Chapter 5 - Anxiety and Obsessive Compulsive Related Disorders Flashcards

1
Q

Fear vs. Anxiety

A

Fear: more focused and specific
Anxiety: more diffuse and generalized, both fear and apprehension

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2
Q

What are the anxiety disorders?

A
  • Generalized Anxiety Disorder (GAD)

* Panic Disorder

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3
Q

Characteristics of GAD?

A

Chronic, prolonged, “free-floating” anxiety and dread

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4
Q

According to DSM, what are the criteria for diagnosis of GAD?

A

Must report symptoms for at least 6 months

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5
Q

GAD types of symptoms

A

1) Motor Tension - muscular tension
2) Autonomic Reactivity - increased heart rate, BP, arousal
3) Apprehension about the future - sense of impending doom
4) Hypervigilance

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6
Q

GAD onset

A

50% of those diagnosed are diagnosed during childhood/adolescence

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7
Q

Panic Disorder characteristics

A
  • Can be cued or un-cued
  • Sudden intense arousal - symptoms may resemble heart attack
  • Must experience some un-cued episodes
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8
Q

GAD vs. PD

A
  • Onset more abrupt for PD
  • Onset typically later for PD (avg 20-24 yrs old)
  • More heredity evidence for PD
  • Higher rates of alcoholism and depression for PD
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9
Q

What is PD comorbid with?

A

Comorbid with agorophobia

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10
Q

Characteristics of phobias

A

Irrational unrealistic fear of an object, event, or situation

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11
Q

How can phobias be acquired?

A

May begin with real trauma, GAD, or be vicariously acquired (like being around mother who has phobia)

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12
Q

What is the effect of avoidance in a phobia?

A

When you avoid a feared stimulus, it negatively reinforces the fear and avoidance. Treatment for this is exposure treatment

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13
Q

Phobia subtypes

A
  • Animal type - spiders, snakes, dogs, cats
  • Natural environment type - storms, wind, bodies of water, heights
  • Blood-injection-injury type - seeing blood/injury, injection, medical procedure, may induce fainting
  • Situational type - elevators, tunnels, bridges, flying, driving, enclosed spaces
  • Other type - cued by other stimuli, fear of situations that could lead to choking, vomiting, or illness
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14
Q

What is a social phobia? What is the basis?

A
  • Fear and embarrassment (extreme discomfort) around other people
  • Basis: fear of being observed and evaluated negatively in our culture
  • Most common manifestation: public speaking and meeting new people
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15
Q

What is Taijin Kyofusho?

A

Japanese social anxiety disorder about offending or embarrassing other people

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16
Q

Diagnosis requirements for Taijin Kyofusho?

A
  • Fear of blushing
  • Fear of emitting odors or being flatulent
  • Fear of staring inappropriately
  • Fear of making inappropriate facial expressions
  • Fear of having physical deformity
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17
Q

What is agoraphobia?

A

Fear of open spaces, the marketplace, novel situations, losing control in public

  • Onset: 20-40s, more common among females
  • Co-morbid with PTSD and GAD
18
Q

What is the difference between compulsions and obsessions?

A

Obsessions: Intrusive, unwanted, related thoughts
Compulsions: repetitive acts/behaviors

19
Q

What is “magical thinking”?

A

Thoughts during OCD that defy logic - patient believes performing the compulsion will enable them to control their outcomes, reduces anxiety

20
Q

Common forms of compulsions?

A

Counting, ordering/organizing, checking (locks at front door), touching, washing/cleaning

21
Q

What is hoarding? How is it categorized?

A

Collecting and keeping a large amount of things

*Now is its own category in DSM-5 as an OCD-related disorder, used to just be a compulsion

22
Q

OCD Onset

A

Late adolescence to early adulthood

23
Q

OCD Prevalence

A

Equal among males and females, more common with higher income and intellectual functioning

24
Q

What are OCD spectrum disorders?

A

Disorders that co-vary with rates of OCD - co-morbid with OCD or run in OCD families (trichotillomania, motor tics) - characterized by problems with impulse control

25
Q

What is body dysmorphic disorder?

A

Preoccupation with perceived defect in appearance - exaggerated or imagined flaws

26
Q

When is BDD diagnosed?

A

When it causes significant distress or impairment of functioning

27
Q

Gender differences in BDD?

A

Equal prevalence between genders, but differ by sites:

  • Males: body build, genitalia, hair, height
  • Females: breasts, hips, thighs, weight
28
Q

BDD Onset

A

Early adolescence to early adulthood

29
Q

What is the course of BDD?

A

Will continue without treatment

30
Q

Comorbidity with BDD

A
  • ~1/3 with BDD also have OCD
  • Social anxiety disorders
  • Avoidant personality disorders
  • Major depression and suicidality
  • Substance abuse
31
Q

How does BDD differ with culture?

A
  • American men vs Taiwanese men - Americans express significantly more body dissatisfaction than Taiwanese men
  • College students in Germany vs. US - Germany: 5.3%, US: 13% with BDD symptoms
32
Q

Basis of behavioral treatment of anxiety/OCD?

A

If anxiety is learned and avoidance negatively reinforces these behaviors, anxiety can also be extinguished by removing this reinforcement

33
Q

What are exposure treatments?

A
  • Systematic desensitization: gradual exposure to source of anxiety - establish fear hierarchy, train in relaxation, “walk-through” hierarchy
  • Reciprocal inhibition - underlying principle is that two incompatible responses cannot coexist and that they would reciprocally inhibit one another
34
Q

What is flooding?

A

Sudden, intense exposure to fear. Person must remain with stimulus until anxiety subsides, so that avoidance is not negatively reinforced

35
Q

What is virtual reality exposure?

A

Virtual stimulus exposure - seems to work by classical conditioning

36
Q

What is exposure response prevention therapy (ERP)?

A

For OCD treatment - expose patient to anxiety of obsession and prevent compulsive behavior

37
Q

What is modeling?

A

Observing someone engaging in desired behavior - most effective in participant modeling where they watch a model, then work up to a point when participant can do the behavior

38
Q

What is cognitive restructuring?

A

Learning to “construct” situations differently

39
Q

What is thought-stopping?

A

1) Train participant to recognize maladaptive thoughts

2) Teach to tell self “stop” when they come up

40
Q

What is cognitive rehearsal?

A

Anticipates anxiety-provoking situation and rehearses thought process to do when situation occurs

41
Q

What is acceptance commitment therapy?

A

“3rd gen” cog therapy

  • Acceptance: accept and not avoid thoughts/feelings
  • Mindfulness: be present in the moment, increased awareness of what is current
  • Studies: ACT is effective for mild to moderate anxiety problems
42
Q

Biological treatments for anxiety and OCD

A
  • Drug treatments
  • Anxiolytics (GAD, panic, phobias)
  • Antidepressants like SSRIs (most commonly for OCD, panic)