Course 5: Anxiety and related
disorders
Summary of all tasks (literature), lectures, practical’s and project works.
Inhoud
Tasks (literature).....................................................................................................................................4
Task 1: Anxiety and hyperventilation.....................................................................................................4
What is anxiety (difference with fear and panic) and a brief overview of anxiety disorders?............4
Description of generalized anxiety disorder.......................................................................................5
Description of panic disorder..............................................................................................................9
Description of agoraphobia..............................................................................................................10
What is hyperventilation and the hyperventilation syndrome (think of symptoms)?......................10
What is the cognitive model of panic?.............................................................................................13
Task 2: Fear!.........................................................................................................................................13
What is a specific phobia?................................................................................................................13
Subtypes...........................................................................................................................................14
Treatments specific phobia..............................................................................................................15
What are the basics of the learning theory ? + How do the pathways of Fear work during a fear-
response ?........................................................................................................................................17
Classical conditioning:...................................................................................................................17
Operant conditioning....................................................................................................................19
Are there any criticisms of the learning theory?...............................................................................20
Learning theory, in depth (artikel Andy Field, 11 principles)............................................................21
What is the cognitive theory and how is it implied in anxiety disorders?.........................................24
What is the information processing theory?....................................................................................26
What are attention, interpretation, memory - and judgemental biases? +......................................26
How can you measure these biases? +.............................................................................................26
How do cognitive biases sustain anxiety?.........................................................................................26
Safety behaviours and self-focused attention..................................................................................29
Task 4: Biological substrate and panic & anxiety..................................................................................31
Which medications can be used to treat anxiety disorders, describe specific benefits, side effects
and time to exert its effects?............................................................................................................32
What is the role of neurotransmitters in anxiety disorders, think of GABA, serotonin and
noradrenaline?.................................................................................................................................33
Which brain structures are associated with anxiety +......................................................................35
Which brain structures are involved in regulating and extinction of fear? +....................................35
What is the fear network? Process emotions that are personally related!......................................35
1
, What is the dual pathway model of Ledoux?...................................................................................37
How do neuroimaging studies provide insights in anxiety disorders?..............................................38
Task 5: thought suppression and OCD..................................................................................................38
What is OCD? + Why it has been considered an anxiety disorder for a long time?..........................39
Main differences between OCD-OCPD.............................................................................................41
What are obsessions?.......................................................................................................................41
Difference obsession, rumination, worry..........................................................................................41
How can normal and abnormal obsessions be distinguished?.........................................................41
What are compulsions?....................................................................................................................42
What are (2) the motivational dimensions of compulsions?............................................................42
Wat is thought suppression? + What is the role of thought suppression in OCD?...........................42
What is the role of catastrophic thoughts in OCD? ..........................................................................44
What are good arguments for yes it is an anxiety disorder and what is a no for (OCD)...................44
Task 6: Imagery, treatments and PTSD.................................................................................................44
What is PTSD?...................................................................................................................................44
How does memory affect and maintain PTSD (fragmented memory)?............................................47
Should you first stabilize the symptoms (focus on sleeping in the task) or focus directly on the
trauma memories/trauma symptoms? +..........................................................................................48
What is the effect of exposure on PTSD? (Arnst, 2007) +.................................................................48
What is imaginary rescripting? (Arnst, raben et al. 2015) +..............................................................48
What is EMDR? (engelhart) +............................................................................................................48
Can you treat past aversive events in anxiety disorders with imagery treatments?
(intrusions/ruminations?) +..............................................................................................................48
What are flashforwards? give examples! (engelhart).......................................................................50
Lectures (additional information to the tasks).....................................................................................51
Lecture 1: introduction.....................................................................................................................51
Lecture 2: learning theory................................................................................................................53
Lecture 3: information processing theory.........................................................................................53
Lecture 4: neuropharmacology.........................................................................................................54
Lecture 5: neurobiology of anxiety...................................................................................................55
Lecture 6: obsessive compulsive disorder (OCD)..............................................................................57
Lecture 7: post-traumatic stress disorder (PTSD).............................................................................58
Practical’s.............................................................................................................................................60
Practical 1: cognitive practical..........................................................................................................60
Practical 2: exposure practical..........................................................................................................61
Project works........................................................................................................................................63
Project work 1: the model of Mowrer..............................................................................................63
Project work 2: cognitive theory.......................................................................................................63
2
,3
, Tasks (literature)
Task 1: Anxiety and hyperventilation
Resources:
Barlow, D. H. (2002). Anxiety and its Disorders: the nature and treatment of anxiety and panic. Chapter 5 ‘Provoking
Panic in the Laboratory’ (only paragraph Hyperventilation pp. 156-162). New York: The Guilford Press.
