{"id":4189,"date":"2018-09-18T17:12:50","date_gmt":"2018-09-18T21:12:50","guid":{"rendered":"https:\/\/www.amyork.ca\/academic\/zz\/?p=4189"},"modified":"2019-05-26T00:22:04","modified_gmt":"2019-05-26T04:22:04","slug":"anxiety-disorders","status":"publish","type":"post","link":"https:\/\/www.amyork.ca\/academic\/zz\/abnormal-psychology\/anxiety-disorders\/","title":{"rendered":"Anxiety Disorders"},"content":{"rendered":"<ul>\n<li><strong>Anxiety<\/strong> = apprehension over an anticipated problems<\/li>\n<li><strong>Fear<\/strong> = a reaction to immediate danger<\/li>\n<li>Both fear and anxiety can involve arousal or sympathetic nervous system activity *both can be adaptive<\/li>\n<li>Anxiety involves moderate arousal, fear involves high arousal<\/li>\n<li>Fear is fundamental for fight or flight reactions<\/li>\n<li>Anxiety disorders \u2013 fear system misfires, when there is no real immediate danger<\/li>\n<li>Anxiety is adaptive in helping us plan for future threats<\/li>\n<li>Small degree of anxiety improves performance on laboratory tasks<\/li>\n<li>Anxiety has an inverse-U shaped relationship with test performance<\/li>\n<li>Most common type of psyc disorder, phobias in particular *28% report anxiety symptoms<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Associated with twice the average rate of medical costs, higher risk of cardiovascular disease, twice the risk of suicidal ideation and attempt<\/p>\n<p><strong>Clinical Description of Anxiety Disorders<\/strong><\/p>\n<p>1) Symptoms interfere with important areas of functioning or cause marked distress<\/p>\n<p>2) Symptoms are not caused by a drug or a medical condition<\/p>\n<p>3) Symptoms persist for at least 6 months or at least 1 month for a panic disorder<\/p>\n<p>4) The fear and anxieties are distinct from the symptoms of another anxiety disorder<\/p>\n<p>Specific Phobias<\/p>\n<ul>\n<li><strong>Specific phobia<\/strong> = a disproportionate fear caused by a specific object or situation<\/li>\n<li>Recognizes fear is excessive, goes to great lengths to avoid feared object\/situation \uf0b7 May elicit intense disgust<\/li>\n<li>Must be severe enough to cause distress\/interfere with job or social life *avoidance<\/li>\n<li>Common: Claustrophobia and Acrophobia (fear of heights) \uf0b7 Specific phobias are highly comorbid \uf0b7 Criteria:\n<ul>\n<li>Marked and disproportionate fear consistently triggered by specific objects or situations o The object or situation is avoided or else endured with intense anxiety o Symptoms persist for at least 6 months Social Anxiety Disorder<\/li>\n<\/ul>\n<\/li>\n<li><strong>Social anxiety disorder<\/strong> = a persistent, unrealistically intense fear of social situations that might involve being scrutinized by, or even exposed to, unfamiliar people<\/li>\n<li>Labeled as social phobia in DSM-IV-TR<\/li>\n<li>Feel as though all eyes are watching them, others waiting to evaluate them and record embarrassing acts<\/li>\n<li>Avoid social situations, feel social discomfort and experience symptoms for longer time than people who are shy<\/li>\n<li>Common fears: public speaking, speaking up in meetings or classes, meeting new people, talking to people in authority<\/li>\n<li>Those with broader array of fears more likely to experience comorbid depression and alcohol abuse<\/li>\n<li>Often work in occupations far below their talents<\/li>\n<li>1\/3 meet the criteria for avoidant personality disorder<\/li>\n<li>Generally begins during adolescence when peer relationships become particularly important \uf0b7 Tends to be chronic without treatment \uf0b7 Critera:\n<ul>\n<li>Marked and disproportionate fear consistently triggered by exposure to potential social scrutiny<\/li>\n<li>Exposure to the trigger leads to intense anxiety about being evaluated negatively o Trigger situations are avoided or else endured with intense anxiety o Symptoms persist