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Studieboek - Anxiety disorders - Specific models and treatment protocols

29 important questions on Studieboek - Anxiety disorders - Specific models and treatment protocols

What are the steps in the maintaining cycle for a specific phobia? (4)

1. Focus on perceived threat through selective attention
2. Increases the likelihood of perceiving a threat that triggers the phobic response
3. Reinforces over-estimation of the probability of hard and under-estimating of the ability to cope
4. Fear is maintained that drives hypervigilance

How are primary cognitions, physical arousal, and safety-seeking behaviors related to specific phobia, and what is the consequence?

Primary cognitions (fear of an object/situation) exacerbate physiological arousal and safety-seeking behaviors, which stop the fear from being challenged.

What is the effect of secondary cognitions on specific phobia?

Secondary cognitions (beliefs about the meaning of the phobia) can also heighten anxiety.

How can a specific phobia be overcome? (4)

1. Graded exposure (in reality mostly more effective than through imagination) followed by a debriefing to support the emotional opportunity for re-evaluation and change
2. Decreasing focus on the perceived threat (through distraction or BEs to evaluate the consequences of reducing the amount of time spent on checking)
3. Reducing safety-seeking behaviors (via BEs to test the predictions of harm)
4. Addressing misinterpretations (through teaching decentring and cognitive reappraisal of situations)

What are the maintenance factors in panic disorder? (3)

1. Catastrophic misinterpretation of bodily sensations
2. Safety behaviors employed to reduce the likelihood of a catastrophe
3. Selective attention through becoming highly sensitized

What are the steps in the maintenance model of a panic disorder? (4)

1. Trigger results in anxiety and anxiety symptoms
2. Symptoms are misinterpreted, which increases anxiety
3. Safety-seeking behaviors
4. Beliefs remain unchanged and anxiety remains

How can panic disorders be treated? (3)

1. Generating less catastrophic explanations (for the origin and consequences)
2. Setting up BEs (to discover the origin of an unpleasant sensation and to establish the validity of new perceptions)
3. Reduce safety-seeking behaviors (cognitive interventions to explore new ways of coping and reinforcement through behavioral testing)

What can be the maintenance factors in hypochondriasis/health anxiety? (4)

1. Avoidance of situations that trigger health fears
2. Turning to others (safety-seeking behavior)
3. Scanning: focus on the perceived threat with hyperawareness that may lead to misinterpretation of sensations
4. Continuous checking which can easily lead to potentially harmful signs

What are the steps in the maintenance cycle for hypochondriasis/health anxieties? (3)

1. Trigger elicits a catastrophic prediction and preoccupations that results in anxiety
2. Avoidance/reassurance-seeking/scanning can lead to failure to tolerate/address health concerns, only short-term relief, or false positives and increased symptoms
3. Belief that problems are physical is continued and catastrophic prediction and pre-occupation is maintained

What are the treatment elements for health anxieties?

1. Defining and testing the content of the catastrophic prediction
2. Exploration of superstitious thinking
3. Testing unhelpful health-related beliefs
4. Reducing safety-seeking behaviors
5. Theory A vs. theory B strategy

What are the steps in the maintenance cycle for social anxieties? (4)

1. Trigger elicits self-focused attention resulting in perceived social danger and emotional reasoning
2. Increased focus on self and impaired performance which increases self-focused attention or safety-seeking behavior
3. Th latter results in a failure to learn that the worst does not happen. Belief remains unchanged
4. Self-focused attention is maintained

What is important about the definition of self-focused attention in social anxieties?

That it refers to intense self-awareness which can also manifest as self-referent imagery. This heightened self-consciousness is distracting and, this, disabling because the preoccupation takes away from coping resources and prevents the sufferer from reviewing situations objectively

What is meant by emotional reasoning?

Intense introspection that leads to increased awareness of physical symptoms, which heightens self-awareness and increases self-consciousness

What are important elements in interventions for social phobia? (4)

1. Re-focusing attention away from introspection (different sources of information)
2. Developing an assertive or compassionate inner voice
3. Cognitive re-evaluation
4. Questioning beliefs to have to client gain a more balanced perspective

What are the maintenance factors for GAD? (4)

1. Focussing attention on the perceived threat as an attempt to avoid addressing a more distressing fear
2. May reflect an attempt to avoid facing uncertainty which is felt intolerable
3. The meta-cognition of the worry can perpetuate it (type II worry)
4. Undermines the ability for problem-solving (person loses confidence in their ability)