Barlow, D. H. (2002). Anxiety and its Disorders: the nature and treatment of anxiety and panic. Chapter 6
‘Biological Aspects of Anxiety and Panic’ (only paragraph Elevated Sympathetic Activity p. 193-198 & paragraph
Autonomic Inflexibility pp. 200-202). New York: The Guilford Press.
Bernstein, D. A., Penner, L. A., Clarke-Stewart, A., Roy, E. (2012). Health Stress and Coping. In Psychology (9th ed.,
pp. 527–536 & 553 (only the parts that relate to pp527 - 536)). Boston: Wadsworth Cengage Learning.
Schmidt, N. B., Korte, K. J., Norr, A. M., Keough, M. E. and Timpano, K. R. (2014) Panic Disorder and Agoraphobia,
in The Wiley Handbook of Anxiety Disorders (eds P. Emmelkamp and T. Ehring, pp. 321-324 & pp. 328-339),
John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9781118775349.ch19.
Hofmann, S. G., Aka, B. T. and Piquer, A. (2014) Social Anxiety Disorder, in The Wiley Handbook of Anxiety
Disorders (eds P. Emmelkamp and T. Ehring, pp. 359- 366), John Wiley & Sons, Ltd, Chichester, UK. doi:
10.1002/9781118775349.ch20.
Stevens, E. S., Jendrusina, A. A., Sarapas, C. and Behar, E. (2014) Generalized Anxiety Disorder, in The Wiley
Handbook of Anxiety Disorders (eds P. Emmelkamp and T. Ehring, pp. 378-401), John Wiley & Sons, Ltd, Chichester,
UK. doi: 10.1002/9781118775349.ch21.
Wells, A., & Carter, K. (2001). Further tests of a cognitive model of generalized anxiety disorder: Metacognitions and
worry in GAD, panic disorder, social phobia, depression, and nonpatients. Behavior therapy, 32(1), 85-102.
Salkovskis, P.M., & Clark, D.M. (1990). Affective responses to hyperventilation: a test of the cognitive model of panic.
Behavior Research and Therapy, 28, 51-61.
APA. (2015). Diagnostic and statistical manual for mental disorders-5. (for reference only).
What is anxiety (difference with fear and panic) and a brief overview of anxiety disorders?
Fear is the emotional response on an actual or perceived imminent threat.
Anxiety is an innate, adaptive mechanism, that readies human beings for action and protects them
from anticipated threat. So, anxiety is anticipation of future threat.
Panic is an intense fight or flight emotional arousal.
Worry is the apprehensive expectations; repetitive thinking about potential future threats, imagined
catastrophes, uncertainties and risks or a chain of thoughts and images, negatively affect-laden and
relatively uncontrollable.
Anxiety disorders: disorders that share features of excessive fear an axiety and related behavioural
disturbances. There are different types of anxiety disorders that differ from one another in types of
objects or situations that induce anxiety, fear or avoidance behaviour and the associated cognitive
ideation.
Social anxiety disorder (social phobia): fear or anxiety about social situations, in which the
individual is exposed to possible scrunity: criticical observations or negative evaluations, by
others.
Generalized anxiety disorder: excessive anxiety and worry (apprehensive expectations)
about a number of events or activities.
Panic disorder: recurrent unexpected panic attacks and the concern or worry about
additional panic attacks and their consequences.
Agoraphobia: marked fear of anxiety about two (or more) specified public situations, in which
someone feels like escape would be difficult or help might not be available.
Specific phobia: fear or anxiety concerning a specific object or situation.
Separation anxiety disorder: fear or anxiety about being separated from attached individual.
Selective mutism: failure to speak in specific social situations.
Substance/medication induced anxiety disorder: during or soon after intoxication or withdrawal.
Anxiety disorder due to another medical condition: anxiety as a direct consequence of another condition.
Other specified anxiety disorder: do not meet the full criteria, with specific reason.
Unspecified anxiety disorder: do not meet the full criteria, without specific reason.
Description of social anxiety disorder:
Social anxiety disorder is characterized by a marked fear or anxiety about one or more social
situations, in which the individual is exposed to possible scrunity by others, including social
interactions, being observed and performing in front of others. (A)
(B) fear of acting in a way or showing anxiety symptoms that will be negatively evaluated.