for at least 6 months Panic Disorder<\/li>\n<\/ul>\n<\/li>\n<li><strong>Panic disorder<\/strong> = characterized by recurrent panic attacks that are unrelated to specific situations and by worry about having more panic attacks<\/li>\n<li><strong>Panic attack<\/strong> = a sudden attack of intense apprehension, terror and feelings of impending doom, accompanied by at least 4 other symptoms<\/li>\n<li>Physical symptoms: shortness of breath, head palpitations, nausea, upset stomach, chest pain, feelings of choking and smothering, dizziness, light headedness, faintness, sweating\/chills, heat sensation, numbness\/tingling and trembling<\/li>\n<\/ul>\n<p><strong>Depersonalization<\/strong> = a feeling of being outside one\u2019s body<\/p>\n<ul>\n<li><strong>Derealization<\/strong> = feeling of the world not being real<\/li>\n<li>Fear of losing control, going crazy or even dying<\/li>\n<li>Intense urge to flee<\/li>\n<li>Symptoms come on rapidly and peak within 10 minutes<\/li>\n<li>Feel amount of sympathetic nervous system arousal compared to normal when faced with immediate threat to life<\/li>\n<li>Must experience recurrent panic attacks that are unexpected<\/li>\n<li>Must worry about the attacks for at least 1 month<\/li>\n<li>Onset typically in adolescence, symptoms wax and wane over time \uf0b7 Criteria:\n<ul>\n<li>Recurrent unexpected panic attacks<\/li>\n<li>At least 1 month of concern about the possibility of more attacks, worry about the consequences of an attack, or maladaptive behavioral changes because of the attacks<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Agoraphobia<\/p>\n<ul>\n<li><strong>Agoraphobia<\/strong> = anxiety about situations in which it would be embarrassing or difficult to escape if anxiety symptoms occurred *e.g. crowds, crowded places or situations (trains, bridges, road trips)<\/li>\n<li>Unable to leave home<\/li>\n<li>Coded as subtype panic disorder in DSM-IV-TR<\/li>\n<li>At least half of people with agoraphobia do not experience symptoms of panic attacks \uf0b7 Related to significant impairment in daily functioning \uf0b7 Criteria:\n<ul>\n<li>Disproportionate and marked fear or anxiety about at least 2 situations where it would be difficult to escape or receive help in the event of incapacitation or panic-like symptoms, such as:\n<ul>\n<li>Being outside of the home alone; traveling on public transportation; open spaces such as parking lots and marketplaces; being in shops, theaters, or cinemas; standing in line or being in a crowd<\/li>\n<li>These situations consistently provoke fear or anxiety<\/li>\n<li>These situations are avoided, require the presence of a companion, or are endured with intense fear or anxiety<\/li>\n<\/ul>\n<\/li>\n<li>Symptoms last at least 6 months<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Generalized Anxiety Disorder<\/p>\n<ul>\n<li><strong>GAD<\/strong> = central feature is worry, persistently worried often about minor things<\/li>\n<li><strong>Worry <\/strong>= cognitive tendency to chew on a problem and to be unable to let go of it<\/li>\n<li>Cannot settle on a solution to the problem \uf0b7 Worry is excessive, uncontrollable and long-lasting \uf0b7 DSM Criteria:\n<ul>\n<li>1) Excessive anxiety and worry at least 50% of days about a number of events or activities<\/li>\n<li>2) The person finds it hard to control the worry<\/li>\n<li>3) The anxiety and worry are associated with at least 3 (or 1 in children) of the following:\n<ul>\n<li>Restlessness\/feeling keyed up\/on edge, easily fatigued, difficulty concentrating\/mind going blank, irritability, muscle tension, sleep disturbance<\/li>\n<\/ul>\n<\/li>\n<li>Typically begins in adolescence, often chronic<\/li>\n<li>More strongly related to marital dissatisfaction than any other anxiety disorder<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Comorbidity in Anxiety Disorders<\/p>\n<ul>\n<li>More than 50% meet