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Flashcards in Anxiety/Stress Disorders Deck (86):
1

Define Fear

Response to a real or perceived immediate threat

2

Define Anxiety

Expectation of future threat, feeling of fear, worry, and uneasiness to an overreaction to a situation that is only subjectively seen as menacing

3

When does anxiety become a disorder?

When symptoms interfere with a persons daily life or ability to function

4

Symptoms of Anxiety Disorder

Muscle tension
Poor memory
Sweaty hands
Fear or confusion
Constant worry

5

Causes of Anxiety

Heart disease
DM
Thyroid problems
Asthma
Drug use/withdrawal
Tumors

6

Risk Factors for Anxiety

Female
Trauma
Stress due to illness
Personality disorders
Depression
Blood relative with anxiety disorder
Drugs/alcohol

7

2 Components of Anxiety

Awareness of physiological sensations
Awareness of being nervous or frightened

8

Emotional Symptoms of Anxiety

Excessive fear & worry
Feelings of apprehension
Trouble concentrating
Feeling tense
Anticipating the worse possible outcome

9

Physical Symptoms of Anxiety

Pounding heart
Sweating
Stomach ache
Frequent urination
SOB
Muscle twitches
Headache
Fatigue

10

Major Neurotransmitters in Anxiety

Norepinephrine: over activation
Serotonin: under activation
Dopamine
GABA

11

Treatment of Anxiety

CBT
Exposure Therapy
Medication
Alternative Treatment

12

Desensitization Exposure Therapy for Anxiety

Combines relaxation with a gradual exposure to whatever provokes the anxiety

13

Flooding Exposure Therapy for Anxiety

Involves intense and prolonged exposure to the feared stimulus

14

Modeling Exposure Therapy for Anxiety

Involves the witnessing of another handle a feared stimulus without anxiety

15

Medication Treatment for Anxiety

SSRIs
SNRIs
Benzodiazepines
TCAs

16

SE of SSRIs

Insomnia
Weight gain
Sexual dysfunction

17

SE of SNRIs

Upset stomach
Sexual dysfunction
Increase in BP
Insomnia

18

SE of TCAs

HTN
Urinary retention
Constipation

19

Alternative Treatment for Anxiety

Stress & relaxation techniques
Meditation
Yoga
Acupuncture
Kava: improves mood; OTC or herbal places

20

3 Categories of Anxiety

Anxiety Disorders
OCD
Trauma & stress-related disorders

21

Examples of Anxiety Disorders

Separation anxiety disorder
Selective mutism
Specific phobia
Social phobia
Panic disorder
Agoraphobia
GAD

22

Examples of OCD

OCD
Body dysmorphic disorder
Hoarding disorder
Trichotillomania: pull out & eat hair
Excoriation disorder

23

Examples of Trauma & Stressor-Related Disorders

Reactive attachment disorder
Disinhibited social engagement disorder
PTSD
Acute stress disorder
Adjustment disorder

24

Define PTSD

Debilitating condition that can occur in people who have experienced or witnessed a natural disaster, serious accident, terrorist incident, sudden death of a loved one, war, violent personal assault such as rape, or other life-threatening events

25

4 Types of Symptoms of PTSD

Re-experiencing symptoms
Avoidance symptoms
Hyperarousal symptoms
Children

26

Re-experiencing Symptoms

Flashbacks
Bad dreams
Frightening thoughts

27

Avoidance Symptoms

Staying away from events, places, objects
Feeling emotional numb
Feeling strong guilt, depression, worry
Losing interest in activities
Having trouble remembering the dangerous event

28

Hyperarousal Symptoms

Being easily startled
Feeling tense
Difficulty sleeping
Having angry outburst

29

Symptoms in Children

Bedwetting
Forgetting how or being able to talk
Acting out event during playtime
Being unusually clingy

30

Clinical Presentation of PTSD

T: traumatic event
R: re-experience
A: avoidance
U: unable to function
M: month long or more duration of symptoms
A: arousal is increased

31

Diagnosis of PTSD

Symptoms begin within 3 months and last more than a month
At least 1 re-experiencing symptoms, 3 avoidance symptoms, 2 hyperarousal symptoms

32

Treatment for PTSD

Psychotherapy
Medications

33

Psychotherapy for PTSD

CBT
Exposure therapy
Cognitive restructuring
Stress inoculation training

34

Medications for PTSD

1st: SSRI, SNRI
2nd: TCA
Benz's short term

35

Define Acute Stress Disorder

Minimum of 3 days & maximum of 4 weeks

36

Treatment of Acute Stress Disorder

CBT
Benzodiazepines: clonazepam

37

Define General Anxiety Disorder

Applies to people who are worried or anxious about almost everything
Think things will always go bad
The worrying causes impaired functioning

38

Epidemiology of General Anxiety Disorder

Average onset: 31 year old
Women > Men

39

Signs/Symptoms of General Anxiety Disorder

Can't relax
Startle easily
Have difficulty concentrating
Trembling
Irritability
Sweating
Fatigue
Headaches
Light headedness
Hot flashes
SOB

40

Diagnosis of General Anxiety Disorder

Worries excessive about a variety of everyday problems for at least 6 months
GAD-7

