Anxiety Part 1

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rsumule
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122277
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Anxiety Part 1
Updated:
2011-12-10 19:27:05
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Anxiety Finals
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Psyc 553
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  1. The different components of stress:
    Triple Response Model (Lange, 1968)
    • Cognitive
    • Motor Variables
    • Physiological
  2. Theory on how fear is developed:
    Cognitive-Behavioral Theory
    • Genetic Predisposition - Evolution (Seligman)
    • Respondent Conditioning (Watson)
    • 2 Factor Theory (Mowrer)
    • Social Learning (Rachman)
    • Information Transmission (Rachman)
    • Maladaptive Thoughts (Beck)
  3. Theory on fear being developed:
    Genetic Predisposition - Evolution (Seligman)
    Some people are "biologically more anxious" than others.
  4. Theory on fear being developed:
    Respondent Conditioning (Watson)
    The Little Albert experiment
  5. Theory on fear being developed:
    2 - Factor Theory (Mowrer)
    • 1 factor is respondent conditioning (how the fear is developed)
    • 2 factors is the reason fears are maintained: Skinner's operant conditioning (it is reinforced)
  6. Theory on fear being developed:
    Social learning (Rachman)
    Modelling from adults or watching other people
  7. Theory on fear being developed:
    Information Transmission (Rachman)
    Other people tell you what to be afraid of
  8. Theory on fear being developed:
    Maladaptive Thoughts (Beck)
    Chaning irrational/distorted thoughts.
  9. Common examples of Specific Phobia in Youth
    • Small Animals (dogs, cats)
    • Darkness
    • Thunder/lightning
    • Injections
    • Loud noises
    • Sleeping aline (that is not S.A.D.)
  10. Common examples of Obsessions in Youth
    • Germs/contamination
    • Fear of harm: to self & to others
    • Scrupulosity: excessive religiosity, scrutiny of one's thoughts
    • Forbidden thoughts: aggressive, sexual
  11. Common examples of Compulsions in Youth
    • Washing/cleaning
    • Repeating/redoing
    • Checking
    • Touching
    • Counting
    • Ordering/arranging
    • Hoarding
  12. Prevalence Rates in Youth
    • SAD 8% Females Ch
    • GAD 8% Equal Adl
    • Spfc. Phobia 6% Equal Both Ch & Adl
    • Panic Dis. 5% Females Adl
    • SAD 4% Equal Adl
    • OCD 2% Males Adl
    • PTSD 2% Females Adl
  13. Assessing Anxiety Disorder for Children:
    • Structured Interviews
    • Questionnaires (Self-Report)
    • Observations
    • Anxiety Self-Monitoring
  14. Assessment for Anxiety: Interviews
    • Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS)
    • Anxiety Disorders Interview Schedule (ADIS)
  15. Assessment for Anxiety: Questionnaires (Self-Report)
    • Fear Survey Schedule for Children - Revised
    • Revised Children's Manifest Anxiety Scale (RCMAS)
    • Multidimentsional Anxiety Scale for Children (MASC):
    • - Physical Symptom (Tense/Restless; Somatic/Autonomic)
    • - Harm Avoidance (Perfectionism; Anxious Coping)
    • - Social Anxiety (Humiliation/Rejection; Performing in Public)
    • - Separation/Panic
  16. Assessment for Anxiety: Observations
    • Behavioral Avoidance Test:
    • - Fairly flexible
    • - Confront feared object/situation for up to 5 min
    • - Measure time or distance
    • - Use a fear thermometer

    The idea is to expose the child to the feared object, then you observe and measure it: how lng are they willing to hold it, are they getting better overtime or not. It is not a structured test.
  17. Assessment for Anxiety: Self-Monitoring
    • Daily Diary -- THEY WOULD DO IT!
    • -- Time, situation, what you did, thoughts, how afraid (0-10)
    • -- Must "self" child on diary

    • for kids: set up a rewards program for them to do.
    • usually commonly done with adolescents than little children.
  18. Well-Establised for Traumatic Events in Children
    Trauma-Focused CBT (TF-CBT)
  19. Probably Efficacious for Traumatic Events in Children
    School-Based CBT
  20. Well-Establised for OCD in Children
    None
  21. Probably Effucacious for OCD in Children
    • CBT (exposure-based)
    • CBT (exposure-based with SSRI-sertraline)
  22. Well-Establised for Phobic and [most] Anxiety Disorders in Children
    None
  23. Probably efficacious for Phobic and [most] Anxiety Disorders
    • CBT (individual)
    • CBT (group)
    • CBT (group with parents)
    • CBT (group) for social phobia
    • Social Effectiveness Training for Social Phobia
  24. Basic "Core Four" Components (Chorpita, 2007)
    • Fear Hierarchy : Create a fear ladder
    • Education : Learning about anxiety
    • Practice : Exposure
    • Relapse Prevention : Maintenance
  25. Make an example Fear Ladder!
    • younger, older,
    • vary by time
    • vary by intensity
    • imagine / actually doing it
    • picture / toy thing / real thing
    • jarak
    • phone call / talk
  26. Learning about Anxiety for Children and Parents
    • Parts of anxiety = feelings, thoughts, actions
    • everyone has anxiety
    • Anxiety = alarm with stages
    • stage 1 = warning that danger might be coming (yellow light)
    • stage 2 = warning that danger is here (red light)
    • Some anxiety is good (protect us)
    • Some anxiety is bad (false alarm)
    • Goal is to help manage false alarms
    • You can test to see if your fears are false alarms with practice
    • Practice can be gradual
  27. Exposure (practice) possibilities
    • Systematic Desensitization: In vivo (in real life), imaginal, virtual reality
    • Participant Modeling
    • Flooding
  28. Disorder -- Exposure: Panic Disorder
    "Interoceptive Exposure"
  29. Disorder -- Exposure: Agoraphobia
    Places
  30. Disorder -- Exposure: Specific Phobia
    Object / Situation
  31. Disorder -- Exposure : PTSD
    Related Stimuli
  32. Disorder -- Exposure : OCD
    "Exposure with Response Prevention"
  33. Disorder -- Exposure : GAD
    • "Worry Chair"
    • -- setting aside a time to worry, and that is the only time allowed to worry.
  34. Disorder -- Exposure: Social Phobia
    Social situations
  35. Disorder -- Exposure: Separation
    Seperating
  36. Disorder -- Exposure: Mutism
    Speaking
  37. Maintenance and relapse prevention for Anxiety Interventions
    • Praise accomplishements in therapy
    • Make connection between gains and practice
    • Emphasize the need for "continued exposure in everyday life"
    • Discuss "lapse" vs. "relapse"
    • Gradually decrease sessions
  38. Additional possible components for Youth
    • Cognitive Restructuring : Probability Overestimation, Catastrophic Thinking
    • Social Skills : Meeting New People, NonVerbal Communication
  39. Additional possible components for Parent
    • Active ignoring to decrease attention for fearful behavior
    • Increase praise for brave behavior
    • Rewards to increase motivation
    • Time-Out when disruptive behaviors interfere
  40. Additional possible components for Parent

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