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TEST 2 Flashcards

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1
Q

What percent of adult population suffer form one or more anxiety disorders?

A

18%

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2
Q

how many adults with anxiety receive treatment?

A

37%

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3
Q

Checklist for free floating anxiety

A
  1. more than 6 months
  2. symptoms include edginess, fatigue, poor concentration, irritability, muscle tension, sleep problems
  3. significant distress
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4
Q

Where is anxiety most common?

A

western countries

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5
Q

What is anxiety

A

complex pattern of 4 types of reactions to a perceived threat

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6
Q

somatic (anxiety reaction)

A

increase in heart rate and respiration, muscle tension, shaking, and dry mouth

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7
Q

cognitive (anxiety reaction)

A

anticipation of harm, rumination, sense of unreality, problem concentrating

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8
Q

emotional (anxiety reaction)

A

fear, terror, irritability, restlessness, dread

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9
Q

behavioral (anxiety reaction)

A

escape, avoidance, hyper-vigilance, freezing

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10
Q

Is anxiety for GAD free-floating or specific

A

free floating

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11
Q

what is the lifetime prevalence for GAD

A

3% MEN, 5%WOMEN

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12
Q

What is the course onset for GAD

A

Childhood/ adolescence (chronic)

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13
Q

What is the comorbidity for GAD

A

50% another anxiety disorder, 70% mood disorder, 33% substance use

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14
Q

How long do phobias last?

A

more than 6 months

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15
Q

Most typical phobias

A

environment, animals, situations, blood, injections, injuries

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16
Q

What are phobias lifetime prevalence?

A

13%

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17
Q

What is the course onset of phobias?

A

childhood, stable and persistent

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18
Q

Comorbidity for phobias

A

other anxiety disorders, major depression, oppositional defiant disorder, most likely to have only anxiety phobia, no other disorder

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19
Q

How many don’t seek treatment with phobias

A

90%

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20
Q

What is SAD lifetime prevalence?

A

12% in US, 3% internationally, numbers have changed since COVID

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21
Q

SAD course onset

A

usually in adolescence, early preschool

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22
Q

SAD prevalence

A

increase with age (relatively stable)

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23
Q

SAD comorbidity

A

another anxiety disorder, depression, avoidant personality, substance use

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24
Q

What are some symptoms of panic attack disorder

A

heart palpitations, shaking, chest pain, nausea, dizziness, chills, hot flashes, losing control, chocking, sweating, paresthesia (pins and needles)