criteria for another anxiety disorder during lifetime<\/li>\n<\/ul>\n<p>Highly comorbid with other disorders (75%)<\/p>\n<ul>\n<li>\u00be meet criteria for some other psyc disorder<\/li>\n<li>60% meet criteria for MDD (others: substance abuse, personality disorders, medical disorders) <strong>Gender and Cultural Factors in the Anxiety Disorders<\/strong><\/li>\n<\/ul>\n<p>Gender<\/p>\n<ul>\n<li>Women are more vulnerable than men (2:1 gender ratio)<\/li>\n<li>Women are more likely to report their symptoms, gender roles play a role<\/li>\n<li>Men face more pressure to face fears<\/li>\n<li>Women more likely to experience childhood sexual abuse<\/li>\n<li>Women show more biological reactivity to stress than men (HPA)<\/li>\n<\/ul>\n<p>Culture<\/p>\n<ul>\n<li>Culture and environment influence what people tend to fear<\/li>\n<li>Japan \u2013 fear of displeasing others<\/li>\n<li>Inuit \u2013 fear of being alone at sea and drowning<\/li>\n<li>Koro \u2013 fear that genitals will recede into body<\/li>\n<li>Shenkui \u2013 fear of loss of semen due to masturbation<\/li>\n<li>Susto \u2013 fear that fright has caused soul to leave body<\/li>\n<li>Rate of anxiety disorders varies by culture, ration of somatic to psychological symptoms is similar <strong>Common Risk Factors Across the Anxiety Disorders <\/strong><\/li>\n<\/ul>\n<p>Fear Conditioning<\/p>\n<ul>\n<li><strong>Mowrer\u2019s two-factor model<\/strong> = suggests 2 steps in the development of an anxiety disorder:\n<ul>\n<li>1) Classical conditioning \u2013 a person learns ot fear a neutral stimulus (CS) that is paired with an intrinsically aversive stimulus (UCS)<\/li>\n<li>2) A person gains relief by avoiding CS, through operant conditioning, this avoidant response is maintained because it is reinforcing (reduces fear) *helps maintain phobia \uf0b7 Different ways in which classical conditioning could occur:<\/li>\n<li>1) Direct experience (e.g. dog bite)<\/li>\n<li>2) Modeling (e.g. witnessing a dog bite someone)<\/li>\n<li>3) Verbal instruction (e.g. hearing a parent warn that dogs are dangerous)<\/li>\n<\/ul>\n<\/li>\n<li>People with anxiety disorders acquire fears through classical conditioning more readily, and show slower extinction once fear is acquired<\/li>\n<\/ul>\n<p>Genetic Factors<\/p>\n<ul>\n<li>Heritability of 20-40% for specific phobias, social anxiety disorder and GAD \uf0b7 50% for panic disorder<\/li>\n<\/ul>\n<p>Neurobiological Factors: The Fear Circuit and the Activity of Neurotransmitters<\/p>\n<ul>\n<li><strong>Fear circuit<\/strong> = set of brain structures that are engaged when people feel anxious or fearful<\/li>\n<li>Includes the amygdala (temporal lobe) \u2013 involved in assigning emotional significance to stimuli<\/li>\n<li><strong>Medial prefrontal cortex<\/strong> = helps to regulate activity of amygdala, involved in extinguishing fears and appears to be engaged when people are regulating their emotions o Less activity when viewing appraising threatening stimuli in anxiety disorders<\/li>\n<li>Pathway connecting medial prefrontal cortex and amygdala may be deficient<\/li>\n<li>Disruptions in serotonin and GABA receptors<\/li>\n<li>GABA is believed to help inhibit anxiety<\/li>\n<li>Increased levels of norepinephrine and changes in receptor sensitivity o Key in activation of SNS, for fight or flight responses<\/li>\n<\/ul>\n<p>Personality: Behavioural Inhibition and Neuroticism<\/p>\n<p><strong>Behavioural inhibition<\/strong> = tendency to become agitated and cry when faced with novel toys, people, or other stimuli<\/p>\n<ul>\n<li>May be inherited and set the stage for later development of anxiety disorders<\/li>\n<li>Strong predictor of social anxiety disorder<\/li>\n<li><strong>Neuroticism<\/strong> = personality trait defined by tendency to experience frequent\/intense negative affect <strong>o <\/strong>Predicts onset of anxiety disorders and depression, 