05a_Anxiety disorders

Question 1

“Pure” Anxiety Symptoms

Answer 1

ANS arousal

Apprehension

Tension

Trembling

Excessive worry

Nightmares

Question 2

“Pure” Depression Symptoms

Answer 2

Depressed mood

Anhedonia

Loss of interest in usual activities

Suicidal ideation

Decreased libido

Question 3

Separation Anxiety Disorder:

Three Developmentally inappropriate and Excessive fears

Answer 3

Separation from home or attachment figures

Fear of being alone

Physical Complaints

Question 4

Separation Anxiety Disorder:

Duration criteria

Answer 4

4+ weeks = Children and adolescents

6+ months = Adults

Question 5

Separation Anxiety Disorder:

Three Age Ranges associated with School Refusal

Answer 5

5-7yo

10-11yo

14-16yo

Question 6

Separation Anxiety Disorder:

Frequent Precipitating Stressors

Answer 6

Death of a relative or pet

Parental divorce

Move to new neighborhood

Question 7

Separation Anxiety Disorder:

Differential diagnosis

Answer 7

Developmentally appropriate separation anxiety

Agoraphobia

GAD

Conduct disorder

SAD

Question 8

Separation Anxiety Disorder:

Treatment

Answer 8

Systematic desensitization and other behavioral interventions

Cognitive approaches for older children and adolescents

Question 9

School refusal:

Primary goal of treatment

Answer 9

Immediate return to school

Limit academic failure, social isolation, and other secondary impairments

Question 10

Specific phobia:

Duration criteria

Answer 10

6+ months

Question 11

Specific phobia:

Subtypes

Answer 11

Animal

Natural environment

Blood-injection-injury

Situational

Question 12

Specific phobia:

Etiology

Answer 12

Abnormal levels of 5HT, NE, GABA

Cognitive factors

Classical conditioning

Question 13

Specific phobia:

Two-factor Theory

Answer 13

Phobia is developed through Classical Conditioning

Phobia is maintained through Operant Conditioning
Negative Reinforcement of Avoidance

Question 14

Specific phobia:

Treatment

Answer 14

In vivo exposure

Cognitive self-control

Question 15

Social Anxiety Disorder (social phobia):

Duration criteria and symptoms

Answer 15

6+ months

Fear of negative evaluation

Avoidance of situations
*Or endurance with intense anxiety

Question 16

Social Anxiety Disorder:

Potential Etiology

Answer 16

Behavioral inhibition temperament

Selective attention

Question 17

Social Anxiety Disorder:

Treatment

Answer 17

ERP

Social skills training or cognitive restructuring

Pharmacotherapy, including beta blockers

Question 18

Panic Disorder:

Diagnostic Criteria

Answer 18

1+ panic attack

1+ month of persistent concern about additional attacks

4+ characteristic symptoms

Question 19

Panic attack:

Characteristic symptoms

Answer 19

Palpitations or accelerated heart rate

Sweating

Trembling

Feelings of choking

Chest pain or discomfort

Paresthesias

Derealization or depersonalization

Fear of losing control

Question 20

Panic Attack:

Definition

Answer 20

Abrupt surge of intense fear or intense discomfort

Reaches a peak within minutes

Question 21

Panic Disorder:

Rule outs

Answer 21

Hyperthyroidism

Hypoglycemia

Cardiac arrhythmia

Other medical conditions

Question 22

Panic Disorder:

Prevalence

Answer 22

2-3% for adolescents and adults

Females 2:1

Question 23

Panic Disorder:

Primary reason children do not receive diagnosis

Answer 23

Cognitive limitations preclude catastrophic interpretations of bodily symptoms

Question 24

Panic Disorder:

Treatment

Answer 24

Exposure

Panic control therapy (PCT)

Pharmacotherapy
*High risk for relapse when used alone

Question 25

Agoraphobia: Feared situations

Answer 25

Public transportation Open or enclosed spaces Lines / Crowds Outside of home alone

Question 26

Agoraphobia: Diagnostic Criteria

Answer 26

2+ feared situations 6+ months

Question 27

Agoraphobia: Differential diagnosis: specific phobia

Answer 27

Phobia typically involves only a single situation Phobia is not mainly focused on panic-like, incapacitating, or embarrassing symptoms

Question 28

Agoraphobia: Differential diagnosis: Social Anxiety Disorder

Answer 28

SAD = Fear of Negative Evaluation *Anxiety increases in the presence of a family member or friend Agoraphobia: friend/family reduces anxiety ("safe person")

Question 29

Agoraphobia: Treatment

Answer 29

In vivo exposure

Question 30

Generalized Anxiety Disorder: Diagnostic criteria

Answer 30

Excessive anxiety and worry about multiple domains 6+ months 3+ characteristic symptoms

Question 31

Generalized Anxiety Disorder: Characteristic Symptoms

Answer 31

Restlessness or feeling keyed up or on edge Being easily fatigued Difficulty concentrating Irritability Muscle tension Sleep disturbance

Question 32

Generalized Anxiety Disorder: Comorbidity

Answer 32

*Highest comorbidity rate of all anxiety disorders** 50% have additional diagnoses 90% have 1 other lifetime psychiatric diagnosis

Question 33

Generalized Anxiety Disorder: Comorbidities, highest to lowest frequency

Answer 33

MDD or PDD Substance use disorder Simple phobia Social anxiety disorder

Question 34

Generalized Anxiety Disorder: Age-related focus of Worry

Answer 34

Children and adolescents: performance in school, sports, and natural disasters Young adults: work, family, finances, future Older adults: personal health, minor/routine matters

Question 35

Generalized Anxiety Disorder: Treatment

Answer 35

CBT Combination of CBT and pharmacotherapy

Question 36

Generalized Anxiety Disorder: Two pharmacotherapy choices when individual is nonresponsive to SSRI or SNRI

Answer 36

Benzodiazepine Buspirone (BuSpar)