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Summary Alles van Fear, anxiety and Related disorders
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Literatuur + LecturesLecture 1 — From anxiety to anxiety disorders
Lecture 1: Overview of anxiety disorders/From anxiety to anxiety disorders
High Risk Studies and Developmental Antecedents of Anxiety Disorders
Cognitive-Behavioral Therapy for Adult Anxiety Disorders: A Meta-Analysis of Randomized Placebo-Controlled Trials
Cognitive Vulnerability to Emotional Disorders
Learning objectives: From anxiety to anxiety disorder
Lecture 2 — Specific phobia
Lecture 2: Specific Phobia
Specific fears and phobias in the general population: Results from the Netherlands Mental Health Survey and Incidence Study
(NEMESIS)
The relative contributions of fear and disgust reductions to improvements in spider phobia following exposure-based treatment
Pathways to change in one-session exposure with and without cognitive intervention: An exploratory study in spider phobia
Observational Conditioning of Snake Fear in Rhesus Monkeys
Effect of multiple context exposure on renewal in spider phobia
It was as big as my head, I swear! Biased spider size estimation in spider phobia
Learning objectives: Specific Phobia
Lecture 3 — PTSD
Lecture 3: PTSD: Diagnosis and treatment
Finalizing PTSD in DSM-5: Getting Here From There and Where to Go Next
Emotional Processing Theory (EPT) and Exposure Therapy for PTSD
Tones inferior to eye movements in the EMDR treatment of PTSD
Learning objectives: PTSD
Workgroup — PTSD & Imaginal exposure
Van Minnen, A., & Arntz, A (2011). Protocollaire behandeling van patiënten met een posttraumatische stressstoornis-(Imaginaire)
exposure. In Keijsers, G.P.J., Minnen, A. van, Hoogduin, C.A.L. (ed.). Protocollaire behandelingen voor volwassenen met psychische
klachten, deel 1, 181-212. Amsterdam: Boom
Lecture 4 — OCD
Lecture OCD
The Practice of Exposure Therapy: Relevance of Cognitive-Behavioral Theory and Extinction Theory
Strategies for Improving Long-Term Outcomes in Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder: Insights From
Learning Theory
When more is less: Doubt, repetition, memory, metamemory, and compulsive checking in OCD
Learning objectives: OCD
Lecture 5 — Generalized anxiety
Lecture generalized anxiety disorder
Current theoretical models of generalized anxiety disorder (GAD): Conceptual review and treatment implication
Applied relaxation vs. cognitive therapy in the treatment of generalized anxiety disorder
Worry and Generalized Anxiety Disorder: A Review and Theoretical Synthesis of Evidence on Nature, Etiology, Mechanisms,
and Treatment
Learning objectives: GAD
Lecture 6 — Social anxiety disorder
Lecture: Social anxiety disorder
Internet-delivered attention bias modification training in individuals with social anxiety disorder - a double blind randomized controlled
trial
Clinical Implications of Cognitive Bias Modification for Interpretative Biases in Social Anxiety: An Integrative Literature Review
Cognitive-Behavioral Models of Social Anxiety Disorder
Cognitive-Behavioral Therapy for Social Anxiety Disorder
Learning objectives: SAD
Lecture 7 — Transdiagnostic & enhancements
Lecture 7 — Enhancement of CBT for anxiety disorders
The Small World of Psychopathology
Transdiagnostic Treatment for Anxiety and Depression
Can fear extinction be enhanced? A review of pharmacological and behavioral findings
Literatuur + Lectures 1
, Cognitive enhancers for anxiety disorders
Learning objectives
Lecture 8 — Panic disorder ans Agoraphobia
Lecture — Panic Disorder and Agoraphobia
Causal modeling of panic disorder theories
An evidence-based causal model of panic disorder
Diversity of effective treatments of panic attacks: what do they have in common?
Learning objectives: Panic disorders
Lecture 1 — From anxiety to anxiety disorders
Lecture 1: Overview of anxiety disorders/From anxiety to anxiety disorders
Fear and Anxiety
If there is a brain, there is an ability to be anxious (for example this is not the case for being sad), this is because it is so
important for surviving. For people it is “rather be safe than sorry”. We can see the evolutionary importance in what people
are afraid of; for example a lot of people are afraid of spiders, even though only a few have been bitten by a spider, while not
much people are afraid of knifes, but a lot more have been cut because of a knife (thus people are afraid of the evolutionary
threats of early days)
Fear is a state of immediate alarm in response to a serious, known threat to one’s well-being — there is a clear object
(phobias)
An emotional response to perceived threat
Adaptive and has evolutionary value — want to be prepared really fast, thus a fear response is triggered really fast
(amygdala might know sooner that there is a threat, than the prefrontal cortex). This fast reaction can be helpful, but not
sufficient if it is a false alarm.
Humans are predisposed biologically
Involves activation of the sympathetic nervous system
“Fight or flight” phenomenon
Anxiety is a state of alarm in response to a vague sense of threat or danger — linked to anxiety is worry/rumination and
fight-or-flight reaction. This is more a human phenomenon, may be due to the ability to see consequences or see what is
coming next (cognitive abilities needed)
When does anxiety develop into a disorder?
This is extreme difficult to define because it is a dimensional thing (lineair line)
Normal anxiety is adaptive. It is an inborn response to threat or to the absence of people or objects that signify safety
can result in cognitive (worry) and somatic (racing heart, sweating, shaking, freezing, etc.) symptoms.
Pathologic anxiety is anxiety that is excessive, impairs function. Suffer more than you want to suffer.
DSM-Definition Anxiety
Unreasonably strong or permanent
Arises without sufficient reason
Cannot be controlled or endured
Causes suffering and constrain life
and
Typical symptom patterns are present!
Diagnostic Process for Anxiety Problems
Literatuur + Lectures 2
, Somatic — drug-induced anxiety.
Mental underlying — schizophrenia.
OCD and PTSD not classified as anxiety disorders anymore in the current DMS.
Social phobia is now more seen as social anxiety, due to not a sudden feeling and the repetitive negative thinking;
for example post-event processing (did is talk to much?) Exposure is the best option for social anxiety, but the post-
event processing counteract the sufficient effects of exposure.
GAD and Social Anxiety do not great in treatment
Most typical behavior for Anxiety, OCD or PTSD: Avoidance
The one behavior that influence the life of the patient the most and is the one behavior that is responsabel for
maintaining the behavior.
Patients try to alleviate the unpleasant feeling of anxiety by:
Avoiding the trigger
Developing a safety behavior (i.e. having someone else
accompany them)
If you do not target them during treatment, it has counter effects for treatment effects
Using a substance or medication — alcohol (mostly
Epidemiology of anxiety disorders
Lifetime prevalence for any anxiety disorder ranges from 10% to 29%
For men the numbers are lower.
12 month prevalence 18%
Literatuur + Lectures 3
, Women are much more likely to develop anxious feelings if you trigger them, but also cultural effect (boys are not aloud to show fear)
The mental disorder that start in early. Already anxiety at 3 years old. We have a clear timeline of what people are afraid of.
Development of fears/disorders
In infancy and early childhood, children are fearful of immediate, concrete threats in the environment.
Later: fears begin to incorporate anticipatory events and stimuli of an imaginary or abstract nature.
Spontaneous remissions from an anxiety disorder are frequent, but syndromal shifts frequently occur!
Both have the same physiological features: increase in respiration, perspiration, muscle tension, etc.
Etiology
If you have a good idea of the etiology; then treatment is possible (the idea what is happening is important for treatment)
Literatuur + Lectures 4
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