Ch. 5: (pt1) Anxiety Disorders Flashcards

Question

What is the clinical description for panic disorders and agoraphobia?

Answer 1

DSM-IV integrated the two into one disorder called panic disorder with agoraphobia, but many individuals have panic disorder without ever developing agoraphobia and vice versa • In panic disorder, anxiety and panic are combined in one individual – Panic attacks and anxiety surrounding the possibility of having future panic attacks or implications of future panic attacks as impending doom or death • Agoraphobic avoidance behavior as a complication of severe, unexpected panic attacks

Answer 2

• 2.7% of the population meet criteria for panic disorder during a given 1-year period and 4.7% meet criteria at some point during their lives – 2/3 of those who meet criteria are women • Onset of panic disorder is typically early adult life (mid-teens to 40 years old) – Median age of onset is between 20-24 years old • The prevalence of panic disorder and agoraphobia decreases among the elderly from 5.7% at ages 30-44 to 2.0% or less after age 60

Answer 3

Exists worldwide with expressions of panic differing among the cultures – Lowest prevalence rates in Asian and African countries – Better mental health associated with male gender, higher income, marriage, and higher education • Susto in Latin America • Ataques de nervios is the common term used by Hispanic Americans from the Caribbean • Kyol goeu among Cambodian and Vietnamese refugees in America

Answer 4

• Likely due to change in stage of sleep and physical sensation of letting go is frightening to an individual with panic disorder • Seen in children as sleep terrors • Isolated sleep paralysis that is culturally determined

Answer 5

Generalized biological vulnerability – Learned alarm reaction to stress – Cues associated with several different internal and external stimuli through a learning process • Generalized psychological vulnerability – Anxiety surrounding future panic attacks – Hypervigilance – Increased interoceptive awareness

Answer 6

Pharmacological Interventions – SSRI’s are often the medication of choice to treat panic disorder – Prozac and Paxil – Benzodiazepines are used but adversely affect cognitive and motor functioning – 60% of patients are free of panic if medication compliant, but 20% are non- compliant and stop medications before treatment is completed • Psychological Interventions – Panic Control Treatment – CBT for panic attacks involving gradual exposure to feared somatic sensations and modification of perceptions and attitudes about them – Gradual exposure exercises combined with anxiety- reducing coping mechanisms – Relaxation – Breathing exercises PD Treatment – 50% relapse rate once Combined Psychological and Drug Treatment – Primary care physicians (PCP’s) are usually the first point of contact by an individual with panic disorder so therapy is not usually readily available in this setting – Start with medications and refer their patients to seek out a therapist/psychologist for the therapy to address panic – Studies have shown that a combination of medication and therapy do not have an advantage over treatment alone for panic disorder – Psychotherapy/CBT is the best in the long run to treat panic disorder

Answer 7

Specific phobias are unreasonable fears of a specific object or situation that markedly interferes with daily life functioning

Answer 8

Unreasonable fear and avoidance of exposure to blood, injury, or the possibility of an injection

Answer 9

Involves enclosed places or public transportation

Answer 10

Fear of situations or events in nature, especially heights, storms, and water

Answer 11

Unreasonable, enduring fear of animals or insects that usually develops early in life

Answer 12

Median age of onset for specific phobias is 7 years old and tends to last a lifetime – Must be aware of types of normal fears and anxieties experienced throughout childhood

Answer 13

Phobia acquisition – Direct experience, Experiencing a false alarm, Vicarious experience, and Learned • Phobia development – Traumatic conditioning experience – Inherited tendency to fear – Susceptible to developing anxiety about the possibility the event will happen again

Answer 14

Psychological interventions – Exposure-based exercises in a safe environment – Therapist works with the individual working through exposure exercises to expose the individual to their fear. The individual then practices approaching the phobia object/situation at home and checks- in with the therapist – Helps to rewire the brain and lower subjective units of distress, or SUDS

Answer 15

Separation anxiety disorder is an excessive, enduring fear in some individuals that harm will come to them or their loved ones when they are apart

Answer 16

Treatment in children involves the parents to structure exercises and address their reaction to the anxiety in the children

Answer 17

Social anxiety disorder, or social phobia, is an extreme, enduring, irrational fear and avoidance of social or performance situations

Answer 18

Marked fear or anxiety focused on one or more social or performance situations

Answer 19

• Inherited tendency – Fear of angry, critical, or rejecting people – Aggressive individuals with angry faces are avoided • Exposure to trauma – Traumatic conditioning experience – Inherited tendency to fear – Social evaluation can be dangerous

Answer 20

• Pharmacological interventions – Several different medications used – Initially beta-blockers used with thought to lower heart rate and blood pressure – SSRI’s have been FDA approved and show effectiveness comparable to CBT alone – D-cycloserine (DCS) can be used in combination with CBT • Psychological interventions – Cognitive-Behavioral Therapy – Exposure, rehearsal, and role- playing – Group therapy – Best outcome for social anxiety disorder

Answer 21

Selective mutism is a rare childhood disorder characterized by a lack of speech in one or more settings in which speaking is socially accepted

Answer 22

Occurs in some settings but not others • Strongly related to social anxiety evidenced by high co-morbidity rate of selective mutism and anxiety disorders, specifically social anxiety disorder • Some evidence that well-meaning parents enable this behavior by being more readily able to intervene and talk for the children • Treatment in children intensive group treatment that allows children to interact with strangers in a safe group environment – Go on field trips, classroom-like activities, play socializing games that promote verbal participation, and spontaneous speaking

Ch. 5: (pt1) Anxiety Disorders Flashcards

(46 cards)