2x as likely with high levels<\/li>\n<\/ul>\n<p>Cognitive Factors<\/p>\n<ul>\n<li>Sustained Negative Beliefs About the Future:\n<ul>\n<li>Believe that bad things are going to happen<\/li>\n<li><strong>Safety behaviours<\/strong> = behaviours that maintain feared beliefs (e.g. stop all physical activity if believe they will die from fast heart rate)<\/li>\n<li>Believe only their safety behaviours are what have kept them alive \uf0b7 Perceived Lack of Control:<\/li>\n<li>May be promoted by childhood traumatic events, punitive parenting or abuse o Often develop after serious life events that threaten the sense of control over one\u2019s life o More than 70% report serious life event before onset of disorder \uf0b7 Attention to Threat:<\/li>\n<li>Pay more attention to negative cues in environment than those w\/o anxiety disorder o Heightened attention to threatening stimuli *automatically and quickly<\/li>\n<li>Stay focused on threatening object longer than others do<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>Etiology of Specific Anxiety Disorders<\/strong><\/p>\n<p>Etiology of Specific Phobias<\/p>\n<ul>\n<li>2-factor model of behavioural conditioning (classical and operant)<\/li>\n<li>Specific phobias seen as a conditioned response that develops after a threatening experience and is maintained by avoidant behaviour<\/li>\n<li>Phobias could be conditioned by direct trauma, modeling, or verbal instruction<\/li>\n<li>People may forget conditioning experiences that lead to phobia<\/li>\n<li>Only certain kinds of stimuli and experiences will contribute to the development of a phobia o Could have evolutionary\/adaptability basis\n<ul>\n<li><strong>Prepared learning<\/strong> = evolution may have prepared our fear circuit to learn fear of certain stimuli very quickly and automatically<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Etiology of Social Anxiety Disorder<\/p>\n<ul>\n<li>Behavioural Factors: Conditioning of Social Anxiety Disorder:\n<ul>\n<li>2-factor conditioning model<\/li>\n<li>Negative social experience can lead to conditioned fear of stimulus, person avoids those situations\/stimuli<\/li>\n<li>Safety behaviours: avoiding eye contact, disengaging from conversation, standing apart from others<\/li>\n<\/ul>\n<\/li>\n<li>Cognitive Factors: Too Much Focus on Negative Self-Evaluations:\n<ul>\n<li>Unrealistically negative beliefs about the consequences of their behaviour<\/li>\n<li>Attend more to how they are doing in social situations and their own internal sensations than most people do<\/li>\n<li>Overly negative in evaluating their social performance<\/li>\n<li>Attend more to internal cues than external<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Etiology of Panic Disorder<\/p>\n<ul>\n<li>Neurobiological Factors:\n<ul>\n<li><strong>Locus coeruleus<\/strong> = major source of norepinephrine in the brain<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>Surges of norepinephrine are a natural response to stress, associated with increased activity of sympathetic nervous system\n<ul>\n<li>Faster heart rate, other fight or flight responses o W\/anxiety disorder, show more dramatic biological response to drugs that trigger release of norepinephrine<\/li>\n<\/ul>\n<\/li>\n<li>Drugs that increase activity in locus coeruleus can trigger panic attacks, decrease (clonidine and antidepressants) decrease risk of panic attacks<\/li>\n<\/ul>\n<p>Behavioural Factors: Classical Conditioning<\/p>\n<ul>\n<li>Panic attacks are often triggered by internal bodily sensations of arousal<\/li>\n<li>Panic attacks are classically conditioned responses to situations that trigger anxiety or internal bodily sensations of arousal<\/li>\n<li><strong>Interoceptive conditioning<\/strong> = classical conditioning of panic attacks in response to bodily sensations \uf0b7 Cognitive Factors in a Panic Disorder:\n<ul>\n<li>Focus on catastrophic