What are the steps in the maintenance cycle for GAD? (4)

1. Trigger leads to worry ('what if'?)
2. Meta-cognition of worry leads to more worrying, or initial worry leads to a failure to address the core concern(s)
3. No opportunity to problem-solve, resulting in a lack of confidence in problem-solving abilities
4. Continued belief in inability to cope with adversity maintains the worrying

What are the important elements of the treatment for GAD? (5)

1. Normalizing worry and worry awareness training
2. Overcoming avoidance (encourage articulation and help to address the fears)
3. Identifying meta-cognitions and testing unhelpful cognitions
4. Teaching alternative responses to worry to teach them that all is well even if they disengage from the worry
5. The worry decision tree (useful yes or no, if something can be done yes or no)

What is the basic premise of OCD?

That intrusive thoughts are normal, but they turn problematic when they are interpreted as that something bad is happening and that the sufferer is responsible for preventing it

What are the most common obsessional worries? (4)

1. Contamination
2. Fear of missing something potentially dangerous
3. Over-concern with orderliness and perfection
4. Fears of uncontrollable and inappropriate actions

What are key cognitions in OCD? (6)

1. Thought-action fusion (the idea that thoughts can result in real consequences)
2. Inflated responsibility
3. Beliefs about the controllability of the thought (the idea that one ought to be able to control 'bad' thoughts)
4. Perfection
5. Overestimation of threat
6. Intolerance of uncertainty

What is common in sufferers of OCD? (2)

1. Thoughts about negative thoughts can heighten the anxiety
2. Emotional reasoning

What are the steps in the maintenance cycle of OCD? (4)

1. Trigger results in intrusive cognitions, which are perceived as important/dangerous and that action must be taken
2. Safety-seeking behavior (neutralizing/avoidance/thought suppression)
3. Failure to learn that the worst does not happen
4. Cognitions are still perceived are important/dangerous, or it results in anxiety which leads to more intrusive thoughts

What are the elements of interventions for OCD? (3)

1. Exposure and response prevention
2. Testing unhelpful thoughts and beliefs (continuum method or scaling especially helpful in addressing the extreme perspective of perfectionists)
3. Theory A vs. theory B

What are the core areas of symptoms in PTSD? (5)

1. Emotion of fear or horror as the main affective component (also other emotions)
2. Vivid memories that promote the experience of danger still being current
3. Memories being disconnected from an intellectual understanding of trauma which might otherwise put them into perspective
4. Memories being intrusive
5. Memories being experienced as nightmares

What are the maintenance factors of PTSD? (3)

1. Safety-seeking behaviors that prevent the processing of the memory (behavioral or physical avoidance)
2. Neurological inhibition of memory processing (over-arousal in the limbic system during a flashback can prevent the natural processing of the memory. Recollection remains emotionally over-intense and disconnected from current reality)
3. Misinterpretations (can further worsen distress and increase arousal and safety-seeking behaviors)

What are the steps in the maintenance cycle for PTSD? (3)

1. Trigger results in vivid traumatic memories giving a sense of present threat and there is an overestimation of the threat
2. Produces high levels of anxiety, which can lead to safety behavior or to failure to contextualize the memory or to learn to appraise the danger accurately
3. Vivid, traumatic memories are maintained

What elements might treatment for PTSD address? (5)

1. Diminishing the high levels of arousal associated with spontaneous imagery so that the memories can be contextualized which eliminates the sense of present threat (through cognitive restructuring while reliving the trauma and encouraging them to expose themselves)
2. Reducing safety-seeking behaviors by reviewing unhelpful beliefs and field-testing new possibilities
3. Reappraising misinterpretations by reviewing conclusions and creating plausible alternatives
4. Addressing selective memory processes and other cognitive biases by teaching the technique of decentring
5. 'Reclaiming your life' (assignments to re-engage with activities that contribute to well-being

With what problems do anxiety disorders often show co-morbidity?

OCD, eating disorders, alcohol abuse, and depression caused by chronicity. Trans-diagnostic approaches may be beneficial with in these cases

What are the potential problems when working with specific models and treatment protocols? (3)

1. Assuming the validity of a diagnosis without carrying a full assessment and then adhering to the treatment protocol
2. Trying to force a client's experiences into a specific model
3. Sticking too rigidly to a protocol when the client is not responding well

The question on the page originate from the summary of the following study material:

Positive Clinical Psychology

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