4
disorders
Summary of all tasks (literature), lectures, practical’s and project works.
Inhoud
Tasks (literature).....................................................................................................................................4
Task 1: Anxiety and hyperventilation.....................................................................................................4
What is anxiety (difference with fear and panic) and a brief overview of anxiety disorders?............4
Description of generalized anxiety disorder.......................................................................................5
Description of panic disorder..............................................................................................................9
Description of agoraphobia..............................................................................................................10
What is hyperventilation and the hyperventilation syndrome (think of symptoms)?......................10
What is the cognitive model of panic?.............................................................................................13
Task 2: Fear!.........................................................................................................................................13
What is a specific phobia?................................................................................................................13
Subtypes...........................................................................................................................................14
Treatments specific phobia..............................................................................................................15
What are the basics of the learning theory ? + How do the pathways of Fear work during a fear-
response ?........................................................................................................................................17
Classical conditioning:...................................................................................................................17
Operant conditioning....................................................................................................................19
Are there any criticisms of the learning theory?...............................................................................20
Learning theory, in depth (artikel Andy Field, 11 principles)............................................................21
What is the cognitive theory and how is it implied in anxiety disorders?.........................................24
What is the information processing theory?....................................................................................26
What are attention, interpretation, memory - and judgemental biases? +......................................26
How can you measure these biases? +.............................................................................................26
How do cognitive biases sustain anxiety?.........................................................................................26
Safety behaviours and self-focused attention..................................................................................29
Task 4: Biological substrate and panic & anxiety..................................................................................31
Which medications can be used to treat anxiety disorders, describe specific benefits, side effects
and time to exert its effects?............................................................................................................32
What is the role of neurotransmitters in anxiety disorders, think of GABA, serotonin and
noradrenaline?.................................................................................................................................33
Which brain structures are associated with anxiety +......................................................................35
Which brain structures are involved in regulating and extinction of fear? +....................................35
What is the fear network? Process emotions that are personally related!......................................35
1
, What is the dual pathway model of Ledoux?...................................................................................37
How do neuroimaging studies provide insights in anxiety disorders?..............................................38
Task 5: thought suppression and OCD..................................................................................................38
What is OCD? + Why it has been considered an anxiety disorder for a long time?..........................39
Main differences between OCD-OCPD.............................................................................................41
What are obsessions?.......................................................................................................................41
Difference obsession, rumination, worry..........................................................................................41
How can normal and abnormal obsessions be distinguished?.........................................................41
What are compulsions?....................................................................................................................42
What are (2) the motivational dimensions of compulsions?............................................................42
Wat is thought suppression? + What is the role of thought suppression in OCD?...........................42
What is the role of catastrophic thoughts in OCD? ..........................................................................44
What are good arguments for yes it is an anxiety disorder and what is a no for (OCD)...................44
Task 6: Imagery, treatments and PTSD.................................................................................................44
What is PTSD?...................................................................................................................................44
How does memory affect and maintain PTSD (fragmented memory)?............................................47
Should you first stabilize the symptoms (focus on sleeping in the task) or focus directly on the
trauma memories/trauma symptoms? +..........................................................................................48
What is the effect of exposure on PTSD? (Arnst, 2007) +.................................................................48
What is imaginary rescripting? (Arnst, raben et al. 2015) +..............................................................48
What is EMDR? (engelhart) +............................................................................................................48
Can you treat past aversive events in anxiety disorders with imagery treatments?
(intrusions/ruminations?) +..............................................................................................................48
What are flashforwards? give examples! (engelhart).......................................................................50
Lectures (additional information to the tasks).....................................................................................51
Lecture 1: introduction.....................................................................................................................51
Lecture 2: learning theory................................................................................................................53
Lecture 3: information processing theory.........................................................................................53
Lecture 4: neuropharmacology.........................................................................................................54
Lecture 5: neurobiology of anxiety...................................................................................................55
Lecture 6: obsessive compulsive disorder (OCD)..............................................................................57
Lecture 7: post-traumatic stress disorder (PTSD).............................................................................58
Practical’s.............................................................................................................................................60
Practical 1: cognitive practical..........................................................................................................60
Practical 2: exposure practical..........................................................................................................61
Project works........................................................................................................................................63
Project work 1: the model of Mowrer..............................................................................................63
Project work 2: cognitive theory.......................................................................................................63
2
,3
, Tasks (literature)
Task 1: Anxiety and hyperventilation
Resources:
Barlow, D. H. (2002). Anxiety and its Disorders: the nature and treatment of anxiety and panic. Chapter 5 ‘Provoking
Panic in the Laboratory’ (only paragraph Hyperventilation pp. 156-162). New York: The Guilford Press.
