week 2

Question 1

shared features of chronic worry

Answer 1

behavioural (escape, avoidance), cognitive (negative self-appraisals), and physiological (involuntary arousal – increased heart rate, rapid breathing, tremors, muscle tension)

Question 2

DSM-III

Answer 2

separation anxiety, avoidance anxiety, overanxious disorder

Question 3

how long should separation anxiety disorder last

Answer 3

4 weeks

Question 4

sad onset age

Answer 4

before 6 it’s early, but always before 18

Question 5

Diagnostic criteria – excessive worry about separation from the caregiver in at least three of the following ways (7)

Answer 5

o Fears about caregiver succumbing to an accident or harm
o Excessive worry about an anticipated separation at some future time
o School refusal
o Fear of being alone with the caregiver
o Reluctance to sleep alone or away from home
o Nightmares about separation
o Repeated physical complaints if separation occurs

Question 6

prevalence of SAD in general and in the clinical population

Answer 6

4 vs 10%

Question 7

separation anxiety is comorbid with

Answer 7

GAD, depression, somatic complaints

Question 8

More than X% of children with SAD or GAD had mothers with history of anxiety disorders

Answer 8

80%

Question 9

SAD treatment

Answer 9

CBT
Coping Cat problem - behaviorally oriented component

Question 10

SAD and school refusal

Answer 10

75% of children with SAD demonstrate school refusal, 1/3 of children who refuse school have SAD

Question 11

selective mutism - how long till diagnosed

Answer 11

1 month

Question 12

mutism prevalence

Answer 12

0.3-1%

Question 13

mutism onset

Answer 13

5 years - could be later if the child is homeschooled

Question 14

controversy as to how to best conceptualize mutism

Answer 14

some see it as an early precursor to social anxiety disorder and other considering it a specialized form of language disorder impairment – 30-38% of children with selective mutism also experience speech or language disorders

Question 15

when do fears tend to decrease

Answer 15

7 years

Question 16

most common phobias

Answer 16

animals, natural environment, blood-injection-injury, situational causes

Question 16

specific phobia

Answer 16

persistent, significant fears of an object or place that doesn’t have a reasonable basis
o Frequent avoidance of the feared object
o Exposure to it – significant physiological responses (dizziness, shortness of breath, increased heart rate, fainting)

Question 17

Symptoms of phobias

Answer 17

excessive reactions to encountering a feared object or situation and can include provoked responses involving the following
o Immediate fear, anxiety
o Avoidance (active avoidance)
o Excessive responses, out of proportion to the danger assessed
o Persistence

Question 18

how % of anxiety is specific phobia

Answer 18

15%

Question 19

three broader types of phobias have been associated with onset most likely in middle adolescence

Answer 19

social anxiety disorder, panic disorder, agoraphobia

Question 20

when do most phobias develop

Answer 20

childhood and adolescence
mean age is 10 and the onset is usually 7-11

Question 21

behavioral explanations for phobias

Answer 21

classical conditioning, observation, modelling, operant conditioning

Question 22

phobia treatment

Answer 22

systematic desentization

Question 23

what is social anxiety disorder

Answer 23

• Pervasive fear of embarrassment or humiliation  avoidance of social or performance situations
  o Situations where an individual feels they’re being evaluated or scrutinized – social interactions, being engaged in activities in public or performing

Question 24

criteria for social anxiety

Answer 24

at least 6 months and interferes with functioning

Question 25

two factors for social anxiety

Answer 25

o Personal fable – no one has ever experienced what they’re experiencing o Imaginary audience – everyone is looking at them

Question 26

lifetime prevalence for social anxiety

Answer 26

3-13%

Question 27

prevalence for social anxiety for children

Answer 27

1-2%

Question 28

onset for social anxiety

Answer 28

median age is 13,

Question 29

social anxiety treatment

Answer 29

social skill training

Question 30

what are panic attacks

Answer 30

intense, overwhelming, inescapable fear that permeates thoughts, feelings, sensations o Attacks are sudden and acute, last about 10 minutes

Question 31

symptoms of panic attacks (4/13)

Answer 31

o Heart palpitations o Sweating o Trembling/shaking o Nausea and abdominal discomfort o Chills or heat o Feeling dizzy o Numbness or tingling o Feeling of loss of control o Depersonalization o Sensations of chocking o Chest pain o Shortness of breath o Fear of dying

Question 32

lifetime prevalence for panic attacks

Answer 32

from 3.3% to 11.6%

Question 33

who has higher prevalence for panic attacks

Answer 33

older youth

Question 34

onset for panic attacks

Answer 34

15-19

Question 35

when is panic disorder diagnosed

Answer 35

if someone who experiences repeated panic attacks becomes preoccupied with the fear of having them

