Anxiety Disorders in Young People

Question 1

State at least 4 types of anxiety disorder in young people

Answer 1

Separation anxiety disorder, generalised anxiety disorder, social anxiety disorder, agoraphobia, specific phobias, panic disorder,

Question 2

Define social anxiety disorder

Answer 2

The fear of being perceived as foolish or stupid, resulting in avoidance of being the focus of attention (e.g. avoiding eating or talking in public)

Question 3

Define agoraphobia

Answer 3

Extreme fear and avoidance of crowds, public places, and independent travel

Question 4

Define panic disorder

Answer 4

Repeated experience of unprovoked panic attacks with intense fear and physical symptoms

Question 5

Why was obsessive compulsive disorder separated from anxiety disorders in DSM-V?

Answer 5

Its compulsive element

Question 6

Other than obsessive compulsive disorder, which other disorders are classed as compulsive?

Answer 6

Body dysmorphic disorder, hoarding disorder, trichotillomania, excoriation (skin-picking disorder)

Question 7

What is the core feature of all anxiety disorders?

Answer 7

Withdrawal

Question 8

State some typical features of anxiety disorders

Answer 8

Hesitancy, withdrawal, ritualised actions, fearfulness, distrust, shyness, expectation of threat, rumination, negative thoughts

Question 9

State some physical symptoms of anxiety disorders

Answer 9

Difficulty sleeping, tension headache, dizziness, hyperventilation, ‘lump in the throat’ causing difficulty swallowing, shortness of breath, chest pain, abdominal pain, bowel urgency, bladder urgency

Question 10

How many people diagnosed with an anxiety disorder have more than one?

Answer 10

75%

Question 11

How many people diagnosed with an anxiety disorder have a comorbid mental health disorder?

Answer 11

80-90%

Question 12

Name the three most common comorbid mental health disorders with child or adolescent anxiety disorders

Answer 12

Depression, conduct disorder, ADHD

Question 13

What percentage of treatment-seeking children with anxiety meet the criteria for an additional mood disorder?

Answer 13

10-15%

Question 14

What percentage of treatment-seeking adolescents with anxiety meet the criteria for an additional mood disorder?

Answer 14

30%

Question 15

State the three components of an anxiety disorder assessment in young people

Answer 15

Questionnaire, diagnostic interview, behavioural observation

Question 16

State a difficulty in assessing a young person for an anxiety disorder

Answer 16

The young person may ‘fake being good’ and provide answers they believe to be socially acceptable rather than the truth

Question 17

State a difficulty in interviewing a young person’s parent about their child’s anxiety

Answer 17

Anxious parents may exaggerate their child’s symptoms

Question 18

Over what age should children with a suspected anxiety disorder be interviewed separately from their parents?

Answer 18

8

Question 19

How is the primary disorder identified?

Answer 19

It is the one which produces the greatest impact on and interference with the young person’s life

Question 20

What is the prevalence of child and adolescent anxiety disorders in Western populations?

Answer 20

5%

Question 21

What is the most common anxiety disorder in childhood and adolescence?

Answer 21

Specific phobia

Question 22

What is the second most common anxiety disorder in childhood and adolescence?

Answer 22

Separation anxiety

Question 23

What is the male to female ratio of anxiety disorder prevalence?

Answer 23

1:1.5-2

Question 24

What is the male to female ratio of individuals with anxiety disorder seeking treatment?

Answer 24

1:1

Question 25

Describe the relationship between development of fears and anxiety disorders

Answer 25

The development of normal fears and anxiety disorders coincide - for example, specific animal phobias tend to have an onset before 5, whereas social phobia tends to start at puberty

Question 26

What is the average age of onset for generalised anxiety disorder? (de Lijster et al, 2017)

Answer 26

10-12 years

Question 27

What is the average age of onset for social anxiety disorder? (de Lijster et al, 2017)

Answer 27

11-13 years

Question 28

What is the average age of onset for panic disorder? (de Lijster et al, 2017)

Answer 28

22-24 years

Question 29

What is the average age of onset for obsessive-compulsive disorder? (de Lijster et al, 2017)

Answer 29

13-15 years

Question 30

Describe the association between anxiety disorders and parental marital status

Answer 30

There isn’t one

Question 31

How can parenting characteristics affect the risk of developing an anxiety disorder?

Answer 31

Overprotection, intrusiveness, and negativity are associated with anxiety disorders - although the extent to which these cause anxiety vs develop due to the child exhibiting anxiety is debated

Question 32

State at least 3 risk factors for developing an anxiety disorder

Answer 32

Family history, general neuroticism and inhibition, exposure to violence, overprotective and intrusive parenting

Question 33

How much of the risk of developing an anxiety disorder is attributed to genetics? (Gregory & Eley, 2007)

Answer 33

40%

Question 34

Give 3 maintaining factors of anxiety disorders

Answer 34

Bullying peer rejection or neglect, cognitive biases (heightened threat beliefs and expectations)

Question 35

Describe the relationship between anxiety disorder and major depression

Answer 35

Childhood anxiety may be followed by major depression later in life

Question 36

Name the 3 main neurotransmitters involved in anxiety disorders

Answer 36

Gamma-hydroxybutyric acid (GABA), serotonin, noradrenaline

Question 37

Describe the changes seen on fMRI in the brains of young people with anxiety disorders

Answer 37

Increased response by the amygdala, prefrontal cortex, and striatum to anxiety-inducing stimuli

Question 38

What is the first-line treatment for anxiety disorders in young people?

Answer 38

Cognitive behavioural therapy (CBT)

Question 39

State an alternative treatment to CBT for anxiety disorders in young people

Answer 39

Skills-based psychological treatment (e.g. psychoeducation, relaxation training, exposure, cognitive restructuring)

Question 40

Name the 2 most commonly prescribed SSRIs in young people

Answer 40

Sertraline and fluoxetine

Question 41

How long should SSRIs for anxiety disorders in young people be prescribed for?

Answer 41

10-15 weeks