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25
What are two requirements for Agoraphobia
they are unable to go to 2 or more place, for more than 6 months
26
what percentage of adults have panic attacks
28%
27
What is the lifetime prevalence of panic attacks
3-5%, more common in women | 1/2-1/3 of those have agoraphobia
28
Panic attack course onset
late adolescences, early adulthood, chronic
29
Comorbidity of Panic attack
GAD, depression, alcohol abuse, increased risk of suicide attempts
30
PTSD Prevalence
lifetime 8.3%, past 12 months of T 4.7%
31
PTSD course onset
average age 25 yrs, about 50% chronic
32
PTSD comorbidity
very common to have more than one disorder; depression, substance use, anxiety disorder, traumatic brain injury (TBI)
33
OCD prevalence
lifetime 1-3%
34
OCD course onset
age onset 6-15 yrs for males, 20-29 yrs for females, chronic
35
OCD comorbidity
60-80% cases occur with at least one other disorder, 50% multiple disorders, 66% with depression
36
Biological Theories for disorders
genetic, neurotransmitters, brain circuits
37
Biological theory: genetic
higher concordance rate in monozygotic twins than dizygotic twins
38
Biological theory: neurotransmitters
dysregulation of GABA, norepinephrine, serotonin, glutamate, and CCK implicated
39
Brain circuit dysregulation: panic circuit
amygdala, hippocampus, ventromedical, nucleus of hypothalamus, locus cocruleus
40
Brain circuit dysregulation: OCD
Cortico-striato-thamamo- corticol circuit (hyperactive)
41
Brain circuit dysregulation: PTSD
HPA axis, amygdala, anterior cingulate cortex insula hypothamalus (stress circuit) both are overactive
42
Learning Theories for anxiety disorders
classical conditioning, operant conditioning; fear response positively reinforced, observational learning
43
Cognitive theory Anxiety
interceptive awareness, anxiety sensitivity, cognitive distortions, tendency towards maladaptive assumptions, difficulty turning off thoughts
44
interceptive awareness
increased attention to body sensations
45
anxiety sensitivity
belief that body symptoms have harmful consequences
46
cognitive distortions
catastrophizing, control fallacies, polarizing
47
maladaptive assumptions
expecting the worst
48
4 primary problems for treating anxiety
- excessive escape and avoidance behavior - emergency physiological reactions to perceived threats - sense of lack of control - distorted information processing
49
Behavioral Tx for AD
- systematic desensitization - modeling - exposure and response prevention - flooding
50
Cognitive Behavioral therapy for anxiety
- focus on decreasing negative thoughts, increase problem solving, address though process and behavioral experiences, F.E.A.R.
51
FEAR CBT
F (Feelings), E(experiences), A (attitudes and actions), R(results and rewards)
52
latrogenic
do more harm than good
53
synergetic
drugs from the same class, increased effects
54
antagonistic
use drugs to counteract effects of others drugs
55
What is Substance Intoxication Disorder
experience of significant maladaptive behavioral and psychological symptoms due to the effect of a substance on the central nervous system
56
What is Substance Withdrawal Disorder
experience of clinically significant distress in social, occupational, or other areas of functioning due to the reduction of substance
57
What is Substance Use Disorder
problematic pattern of substance use that leads to clinically significant impairment or distress , m manifest by two or more criteria: (within 12 months) impaired control, social impairment, risky use, pharmacological criteria
58
What is impaired control
1. taking it more often in larger amounts or overlong periods than intended 2. craving 3. persistent desire for drug, unsuccessful efforts to cut down or control use 4. lots of time spent on activities necessary to obtain, use, or recover from substance effects
59
What is social impairment
5. recurrent substance use results in a failure to fulfill major role obligations at work, school, home 6 continued substance use despite having social or interpersonal problems caused the effects substance use 7. important social, occupational, recreational activities are given up Or reduced by substance use
60
What. is risky use
8. recurrent substance in situations in which its physically hazardous 9. substance use is continued despite knowledge of a physical or psychological problem
61
What is pharmacological criteria
10. tolerance | 11. withdrawal
62
Anhedonia
diminish or lost of pleasure in all activities
63
Major Depressive Episode Disorder lifetime prevalence and age onset
20 % (PRECOVID, varies internationally) annual prevalence 8% onset age 19 years
64
Persistent Depressive Disorder
one year prevalence (1.5-5%) average age 10-25 yr, course: chronic, fluctuating, comorbidity: 70%
65
Biological Etiological theories for Depression
- genetic factors ( genetic abnormalities, serotonin transporter gene abnormalities) - neurotransmitter theories (monoamines, specifically norepinephrine and serotonin)-Dysfunction in synthesis and release and sensitivity of post synaptic neuron - Brain circuits( prefrontal cortex, hippocampus, amygdala, subgenus cingulate (Brodmann Area))- problematic interconnectivity between structures and decreased norepinephrine and serotonin - Hypothalamus - pituitary- adrenal (HPA)axis: fight and flight response (early or chronic stress, impacts HPA (overactive) which impacts monoamine system)
66
Psychological Etiological theories for Depression
- behavioral (decreased rewards (particularly social) from stress- creates self perpetuating cycle - cognitive: negative views of self, world and future, (distorted thinking) - attribution: Helplessness theory- causual attributions for negative thoughts - --Internal vs. External - ---Stable vs. Unstable - -- Global vs. specific --> depression: internal, stable, global
67
Interpersonal Etiological theories for Depression
- may have chronic conflict with family, friends and coworkers - reaction sensitive and excessive reassurance seeking - may select a less supportive circle
68
biological Etiological theories for SUD
- brain and pleasure pathway - ventral segmental--> nucleus accumbens--> frontal cortex (dopamine is major neurotransmitter, drugs flood the circuits with dopamine--> Euphoric effect, brain is wired to repeat behavior)
69
psychological Etiological theories for SUD
- behavioral: classical conditioning and operant conditioning, observational learning - cognitive: positive expectations about using, lack of coping skills, use when upset - personality: impulsion, sensation seeking, anti social personality
70
Tx SUD
detoxification behavioral treatments (avoidance of stimuli, skills training, averse conditioning, contingency management) cognitive treatments: address faculty expectations and beliefs Biological: benzodiazepines, SSR/SNRI (depressants) and antagonists, methadone, Suboxone maintenance program

PSY 366 (2 decks)

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