Flashcards in Anxiety (13 & 14) Deck (47)
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
Name the main classes of anxiety disorders?
Generalized anxiety disorder
Panic disorder (w/ or w/o agoraphobia)
Phobia/ Social Anxiety Disorder
Acute stress disorder
When diagnosing anxiety...symptoms must:
1- Be persistent (generally >6mo)
2- Interfere with normal functioning
3- Cause significant distress
What are the neurobiological changes/ factors associated with anxiety?
Decreased serotonin and GABA
Increased NE and Glutamate
What are some psychosocial factors associated with anxiety?
Traumatic events/ extreme stressors
Maladaptive coping skills/ personality traits
What is the gender bias of anxiety?
Women > Men
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
What are the additional symptoms of GAD?
Restlessness, easy fatigue, difficulty concentrating, irritability muscle tension, sleep disturbance
Prognosis of GAD?
Gets worse without treatment
What are the main treatments for GAD?
2- Antidepressants (SSRI, SNRI)
3- Buspirone (5HT1 angonist)
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
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
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
Prognosis with panic disorder?
Chronic and recurring
Increased risk of depression and suicide
Treatment for panic disorder?
2- systematic desensitization
3- Fast acting benzo (emergency)
4- SSRI/ SNRI (1st line for long term)
DSM-V criteria for phobia diagnosis?
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
What are the criteria for social anxiety disorder diagnosis?
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
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
Treatment for specific phobias?
2- Systematic desnsitization
What is the treatment for social phobia?
2- Assertiveness training/ Group therapy
3- SSRI/ SNRI
Treatments for performance anxiety?
Beta Blockers (propronolol)
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
What is an obsession?
Recurrent/ persistent thoughts urges and/ or images
They are intrusive and unwanted
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
T/F: A compulsion typically undoes or reduces anxiety
Is OCD more common in women or men?
Same in each
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
What illness is usually seen with OCD?
What type of psychotherapy is used to treat OCD?
ERP (Exposure and Response Prevention)
ACT (Acceptance and Commitment Therapy)