Anxiety (13 & 14) Flashcards Preview

MSII: Behavioral Science > Anxiety (13 & 14) > Flashcards

Flashcards in Anxiety (13 & 14) Deck (47):
1

Name some physical manifestations of anxiety?

Sympathetic NS (diaphoresis, mydriasis, tachycardia, tremor)

GI/GU symptoms (diarrhea, increase urine frequency)

Hyperventilation (dizziness, syncope, parasthesia)

Numbness and tingling

2

Name the main classes of anxiety disorders?

Generalized anxiety disorder

Panic disorder (w/ or w/o agoraphobia)

Phobia/ Social Anxiety Disorder

OCD

Acute stress disorder

PTSD

3

When diagnosing anxiety...symptoms must:

1- Be persistent (generally >6mo)

2- Interfere with normal functioning

3- Cause significant distress

4

What are the neurobiological changes/ factors associated with anxiety?

Decreased serotonin and GABA

Increased NE and Glutamate

5

What are some psychosocial factors associated with anxiety?

Traumatic events/ extreme stressors

Maladaptive coping skills/ personality traits

Learned?

6

What is the gender bias of anxiety?

Women > Men

7

What is the DSM-V criteria for Generalized Anxiety Disorder (GAD)?

Excessive anxiety/worry, occurring more days than not for 6 months about at least one event

It is difficult to control the worry.

At least 3 additional symptoms

Causes significant impairment

8

What are the additional symptoms of GAD?

Restlessness, easy fatigue, difficulty concentrating, irritability muscle tension, sleep disturbance

9

Prognosis of GAD?

Gets worse without treatment

10

What are the main treatments for GAD?

1- CBT

2- Antidepressants (SSRI, SNRI)

3- Buspirone (5HT1 angonist)

4- Benzo

11

What is the DSM-V criteria for panic attacks?

An abrupt, surge of intense fear of discomfort, peaks within minutes, that is unexpected

Must have 4 or more of the following symptoms:

Palpitations, pounding/racing heart, sweating, shaking, SOB, choking feeling, Nausea, dizziness, chills/heat, parasthesias, derealization, fear of losing control/ death

12

What is the DSM-V criteria for Panic Disorder?

1- recurrent unexpected panic attacks

2- 1 or more attacks followed by 1 (more more) month of at least one of the following--> concern about additional panic attacks/ consequences OR significant maladaptive change in behavior related to attacks

13

What are the DSM-V criteria for Agoraphobia?

1- Fear/ anxiety about 2 or more: using public transit, being in open spaces being in enclosed spaces, standing in line or a crowd, being outside home

2- fear of not being able to escape

3- Situation almost always produces anxiety

4- avoids situations

5- Fear/ anxiety out of proportion to acutal danger

6- >6 mo

7- causes signifcant impairment

14

Prognosis with panic disorder?

Chronic and recurring

Increased risk of depression and suicide

15

Treatment for panic disorder?

1- CBT

2- systematic desensitization

3- Fast acting benzo (emergency)

4- SSRI/ SNRI (1st line for long term)

16

DSM-V criteria for phobia diagnosis?

1- >6mo

2- Causes significant impairment

3- marked fear for a specific object/ situation

4- object/ situation ALWAYS produces the fear

5- actively avoids the situation/ object

6- Fear is out of proportion

17

What are the criteria for social anxiety disorder diagnosis?

1- >6mo

2- causes significant impairment

3- marked fear when exposed to social situation w/ possible scrutiny with others

4- fear of acting in ways that will be negatively scrutinized

5- social situation provokes fear

6- Fear out of proportion

18

What is performance only social anxiety disorder?

Fear is restricted to public speaking or performing and does not generalize to other social aspects of life

19

Treatment for specific phobias?

1- Flooding

2- Systematic desnsitization

3- CBT

4- Benzos?

20

What is the treatment for social phobia?

1- CBT

2- Assertiveness training/ Group therapy

3- SSRI/ SNRI

4- MAOI

21

Treatments for performance anxiety?

Beta Blockers (propronolol)

22

What are the criteria for OCD diagnosis?

Criteria A: The presence of Obsessions and Compulsions

Criteria B: The obsession and compulsions must be either time consuming or cause significant distress

23

What is an obsession?

Recurrent/ persistent thoughts urges and/ or images

They are intrusive and unwanted

24

What is a compulsion?

Repetitive behavior or activity that the patient performs in response to an obsession or as a set of rules that must be strictly adhered to

25

T/F: A compulsion typically undoes or reduces anxiety

True

26

Is OCD more common in women or men?

Same in each

27

What is the prognosis of OCD?

Long and variable course

1/3 are cured, and a large amount have moderate improvement while 20-40% remain ill or worsen

28

What illness is usually seen with OCD?

Tourette's Syndrome

29

What type of psychotherapy is used to treat OCD?

CBT

ERP (Exposure and Response Prevention)

ACT (Acceptance and Commitment Therapy)

30

What Rx are used to treat OCD?

1st Line: SSRI

2nd Line: Clomipramine (a TCA)

3rd Line: antipsychotics, other antidepressants

31

What needs to be on the differential diagnosis for OCD?

1- Tourette's Syndrome

2- Temporal Lobe Epilepsy

3- Obsessive Compulsive Personality Disorder

32

What is the most common thing that could cause PTSD?

Death of a loved one

33

What is most likely thing to cause PTSD?

Assault

34

What are the greatest variables associated with PTSD? (4)

Proximity, harm by another human, severity, repititino

35

What is criterion A for PTSD diagnosis?

Exposure to actual or threatened traumatic even (death, serious injury, sexual violence)

36

How long must symptoms be present for PTSD diagnosis?

More than 1 month

37

What are some modes of exposure in PTSD?

1- Directly experiencing events

2- Witnessing events as occur to others

3- Learning that a family member/ friend experienced such an event

4- Directly experiencing repeated/ extreme exposure to horrific details of an event

38

What is criterion B for PTSD diagnosis?

>1 "intrusion Symptom" associated with an event:

Distressing memories, distressing dreams/ nightmares, psychological distress from exposure to clues that symbolize the event, psychological reactions to exposure to external cues

39

What is criterion C for PTSD diagnosis?

Avoidance of stimuli associated with traumatic events

40

What is criteria D for PTSD diagnosis?

Negative changes in cognition and mood with the associated event. Need 2 or more of the following:

- dissociative amnesia or repression
- exaggerated beliefs
- blame
-negative emotional state
- inability to experience positive emotions

41

What is criterion E for PTSD diagnosis?

Alterations in arousal/ reactivity (>2 of the following):

- Irritable behavior/ angry outbursts
- Reakless/ self-destructive behavior
- Hypervigilance
- Exaggerated startle response
- Problems with concentration
- Sleep dusturbance

42

What is the criteria for acute stress disorder?

Same criteria for PTSD, just persists for 3 days - 1 month

43

When is the best time to treat PTSD/ ASD?

The earlier the treatment begins, the better

44

What are some co-morbidities seen with PTSD and ASD?

Depressive disorders

Substance related disorders

Other anxiety disorders

Bipolar disorders

Personality disorders`

45

How is PTSD and ASD treated with psychotherapy?

CBT, Eye-Movement Desensitization and Reprocessing (EMDR), Support groups/ Family therapy

46

What are some Rx used to treat PTSD and ASD?

1st line: SSRI

2nd line: TCAs, atypical antipsychotics

3rd line: MAOi, Trazodone, propranolol

47

What can prazosin treat?

Nightmares