19. Anxiety Disorders Flashcards Preview

M2 Psychiatry > 19. Anxiety Disorders > Flashcards

Flashcards in 19. Anxiety Disorders Deck (41)
1

what are the 3 major anxiety disorders?

panic d/o, generalized anxiety d/o, OCD

2

given that anxiety is a normal response to threat, when does anxiety become maladaptive?

when the level is too high, when it is uncontrolled (do not abate in reasonable amt of time), when it is inappropriate to the situation

3

a few key features of a panic attack?

partially a sympathetic reaction: palpitations, sweating, trembling/shaking, SOB, choking, chest pain/pressure, N/D, dizziness

4

what is the Yerkes-Dodson Law about arousal and performance?

at medium arousal level you will perform your best: too much or too little stress and you will underperform

5

what is psychotic vs neurotic ways of being?

psychotic: disorganized, not integrated
neurotic: rigidly organized, overcontrolled

6

what is the difference between a panic disorder and a panic attack?

attacks are cued, usually have a specific stimulus. could be a phobia.
panic disorder is fear of the attacks themselves and the internal sensations that accompany the attacks. uncued, unpredictable

7

panic disorder, specific phobias, social anx disorder, agoraphobia: what characterizes all these?

fear and avoidance (as opposed to distress)

8

specific phobias: what cues them?

presence of a specific object or situation (flying, heights, animals, blood)

9

define social anxiety disorder

fear of embarrassment, scrutiny

10

define agoraphobia

fear of spaces that cannot be escaped from

11

example of a safety behavior?

in agoraphobia, "safety person". someone who pt can leave the house with

12

evolutionary basis for specific phobias?

ex: blood phobia is adaptive because it slows down HR (we faint, stop pumping blood as fast)

13

what sustains fear and avoidance disorders?

operant conditioning: positive and negative feedback

14

with operant conditioning, what is negative reinforcement?

increases the behavior by removal or prevention of the negative experience

15

GAD: what is the primary feature?

WORRY. made worse by uncertainty, ambiguity

16

what does it mean for GAD to be ego syntonic?

worry is about things that are in harmony with or acceptable to the needs/goals of the ego. pt may have decided that worry is part of their personality.

17

GAD stereotype? what can go wrong?

high achievers, planful. problems when an event throws off the plan and they can't adapt. may worry even about things that are relatively mundane.

18

what can be a positive feature of worry?

it can distract from difficult emotional content.

19

common comorbid conditions with GAD?

GI symptoms, aches and pains

20

GAD: psychotic or neurotic end of the spectrum?

neurotic

21

OCD: overall prevalance greatest in what populations?

boys and adult women

22

4 common symptoms of compulsions?

-symmetry/ordering
-hoarding
-contamination
-obsessions/checking

23

insight in OCD?

most people with OCD have insight that allows them to not be delusional: they know that their thoughts are abnormal, yet still have to comply with the checking in order to feel at ease/be able to relax

24

pt suffers anxiety every day for much of life: dx?

GAD

25

pt experiences symptoms intensely/abruptly for no apparent reason: dx?

panic d/o

26

pt has anxiety in presence of specific stimulus or environment: dx?

specific phobia, agoraphobia, social anxiety

27

pt has sx when reminded of a specific event: dx?

PTSD

28

pt has compulsive rituals that have become the source of anxiety: Dx?

OCD

29

sense of impending doom: dx?

panic disorder

30

what is one bad result from panic disorder?

patient's lifestyle may become restricted because of need to avoid situations where panic has occurred, or may require that locations have easy escape routes. may coexist with agoraphobia

31

tx for panic disorder?

-CBT (cognitive restructuring, exposure therapy) -pharmacotherapy (SSRIs most commonly used)

32

how does GAD compare to panic?

generally less severe but more continuous. worried/tense rather than terrified

33

tx for GAD?

multimodal: CBT, meditation and SSRIs/SNRIs

34

somatic experiences in phobic disorders such as social phobia and specific phobias?

tachycardia, sweating, flushing

35

tx for phobic disorders?

-make sure not secondary to panic, depression, schiz
-CBT (exposure, cog restructuring). propanolol.

36

cardinal sx of OCD?

intrusive thought and ritual which the pt experiences as alien but is powerless to control.

37

tx for OCD?

CBT, clomipramine (tricyclic), SSRIs (fluoxetine, fluvoxamine). usually behavioral and pharm tx used together.

38

describe exposure therapy?

repeated and prolonged exposure to feared stimuli resulting in reduced anxiety

39

describe cognitive restructuring (type of CBT)?

challenging mis-interpretations/over-assumptions
de-catastrophizing

40

front line pharm for anxiety?

SSRIs, SNRIs

41

CBT vs pharm tx: what is most effective?

meds + CBT more effective than either solo