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Psych > 3. Anxiety and adjustment disorders > Flashcards

3. Anxiety and adjustment disorders Flashcards

1
Q

What are some neurotransmitter imbalances seen in anxiety disorder? (3)

A
  • Increased activity of Norepi
  • Decreased activity of GABA
  • Decreased activity of serotonin
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2
Q

Panic attack criteria

A

PANICS

  • palpitations
  • abdominal distress
  • numbness, nausea
  • intense fear of death
  • choking, chills, chest pain
  • sweating, shaking, SOB
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3
Q

What is the time-frame of panic attacks? (peak and how long it lasts)

A
  • peak within 10 min

- usually lasts <25 min

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4
Q

Difference b/w panic attack and panic disorder?

A

Panic disorder = spontaneous RECURRENT panic attacks w/ NO OBVIOUS precipitant

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5
Q

How often do pts w/ panic disorder get panic attacks?

A
  • on avg, 2x per week

but may range from several times/day to few times/yr

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6
Q

What is the criteria for panic disorder? (3)

A

At least 1 of the attacks followed by minimum of 1 month of following:

  • persistent concern about having additional attacks
  • worry about implications of the attack (ex. “going crazy”)
  • sig change in behavior related to the attacks (ex. avoidance of situations that may provoke attacks)
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7
Q

What is the etiology of panic disorder?

A

Dysregulation of ANS, CNS, and cerebral blood flow

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8
Q

What’s the avg age of onset for panic disorder?

A

Late teens to early 30s (avg 25 yo)

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9
Q

What dose do you start SSRIs in panic disorder pts?

A

Low dose and increase slowly (b/c some SSRIs have s/es that may initially worsen anxiety)

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10
Q

What tx is best for immediate treatment of panic disorder?

A

Benzodiazepines (b/c it’s effective immediately); but are best used TEMPORARILY b/c of risk of causing tolerance and dependency

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11
Q

What % of agoraphobia pts have coexisting panic disorder?

A

50-75%

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12
Q

Difference in prognosis of agoraphobia w/ coexisting panic disorder and agoraphobia not associated w/ panic disorder

A
  • agoraphobia w/ panic disorder = when panic disorder is treated, agoraphobia usually resolves
  • when not associated w/ panic disorder, usually chronic and debilitating
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13
Q

What is social phobia/social anxiety disorder?

A

Fear of social situations in which embarrassment can occur

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14
Q

What is a psychiatric disorder that is often associated w/ phobic pts?

A

Major depression

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15
Q

Gender differences in specific phobia vs. social phobia?

A

W>M (by 2 times) for specific phobia

W=M for social phobia

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16
Q

Tx for performance anxiety?

A

Beta blocker

17
Q

Systemic desensitization vs. flooding

A

Systemic desensitization = gradual exposure of a pt to the feared object/situation while teaching relaxation and breathing techniques

Flooding = directly confronting pt with their full fear

18
Q

What are other comorbid disorders with OCD?

A

Tourette syndrome and ADHD

19
Q

What neurochemical abnormality is present in OCD?

A

abnormal regulation of serotonin

20
Q

What medical conditions is OCD associated w/? (4)

A

head injury, epilepsy, basal ganglia disorders, postpartum conditions

21
Q

The onset of OCD is often triggered by?

A

stressful life event in approx 60% of pts

22
Q

What is “exposure and response prevention”?

A

Prolonged exposure to ritual-eliciting stimulus and prevention of the relieving compulsions (ex. pt must touch the dirty floor without washing his/her hands)

23
Q

What last resort tx can be used for treatment-resistant OCD?

A

ECT or cingulotomy (surgery)

24
Q

What are the diagnostic criteria for PTSD? (4)

A
  1. Presence of traumatic experience
  2. Persistent avoidance (ex. of a location that will remind pt of event)
  3. Hyperarousal (or increased psychological and/or physiological tension) - ex. difficulty sleeping, outbursts of anger, hypervigilance, exaggerated startle response
  4. Re-experiencing the traumatic event (dreams, flashbacks)
    ALL FOR MORE THAN 1 month
25
Q

Common comorbidities with PTSD? (2)

A
  • substance abuse

- depression

26
Q

PTSD vs. acute stress disorder?

A

PTSD = event occurred at any time in past
- symptoms last > 1month

Acute stress disorder = event occurred less than 1 month ago
- symptoms last <1 month

27
Q

Timeline for diagnosis of GAD? (duration of symptoms)

A

> 6 months

28
Q

What are 6 symptoms of GAD? (need 3 to qualify for dx)

A

restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance

29
Q

What is the lifetime prevalence of GAD?

A

45%

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