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Anxiety Disorders and Developmental Attachment

Introduction

1. Early adversity, and particularly _____ — related trauma, is related to increased risk for anxiety disorders throughout the life span.

A. Physical

B. Emotional

C. Attachment

D. Sexual


Anxiety Disorders

2. It is estimated that anxious children are between 8 and 29 times more at risk for _____ than non-anxious children.

A. Suicidality

B. Depression

C. Self-harm behaviors

D. All of the above


Factors Contributing to the Development of Anxiety Disorders

3. Children with anxiety disorders are more likely to have a parent with an anxiety disorder.

A. True

B. False


4. Anxiety processing and responses rely on specific areas of the brain that perform unique functions.

A. True

B. False


5. Accruing evidence suggests that the neural correlates of anxiety disorders involve an abnormally elected activation pattern in the:

A. Limbic structures

B. Cerebrum

C. Cerebellum

D. All of the above


6. It appears that the prefrontal-amygdala circuit mediates which basic mechanism involved in human anxiety?

A. Attention to threat.

B. Interpretation of stimuli.

C. Acquisition and extinction of conditioned fear.

D. All of the above.


7. Studies have demonstrated that, in the presence of risk factors such as early adversity and stressful events, secure attachment can act as a protective factor moderating the potential for development of psychopathology via the impact on stress regulation.

A. True

B. False


8. Overcontrol and the concomitant discouragement of independence are likely to limit the child’s sense of agency and competence and to reinforce avoidance of potentially threatening situations.

A. True

B. False


9. Of all aspects of parenting style, a low level of _____ was the one most reliably associated with anxiety disorders in children.

A. Parent-child attachment

B. Autonomy granting

C. Warmth

D. All of the above


Attachment Experiences and Stress Regulation

10. Over time, if the attachment figure is reliably available, attentive, and responsive, a secure attachment develops.  This attachment is characterized by:

A. Experiences of reassurance.

B. A sense of safety.

C. Effective affect regulation.

D. All of the above.


11. Securely attached individuals can efficiently regulate stress and anxiety by:

A. Seeking proximity to a reliable attachment figure in their actual environment.

B. Mentally drawing upon past experiences in which stress was effectively co-regulated.

C. Either (A) or (B).

D. None of the above.


12. A mother’s mentalizing ability, that is, the parent’s ability to treat the child as a psychological agent with mental states independent of their own, predicts:

A. Secure attachment.

B. Their child’s own capacity to mentalize.

C. Both (A) and (B).

D. None of the above.


13. Studies investigating stress responsivity in both human and animals have demonstrated that a secure attachment leads to an “adaptive hyperactivity” of the HPA-axis.

A. True

B. False


14. Which of the following has been associated with the development of anxiety disorders?

A. Anxious attachment patterns.

B. Disorganized attachment patterns.

C. Both anxious and disorganized attachment patterns.

D. None of the above.


15. Childhood anxiety classification is predictive of anxiety symptoms which in turn predicts negative adolescent peer relationships.

A. True

B. False


16. In adults, hyperactivation has been found to result in an altered and more sensitive HPA-axis and to have direct effects on reducing hippocampal cell density which might reflect a stress-driven neurotoxic impact on the glucocorticoid system.

A. True

B. False


17. Which of the following brain areas has been consistently shown to underpin mentalization?

A. Medial PFC

B. Superior temporal sulcus

C. Temporal lobes

D. All of the above


18. Which of the following has been shown to results in a relative deactivation of core areas associated with mentalization?

A. Attachment-related (interpersonal) stress induction.

B. General stress induction.

C. Both (A) and (B).

D. None of the above.


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