Anxiety Disorders Flashcards

Question

Generalized Anxiety Disorder (GAD) Etiology

Answer 1

_Biological Factors:_ Efficacy of Benzodiazepines and Buspirone suggests involvement of **GABA and Serotonin** _Cognitive‐Behavioral:_ theories focus on **distorted interpretation of perceived threats** _Psychoanalytic theories_ hypothesizes that anxiety is a symptom of **unresolved, unconscious conflicts**

Answer 2

* **Sustained and excessive anxiety and worry accompanied by either motor tension or restlessness** * **Excessive and interferes w/ other aspects of a person's life** * Motor tension is most commonly manifested as shakiness, restlessness, and headaches * Anxious for as long as they can remember * Seek out treatment usually in their 20’s * Use. will seek out a general practitioner or internist for help w/ a somatic symptom * Course is often **chronic** * Multiple psychiatric comorbidities – **depression, other anxiety disorders**

Answer 3

* _Pharmacotherapy_ * **SSRI’s** * **Venlafaxine** * **? Benzodiazepine** * **Buspirone** * **Tricyclic's, MAOI** * _Psychotherapy_ * **CBT** has the most evidence base

Answer 4

Anxiety Disorders secondary to other medical conditions Anxiety Disorders secondary to substance use or withdrawal

Answer 5

**1. Obsessive‐compulsive disorder (OCD)** 2. Body dysmorphic disorder **3. Hoarding disorder** 4. Trichotillomania (hair‐pulling disorder) 5. Excoriation (skin‐picking) disorder 6. Substance/medication‐induced obsessive‐compulsive and related disorder 7. Obsessive‐compulsive and related disorder due to another medical condition 8. Other specified obsessive‐compulsive and related disorder and unspecified obsessive‐compulsive and related disorder (e.g., body‐ focused repetitive behavior disorder, obsessional jealousy).

Answer 6

Common, disabling psychiatric disorder characterized by: * **Obsessions** * _Recurrent and persistent_ **thoughts, images, or urges** * Experienced, at some time, as **intrusive** and **unwanted** * Cause marked **anxiety** or **distress** * Attempts to **ignore** or **suppress** such thoughts, urges, or images, or to **neutralize them w/ some other thought or action** (i.e., by performing a compulsion) * Types of Obsessions: Doubts, Images, Thoughts * **Compulsions** * **Repetitive behaviors** (e.g., hand washing, ordering, checking) or **mental acts** (e.g., praying, counting, repeating words silently) * Individual **feels driven to perform in response to an obsession** or **according to rules that must be applied rigidly** * Aimed at **preventing or reducing anxiety or distress**, or preventing some dreaded event or situation * Are not connected in a realistic way or are clearly excessive * Types of Compulsions: Yielding, Controlling

Answer 7

* _Biological factors:_ * **Genetic predisposition** likely * **Dysregulation of 5-HT** is involved in the sx formation of obsessions and compulsions in the disorder * SSRI’s are most effective in tx OCD * Link between **GAS strep infection** and OCD * Altered function in the neurocircuitry between **orbitofrontal cortex, caudate, and thalamus** * _Psychological:_ * **Psychoanalytic theories** view OCD as a **regression to the anal stage** * Learning Theory: * Obsessions are **conditioned stimuli** ⇒ neutral objects and thoughts become conditioned stimuli capable of provoking anxiety or discomfort * Compulsions are **reinforced** ⇒ ritualistic behaviors reduce the anxiety * _Developmental factors:_ * **Emotional, physical, and sexual abuse or neglect, social isolation, teasing, or bullying** * Other stressors include **pregnancy** and the postnatal period

Answer 8

* Depression * Tourette’s Disorder * Schizophrenia * Other Anxiety Disorders

Answer 9

* _Pharmacotherapy_ * **SSRI’s** * **Clomipramine** * **Benzodiazepines** * TCA, MOAI, Neuroleptics * _Psychotherapy_ * **Cognitive behavioral therapy** that includes **“exposure and response prevention”** * _For severe incapacitating OCD:_ * **Deep Brain Stimulation** * **Ablative neurosurgery** (e.g., capsulotomy and cingulotomy)

Answer 10

Preoccupation w/ **one or more perceived defects or flaws in physical appearance** that are _not observable or appear slight to others_ * **Repetitive behaviors** (e.g., mirror checking, excessive grooming, skin picking, reassurance seeking) * **Mental acts** (e.g., comparing his or her appearance w/ that of others) in response to the appearance concerns * Eating Disorders are excluded * The patient’s belief may reach **delusional** proportions – in which case it is classified as a **delusional disorder**