41

Treatment of General Anxiety Disorder

1st: CBT, SSRI, SNRI
2nd: TCAs, Benzo's

42

Examples of SSRI for General Anxiety Disorder

Paroxetine
Sertraline
Citalopram

43

TCA for General Anxiety Disorder

Imipramine

44

Short Acting Benzodiazepines for General Anxiety Disorder

Alprazolam
Lorazepam

45

Long Acting Benzodiazepines for General Anxiety Disorder

Diazepam
Flurazepam

46

Define Panic Disorder

Sudden & repeated attacks of fear that last for several minutes

47

Define Panic Attacks

Characterized by a fear of disaster or of losing control even when there is no real danger

48

Epidemiology of Panic Disorder

Women > Men
Late adolescence or early adulthood

49

Signs/Symptoms of Panic Disorder

Sudden & repeated attacks of fear
Feeling being out of control during a panic attack

50

Signs/Symptoms During a Panic Attack

Pounding or racing heart
Sweating
Weakness or dizziness
Hot/cold
Chest pain
Tingling/numb
Abdominal pain

51

Diagnosis of Panic Disorder

Attacks occur any time
Attack will peak in 10 minutes
1/3 of people become housebound

52

Treatment of Panic Disorder

CBT
Medication

53

Types of CBT for Panic Disorder

Education
Self-monitoring
Breathing retraining
Muscle relaxation
Cognitive restructing
Exposure
Relapse prevention

54

Medications for Panic Disorder

1st: SSRIs
2nd: another SSRI or SNRI
3rd: TCAs, Benzodiazepines

55

Examples of SSRIs for Panic Disorder

Fluoxetine
Paroxetine
Sertraline
Fluvoxamine
Citalopram
Escitalopram

56

SNRI for Panic Disorder

Venlafaxine ER

57

Examples of TCAs for Panic Disorder

Imipramine
Clomipramine

58

Examples of Benzodiazepines for Panic Disorder

Alprazolam
Clonazepam

59

Define Agoraphobia

Person feels fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed

60

Epidemiology of Agoraphobia

Onset: Men

61

Risk of Developing Agoraphobia

Tendency to be nervous or anxious
Experiencing stressful life events
Having a blood relative with agoraphobia

62

Signs/Symptoms of Agoraphobia

Fear of leaving the house
Dependence on others
Fear of being alone
Fear of being in places that would be difficult to escape
Symptoms of a panic attack: helpless, anger, feel like body isn't real

63

Treatment of Agoraphobia

CBT: exposure therapy, service animals
Medications: SSRIs, SNRIs, TCAs, benzodiazepines

64

Define Specific Phobia

Intense fear, anxiety, & avoidance of specific object or situation

65

Define Social Phobia

Intense fear, anxiety & avoidance of social situations where there is the potential of being scrutinized or negatively judge by others

66

5 Major Specific Phobias

Animal
Natural environment: storms, heights
Blood-injection-injury
Situational: airplane, elevators, closed spaces
Other: chocking, vomiting, clowns, costume characters (clowns)

67

Epidemiology of Specific Phobias

Females > Males
Run in families
Appear in adolescence or adulthood

68

Symptoms of Specific Phobia

Persistent fear that is excessive or unreasonable
Exposure provokes immediate anxiety response
Fear or anxiety is out of proportion to the actual danger posed

69

Epidemiology of Social Phobias

Women = Men
Onset in childhood or early adolescence

70

Signs/Symptoms of Social Phobia

Anxious about being with other people
Have hard time talking to other people
Self-conscious & feel embarrassed
Afraid other people with judge them

71

Treatment of Phobias

CBT
Medications

72

1st Line Treatment for Specific Phobias

CBT

73

1st Line Treatment for Social Phobia

Group & individual CBT

74

Medications for Specific Phobias

2nd: benzodiazepines
3rd: SSRI

75

Medications for Social Phobias

1st: SSRIs & SNRIs
2nd: benzodiazepines
Performance: beta-blockers

76

Define Obsessive-Compulsive Disorder

Characterized by intrusive thoughts that produce uneasiness, apprehension, fear or worry (obsessions), repetitive behaviors aimed at reducing the associated anxiety (compulsions), or a combination of obsessions & compulsions

77

Epidemiology of Obsessive- Compulsive Disorder

Average onset: 19
Men = Women

78

Define Obsessions

Recurrent & persistent thoughts, impulses, or images that cause distressing emotions such as anxiety or disgust

79

Define Compulsions

Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession

80

Treatment of Obsessive-Compulsion Disorder

1st: CBT, SSRI
2nd: TCAs
3rd: SNRI

81

Examples of SSRIs for Obsessive Compulsive Disorder

Fluoxetine
Sertraline
Paroxetine

82

TCA for Obsessive Compulsive Disorder

Clomipramine

83

SNRI for Obsessive Compulsive Disorder

Venlafaxine

84

Define Anxiety Disorder due to a Medical Condition

Fear & anxiety symptoms are the direct effect of a medical condition

85

Associated General Medical Conditions that Lead to Anxiety

Endocrine conditions (thyroid)
CV conditions
Respiratory conditions
Metabolic conditions
Neurological conditions

86

Treatment of Anxiety Disorder due to a Medical Condition

Treat the medical condition
Short acting benzodiazepines
SSRIs