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Flashcards in Anxiety, Weiss Deck (48):
1

Anxiety

excessive worry
has phsyical Sx
avoidant behavior
sense of dread
heightened apprehension

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most common class of mental disorders in general population

anxiety disorders

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causes of anxiety

psychological
psychoanalytic
behavioral
biological

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pyschoanalytical theory of anxiety

signal to ego that unacceptable drive is pressing for conscious representation

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behavioral therapy of anxiety

conditioned response to specific environmental stimuli

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biological theory of anxiety

NT: NE serotonin, GABA

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sub types of anxiety disorders

panic, agorophobia, generalized, specific phobias, social, separation, etc...

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panic disorder

recurrent panic attacks followed by at least 1 mo of persistent concern, worry of implications, significant change in behavior related to attacks

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what is a panic attack

discrete period of intense fear or discomfort assoc with multiple physical manifestations developing abrubtly and reaching peak in 10 min

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Sx panic attack

palpitations
sweathing
tremor
SOB
chest pain and discomfort
nausea, dizziness
fear of losing control
fear of dying

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agoraphobiea

anxiety about being in places or situations from which escape is difficult or embarrassing if have panic attack there

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demographics panic disorder

1:2 M:F
2% population
onset early adulthood

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risk of panic disorder

higher rate of suicide

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what medical disorders present like panic disorder

CV disease
pulm disease
neuro disease
endo disease
drug intoxication
drug withdrawal

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mental disorders that present like panic

malingering
hypochondriasis
phobias
PTSD

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pharmacotherapy for panic disorder

TCA
SSRI!!
benzos-- until on SSRI (used short term)

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CBT for panic disorder

cognitive behavioral therapy
address patients false beliefs about attacks
gain sense of control

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what is phobia

irrational fear resulting in conscious avoidance of feared object, activity or situation

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increased risk for what with phobias

depression and substance abuse

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common phobias

animals, insect, injury or procedures, heights, darkness

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social phobia

fear of humiliation or embarrassment in either general or specific social situations
public speaking, urinating in public restrooms, stage fright

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social phobia

fear of humiliation or embarrassment in either general or specific social situations
public speaking, urinating in public restrooms, stage fright

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patients with performance phobias release more what

NE than Epi

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genetics in social phbia

first degree relatives 3x more likely to be affected

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Tx specific phobias

exposure therapy
insight oriented psychotherapy
pharmacotherapy

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Tx social phobias

psychotherapy
pharmacotherapy (beta blockers, SSRIs, benzos or buspirone

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demogrpahic OCD

male= female
4th most common psych disorder
mean onset 20 y.o

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etiology OCD

biological factors: NT dystregulation, genetics
pyschological factors
learned theroty

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what is learned theory in OCD

person discovers that certain action reduces anxiety
personality traits

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brain imaging in OCD

increased frontal lobe, basal ganglia and cingulum activity
Tx reverses this
dec size caudates b/l

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obsession

recurrent and intrusive thought, feeling, idea or sensation

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compulsion

a conscious, standardized, recurrent thought or behavior, such as coutning, checking or avoiding

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obsession and compulsion affects on anxiety

obsession inc
compulsion dec

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most common pattern compulsion

obsession of contamination, compulsion washing and avoidign

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2nd pattern compulsion

doubt then checking

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pharmacotherapy Tx of OCD

clomipramine
SSRI
lithium
benzos

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psychotherapy for OCD

behavioral and family

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PTSD

emotional stress in life threatening magnitude
reexperience trauma in dreams and waking thoughts
avoid reminders
numb responsiveness
persisten hyperarousal

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epidemiology PTSD

combat related in men
women from assualt

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predisposing vulnerability to PTSD

presence of chilhood trauma, personality disorders, poor social support, genetic vulnerability to psych illness, recent stressful life change, recent excessive alcohol use

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good prognostic factors for PTSD

rapid onset Sx, short duration, good premorbid functioning, strong support, absence other disorders

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pharmacotherapy for PTSD

SSRI
mood stabilizer
hypnotic
anxiolytics
antipsychotics

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pyschotherapy for PTSD

supportive
cognitive
gorup
family

44

generalized anxiety disorder

excessive and pervasive worry accompanied by variety of somatic Sc that cause significant impairment in social or occupational funcitoning or marked distress

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demographics generalized anxiety disorder

co exists with another psych disorder
W:M 3:2
first seek Tx in 20s

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clinical features of generalized anxiety disorder

anxiety, motor tension, autonomic hyperactivity
shakiness, restlessness
SOB, sweating, palpitations, GI
easy startle, irritability
chronic condition

47

pharmacotherapy for generalized anxiety disorder

benzo
busprione
mood stabilizer
antipsychotic
SSRI

48

psychotherapy for generalized anxiety disorder

cognitive behavioral
insight oriented
supportive