most of the days over a period
of 6 months)
a. Restlessness or feeling on edge
b. Being easily fatigued
c. Difficulty concentrating or mind going blank
d. Irritability
e. Muscle tension
f. Sleep disturbance (difficulty falling/ staying asleep, unsatisfying
sleep, etc.)
D. Anxiety and worrying cause clinically significant distress or impairment in
social, occupational or other important areas of functioning.
E. Disturbance not attributable to substance (ab)use or another medical
condition
F. Disturbance not better explained by other mental disorder
Anxious people are constantly in state of ‘over preparedness’.
i. Well’s cognitive model: type I and type II of worry
According to metacognitive framework, individuals with GAD use worrying as a
means of coping with threat. Stimulated by positive metacognitive beliefs
about worrying (e.g. worrying makes me a good mom). Everyone has this to a
certain degree, in GAD linked to maintenance of worrying as coping. It is the
development of negative beliefs, associated appraisal of worry (meta-worry)
and linked responses that contribute to distress and development of pathological
worrying.
- Type 1
Worry concerning external events and non-cognitive internal events (e.g.
worrying over getting in an accident, competence at work place, etc.).
Mostly in SAD
- Type 2
Worry concerning thoughts, uncontrollability of worry, consequences of
worry for mental and physical health. Essentially worrying about worrying
(meta-worry). Stronger predictor of pathological worry than type 1. Mostly
in GAD and PD
, How you feel about worrying:
Positive metacognitive belief = positive belief about cognitions about
worrying
Negative metacognitive beliefs = negative beliefs about cognitions about
worrying
Type 2 worry contributes to 2 feedback-cycles that maintain the worry-process:
1. Reassurance seeking or avoidance of cues that trigger worry
Maintain negative beliefs about the danger and uncontrollability of worry.
Individual keeps relying on external information to control thoughts,
missing out on opportunities to learn that worrying is controllable and
harmless > learning new adaptive coping skills prevented.
2. Thought control strategies (e.g. suppression of thoughts that trigger
worry)
Though-control strategies hypothesized to actually increase number of
thought intrusions and reinforce idea that worry is uncontrollable.
GAD patients have higher scores on negative meta-cognitions and type-2-worry
than other anxiety disorders, but no differences in positive beliefs.
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