misinterpretations of somatic changes<\/li>\n<li>Panic attacks develop when a person misinterprets bodily sensations as signs of impeding doom (increased heart rate = heart attack)<\/li>\n<li><strong>Anxiety sensitivity index<\/strong> = measures the extent to which people respond fearfully to their bodily sensations\n<ul>\n<li>Can predict onset of panic attacks in longer-term studies<\/li>\n<\/ul>\n<\/li>\n<li>Putting it All Together: A Gene that Influences Neurobiological and Psychological Risk Factors for Panic Disorder:\n<ul>\n<li>Polymorphism in gene guiding neuropeptide S function \u2013 NPSR1 gene \u2013 tied to increased risk of panic disorder<\/li>\n<li>Neuropeptide S related to anxiety-like behaviours in mice<\/li>\n<li>NPSR1 gene related to increased amygdala response to threat stimuli, larger cortisol response to stressor, higher anxiety sensitivity scores<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Etiology of Agoraphobia<\/p>\n<ul>\n<li>Related to genetic vulnerability and life events<\/li>\n<li><strong>Fear-of-fear hypothesis<\/strong> = agoraphobia is driven by negative thoughts about the consequences of experiencing anxiety in public<\/li>\n<\/ul>\n<p>Etiology of GAD<\/p>\n<ul>\n<li>Tends to co-occur with other anxiety disorders<\/li>\n<li>People who meet diagnostic criteria are much more likely to experience episodes of MDD<\/li>\n<li>Seems to involve general tendency to experience general distress more than a specific pattern of intense fear<\/li>\n<li>Related to a more amorphous profile of general distress<\/li>\n<li>Worry is reinforcing because it distracts people from more powerful negative emotions and images<\/li>\n<li>Worry does not involve powerful visual images and doesn\u2019t produce the physiological changes that accompany emotion<\/li>\n<li>More of a repetitive self-talk about bad things that might happen<\/li>\n<li>Worrying decreases psycho-physiological arousal<\/li>\n<li>Maltreatment predicts a 4 fold risk of developing GAD *worry distracts from remembering trauma<\/li>\n<li>People with GAD may be avoiding emotions<\/li>\n<li>People who have a hard time accepting ambiguity are more likely to worry and develop GAD<\/li>\n<\/ul>\n<p><strong>Treatment of Anxiety Disorders<\/strong><\/p>\n<ul>\n<li>Most individuals visit a family doctor for treatment and are prescribed benzodiazepines Commonalities Across Psychological Treatments<\/li>\n<\/ul>\n<p>Common focus: exposure<\/p>\n<ul>\n<li>CBT begins by making a list of <strong>triggers<\/strong> = situations and activities that might elicit anxiety or fear<\/li>\n<li>Create an <strong>exposure hierarchy<\/strong> = a graded list of the difficulty of these triggers<\/li>\n<li>Begin with exposure to less challenging triggers<\/li>\n<li>Exposure treatment is effective for 70-90% of clients<\/li>\n<\/ul>\n<p>1) Exposure should include as many features of the feared objects as possible<\/p>\n<p>2) Exposure should be conducted in as many different contexts as possible<\/p>\n<ul>\n<li>Works by extinguishing the fear response<\/li>\n<li>Extinction involves learning new associations to stimuli related to the feared stimulus *which inhibit activation of fear<\/li>\n<li>Extinction involves learning not forgetting<\/li>\n<li>Cognitive &#8211; Exposure helps people correct their mistaken beliefs that they are unable to cope with the stimulus o Relieves symptoms by allowing people to believe that they can tolerate aversive situations o Focus on: 1) Challenging a person\u2019s beliefs about the likelihood of negative outcomes if he faces an anxiety-evoking situation, and 2) Challenging the expectation that he will be unable to cope<\/li>\n<li>Exposure to simulated situations can be just as effective as <strong>in-vivo<\/strong> exposure<\/li>\n<\/ul>\n<p>Psychological Treatments of Specific Anxiety Disorders \uf0b7 Psychological Treatment of Phobias:<\/p>\n<ul>\n<li>Exposure