Answer 11

* **Persistent difficulty in parting w/ possessions** * Results in **severely cluttered living spaces, distress, and impairment** that are not attributable to another neurologic or mental disorder * Excessively acquire items they do not need or have space for * Limited insight into their difficulties * Reluctant to seek help * **Cognitive behavioral therapy** that is specifically tailored to hoarding difficulties

Answer 12

These disorders have an **exposure to a traumatic or stressful event** is listed _explicitly as a diagnostic criterion_. ## Footnote 1. Reactive attachment disorder 2. Disinhibited social engagement disorder 3. Posttraumatic Stress Disorder (PTSD) 4. Acute stress disorder 5. Adjustment disorders

Answer 13

* _Clinical manifestations:_ * **Emotionally withdrawn behavior** toward adult caregivers * **Rarely or minimally seeks comfort** when distressed * **Does not responds to comfort** when distressed * **Minimal social and emotional responsiveness** to others * **Limited positive affect** * Episodes of **unexplained irritability, sadness, or fearfulness** * _Caused by:_ * **Social neglect or deprivation** in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults * **Repeated changes of primary caregivers** that _limit opportunities to form stable attachments_ (e.g., frequent changes in foster care) * **Rearing in unusual settings** that _severely limit opportunities to form selective attachments_ (e.g., institutions w/ high child‐to‐caregiver ratios)

Answer 14

* _Clinical manifestations:_ * **Reduced or absent reticence in approaching and interacting w/ unfamiliar adults** * **Overly familiar verbal or physical behavior** * **Diminished or absent checking back** w/ adult caregiver after venturing away, even in unfamiliar settings * **Willingness to go off w/ an unfamiliar adult** w/ minimal or no hesitation * _Caused by:_ * **Social neglect or deprivation** in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults * **Repeated changes of primary caregivers** that _limit opportunities to form stable attachments_ (e.g., frequent changes in foster care) * **Rearing in unusual settings** that _severely limit opportunities to form selective attachments_ (e.g., institutions w/ high child‐to‐caregiver ratios)

Answer 15

Conditon present for \> 1 month ## Footnote **_1. Exposure to a traumatic event_** Actual or threatened death, serious injury, or sexual violence Directly experiencing / witnessing in person Event occuring to a close family member or friend (violent or accidental) Repeated or extreme exposure to aversive details (police, first responders) **_2. Intrusion symptoms associated with the traumatic event_** Memories Dreams Dissociative reactions (e.g., flashbacks) Psychological distress to cues Marked physiological reactions to cues **_3. Avoidance of stimuli associated w/ the traumatic event_** Avoids distressing memories, thoughts, or feelings Avoids external reminders **_4. Negative alterations in mood and cognition_** Inability to remember important details Negative beliefs or expectations Distorted beliefs about cause or consequences Negative emotional state Diminished interest or participation in significant activities Detachment or estrangement Inability to experience positive emotions **_5. Alterations in arousal and reactivity associated w/ the traumatic event_** Irritable behavior and angry outbursts, expressed as verbal or physical aggression Reckless or self‐destructive behavior Hypervigilance Exaggerated startle response Difficulty concentration Sleep disturbances

Answer 16

* Social Withdrawal * Depression * Suicide * Alcohol and Substance Abuse

Answer 17

* _Pharmacotherapy_ * **SSRI** * **TCA** * **MAOI** * **Clonidine, Prazosin** * _Psychotherapy_ * **Behavior Therapy** * **CBT** * **Hypnosis** * **Eye Movement Desensitization and Reprocessing (EMDR)**

Answer 18

Difference from PTSD: Duration of Sx **Acute Stress Disorder: 3 days to 1 month** PTSD: \> 1 month

Answer 19

* **Emotional or behavioral sx** in response to an **identifiable stressor occurring within 3 months of the onset of the stressor**. * **Marked distress** that is _out of proportion_ to the severity or intensity of the stressor * **Significant impairment in social, occupational, or other important areas of functioning** * W/ depressed mood * W/ anxiety * W/ mixed anxiety and depressed mood * W/ disturbance of conduct * W/ mixed disturbance of emotions and conduct

Anxiety Disorders Flashcards

(43 cards)