Question 36

the DSM-5 notes that in the month following a panic attack an individual is considered to have developed a panic disorder if

Answer 36

o There’s persistent fear of having another panic attack o Attack results in significant behavioural change resulting from attempts to avoid having another panic attack

Question 37

most common symptoms of the panic disorder in youth

Answer 37

nausea, heart palpitations, shortness of breath, shaking, extremes in temperature

Question 38

lifetime prevalence for panic disorder

Answer 38

to 3.5% with onset between late adolescence and early thirties

Question 39

medium age for panic attack

Answer 39

20-24

Question 40

how many adolescents have at least one panic attack

Answer 40

16%

Question 41

which neurotransmitter is involved in panic attacks

Answer 41

norepinephrine

Question 42

which area triggers emotional reactions

Answer 42

locus coeruleus

Question 43

cognitive theories of panic attacks

Answer 43

panic attacks can result from a misinterpretation of bodily sensations

Question 44

agoraphobia - fears

Answer 44

o Use of public transportations o Open spaces o Enclosed spaces o Standing in line o Being out of home, alone

Question 45

agoraphobia prevalence

Answer 45

1.7%

Question 46

agoraphobia mean onset

Answer 46

17

Question 47

GAD in children vs adults

Answer 47

o Adults require 3 additional symptoms of excessive worry, children only need 1 o The mood must be a pervasive mood over 6 months o The disorder must be responsible for significant adaptive functioning deficits in academic, social or familial relationship areas

Question 48

how many % of people will be diagnosed with GAD

Answer 48

2-5%

Question 49

GAD onset

Answer 49

8-10

Question 50

which neurotransmitter GAD

Answer 50

GABA (gamma-aminobutyric acid)

Question 51

cognitive bias for GAD

Answer 51

- Anxious individuals anticipate and interpret ambiguous events in a negative way o And engage in self-blame more readily + focus on negative aspects of events

Question 52

coping cat acronym

Answer 52

Feel frightened Expect the worst Attitude/actions that can help Results and rewards

Question 53

assessing children for anxiety disorder

Answer 53

Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Version (AIDS for DSM-IV:C/P) + Achebach scales for internalizing disorders for parents

Question 54

Three instruments for evidence-based practice

Answer 54

The Revised Children’s Manifest Anxiety Scale (RCMAS), the State-Trait Anxiety Inventory for Children (STAIC) and the Fear Survey Schedule for children – Revised (FSSC-R)

Question 55

which category is OCD in

Answer 55

includes OCD, body dysmorphic disorder, hoarding disorder, body-focused repetitive behaviours such as hair pulling (trichotillomania) and skin picking (excoriation)

Question 56

prevalence rates for OCD

Answer 56

1%

Question 57

OCD men vs women

Answer 57

slightly more women but men have earlier onset

Question 58

Prevalence rates for body dysmorphia

Answer 58

2%

Question 59

Symptoms of anxiety

Answer 59

o Emotional – anxious feeling o Cognitive – negative thoughts, tunnel vision o Physiological – trembling, palpitations, sweaty hands, tension, headache, abdominal pain, butterflies o Behavioural – avoidance and safety behaviour

Question 60

fear vs anxiety vs phobia

Answer 60

o Fear – emotional response to real or perceived immediate threat o Anxiety – anticipation of future threat – often used interchangeably with fear o Phobia – fearful or anxious about or avoidant of circumscribed object or situation (specific), no specific cognitive ideation (immediate response)

Question 61

why aren't safety behaviors good in the long-term

Answer 61

o Because the child doesn’t experienced that the feared outcomes don’t occur without the safety behaviour or learn to cope with it o The child attributes the absence of negative experience to the safety behaviour and not to own effort or abilities o Safety behaviours can increase the feared outcome

Question 62

protective factors in child

Answer 62

o Deliberate control  Attention control  Behavioural control – physiological  Emotion regulation o Perceived control (also self-esteem)  Sense of security that new situations can be controlled or tolerated

Question 63

family protective factors

Answer 63

o Authoritative parenting style o Family support o Safety (physical, psychological) o Predictability

Question 64

school protective factors

Answer 64

o Positive climate o Mentors o Safety o Predictability

Question 65

Three routes to anxiety

Answer 65

o Classical conditioning/experiential learning o Model learning o Informative learning

Question 66

Cognitive biases

Answer 66

o Fast response to threat stimulus  Stimulus attracts attention but once detected one shifts attention quickly  Implicit association that the stimulus is negative  negative outcomes  Stimulus trigger negative memories o People have little control  Therapy rarely addresses them