treatment including <strong>in-vivo<\/strong> exposure to feared objects o Brief treatments lasting only a couple hours can be very effective \uf0b7 Psychological Treatment of Social Anxiety Disorder:<\/li>\n<li>Exposure therapy<\/li>\n<li>Begin with role playing with therapist or small therapy group o Prolonged exposure can typically extinguish anxiety<\/li>\n<li>Teach clients to stop using safety behaviour (e.g. avoiding eye contact) o Learn not to focus attention internally \uf0b7 Psychological Treatment of Panic Disorder:<\/li>\n<li>CBT focuses on exposure<\/li>\n<li><strong>Panic control therapy<\/strong> (PCT) = based on the tendency of people with panic disorder to over react to the bodily sensations\n<ul>\n<li>Therapist uses exposure \u2013 persuades client to deliberately elicit bodily sensations associated with panic<\/li>\n<li>Learn to stop seeing physical symptoms as signals of los of control \uf0b7 Psychological Treatment of Agoraphobia:<\/li>\n<\/ul>\n<\/li>\n<li>CBT focuses on exposure \u2013 systematic exposure to feared situations<\/li>\n<li>Gradually coached to tackle leaving home, driving a couple miles away, sitting in a public place for a short amount of time<\/li>\n<li>Enhanced results when patient\u2019s partner is involved in exposure \uf0b7 Psychological Treatment of GAD:<\/li>\n<li>Behavioural technique \u2013 relaxation training to promote calmness o g. muscle relaxation or generating calming images<\/li>\n<li>Cognitive therapies to target worry \u2013 asking them to worry only during scheduled times<\/li>\n<\/ul>\n<p>Medications That Reduce Anxiety<\/p>\n<ul>\n<li><strong>Anxiolytics<\/strong> = drugs that reduce anxiety<\/li>\n<\/ul>\n<p><strong>Benzodiazepines<\/strong> e.g. Valium, Xanax &amp; <strong>antidepressants<\/strong> e.g. SSRIs, <strong>serotonin-norepinephrine reuptake inhibitors <\/strong>(SNRIs)<\/p>\n<ul>\n<li>Benzodiazepines referred to as mild tranquilizers\/sedatives<\/li>\n<li>Provide more benefits than placebos<\/li>\n<li>Use <strong>buspirone<\/strong> for GAD<\/li>\n<li>Antidepressants are preferred over benzodiazepines *severe withdrawal symptoms due to addictiveness, cognitive and motor side effects, increased risk of car accidents<\/li>\n<li>Compared to tricyclic antidepressants, SSRIs and SNRIs tend to have fewer side effects *first choice o Can experience: restlessness, insomnia, headache, diminished sexual functioning<\/li>\n<li>Many people relapse once they stop taking medications<\/li>\n<li>Psychological treatment is preferred method with exception of for GAD<\/li>\n<\/ul>\n<p>Medication to Enhance Learning During Psychological Treatment<\/p>\n<ul>\n<li><strong>D-cycloserine<\/strong> (DCS) = a drug that enhances learning *used to bolster exposure treatment<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Anxiety = apprehension over an anticipated problems Fear = a reaction to immediate danger Both fear and anxiety can involve arousal or sympathetic nervous system activity *both can be&hellip; <a class=\"continue\" href=\"https:\/\/www.amyork.ca\/academic\/zz\/abnormal-psychology\/anxiety-disorders\/\">Continue Reading<span> Anxiety Disorders<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[104],"tags":[],"_links":{"self":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4189"}],"collection":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/comments?post=4189"}],"version-history":[{"count":2,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4189\/revisions"}],"predecessor-version":[{"id":4908,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4189\/revisions\/4908"}],"wp:attachment":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/media?parent=4189"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/categories?post=4189"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/tags?post=4189"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}