Barlow, D. H. (2002). Anxiety and its Disorders: the nature and treatment of anxiety and panic. Chapter 6
‘Biological Aspects of Anxiety and Panic’ (only paragraph Elevated Sympathetic Activity p. 193-198 & paragraph
Autonomic Inflexibility pp. 200-202). New York: The Guilford Press.
Bernstein, D. A., Penner, L. A., Clarke-Stewart, A., Roy, E. (2012). Health Stress and Coping. In Psychology (9th ed.,
pp. 527–536 & 553 (only the parts that relate to pp527 - 536)). Boston: Wadsworth Cengage Learning.
Schmidt, N. B., Korte, K. J., Norr, A. M., Keough, M. E. and Timpano, K. R. (2014) Panic Disorder and Agoraphobia,
in The Wiley Handbook of Anxiety Disorders (eds P. Emmelkamp and T. Ehring, pp. 321-324 & pp. 328-339),
John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9781118775349.ch19.
Hofmann, S. G., Aka, B. T. and Piquer, A. (2014) Social Anxiety Disorder, in The Wiley Handbook of Anxiety
Disorders (eds P. Emmelkamp and T. Ehring, pp. 359- 366), John Wiley & Sons, Ltd, Chichester, UK. doi:
10.1002/9781118775349.ch20.
Stevens, E. S., Jendrusina, A. A., Sarapas, C. and Behar, E. (2014) Generalized Anxiety Disorder, in The Wiley
Handbook of Anxiety Disorders (eds P. Emmelkamp and T. Ehring, pp. 378-401), John Wiley & Sons, Ltd, Chichester,
UK. doi: 10.1002/9781118775349.ch21.
Wells, A., & Carter, K. (2001). Further tests of a cognitive model of generalized anxiety disorder: Metacognitions and
worry in GAD, panic disorder, social phobia, depression, and nonpatients. Behavior therapy, 32(1), 85-102.
Salkovskis, P.M., & Clark, D.M. (1990). Affective responses to hyperventilation: a test of the cognitive model of panic.
Behavior Research and Therapy, 28, 51-61.
APA. (2015). Diagnostic and statistical manual for mental disorders-5. (for reference only).
What is anxiety (difference with fear and panic) and a brief overview of anxiety disorders?
Fear is the emotional response on an actual or perceived imminent threat.
Anxiety is an innate, adaptive mechanism, that readies human beings for action and protects them
from anticipated threat. So, anxiety is anticipation of future threat.
Panic is an intense fight or flight emotional arousal.
Worry is the apprehensive expectations; repetitive thinking about potential future threats, imagined
catastrophes, uncertainties and risks or a chain of thoughts and images, negatively affect-laden and
relatively uncontrollable.
Anxiety disorders: disorders that share features of excessive fear an axiety and related behavioural
disturbances. There are different types of anxiety disorders that differ from one another in types of
objects or situations that induce anxiety, fear or avoidance behaviour and the associated cognitive
ideation.
Social anxiety disorder (social phobia): fear or anxiety about social situations, in which the
individual is exposed to possible scrunity: criticical observations or negative evaluations, by
others.
Generalized anxiety disorder: excessive anxiety and worry (apprehensive expectations)
about a number of events or activities.
Panic disorder: recurrent unexpected panic attacks and the concern or worry about
additional panic attacks and their consequences.
Agoraphobia: marked fear of anxiety about two (or more) specified public situations, in which
someone feels like escape would be difficult or help might not be available.
Specific phobia: fear or anxiety concerning a specific object or situation.
Separation anxiety disorder: fear or anxiety about being separated from attached individual.
Selective mutism: failure to speak in specific social situations.
Substance/medication induced anxiety disorder: during or soon after intoxication or withdrawal.
Anxiety disorder due to another medical condition: anxiety as a direct consequence of another condition.
Other specified anxiety disorder: do not meet the full criteria, with specific reason.
Unspecified anxiety disorder: do not meet the full criteria, without specific reason.
Description of social anxiety disorder:
Social anxiety disorder is characterized by a marked fear or anxiety about one or more social
situations, in which the individual is exposed to possible scrunity by others, including social
interactions, being observed and performing in front of others. (A)
(B) fear of acting in a way or showing anxiety symptoms that will be negatively evaluated.
4
