Week 7 Anxiety/OCD/Traumatic Stress Disorder Flashcards Preview

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Flashcards in Week 7 Anxiety/OCD/Traumatic Stress Disorder Deck (25)
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1
Q

What are the levels of anxiety. Explain each

A
  1. Mild: can be productive; more observant, learning is possible
  2. Moderate: attention = more selective; perceptual field narrows; might see peripheral but if someone points it out first
  3. Severe: tunnel vision; perceptual field = greatly reduced
  4. Panic: perceptual field is reduced to a detail which is elaborated by distortion or the focus is scattered
2
Q

Explain panic attack and the symptoms that appear

A

Discrete period of intense fear or discomfort, symptoms develop abruptly and peak within 10 mins of onset

Four or more of these sx must be present:

  • palpitations
  • sweating
  • trembling or shaking
  • SOB and or sensation of smothering
  • feelings of choking
  • chest pain
  • nausea or abdominal distress

**need to rule out MI with ECG, labs (troponin, BNP, CBC) and vitals

3
Q

Explain panic disorder

A

Recurrent, unexpected panic attacks

at least one of the attacks have been followed by one month or more of one the following:

  • persistent concern about having a panic attack
  • worry about implications of the attack and its consequences
  • significant change in behavior related to the attacks (they avoid things that they think will cause a panic attack)
4
Q

What is agoraphobia

A

anxiety about being in places or situations from which escape might be difficult or embarrassing or fear of having an unexpected panic attack without help being available

5
Q

Explain generalized anxiety disorder

A

Excessive anxiety and worry occurring more days than not for at LEAST 6 months

6
Q

Explain selective mutism

A

consistent failure to speak in social situations when there is an expectation to speak

7
Q

What are the meds or substances that can cause anxiety

A

Meds:
- bronchodilators, amphetamines, steroids

Substances:
- caffeine, cocaine, and stimulants

8
Q

What are the treatment options for anxiety

A

Therapy:

  • CBT = primary treatment therapy
  • behavioral
  • exposure (prolonged exposure and cognitive processing used for specific phobias)

Psychopharmacology;

  • in addition to other therapies
  • ameliorate symptom distress
  • safety net or rescue meds (SSRI, Benzos)
9
Q

What would benzodiazepines be used for?

A

used for acute episodes; never for long term use because they can become addicted and experience withdraw symptoms

10
Q

What are the types of OCD

A
  • OCD
  • body dysmorphic disorder
  • hoarding
  • trichotillomania
  • excoriation
  • substance/med induced
  • OCD due to general medical condition
  • OCD other specified or unspecified
11
Q

explain OCD

A

recurrent obsessions (thoughts) or compulsions (behaviors) or a combo of the two

  • persistent thoughts, impulses, or images that cause anxiety or distress
  • not always worries about real life problems
  • person tries to ignore by thinking of other thoughts and actions
  • they have insight, meaning they understand their illness and the compulsions but its just who they are
12
Q

What is trichotillomania

A

recurrent pulling out of one’s hair resulting in hair loss

13
Q

What is excoriation disorder

A

recurrent skin picking resulting in lesions

14
Q

What are the specifiers for body dysmorphic disorder

A
  • with muscle dysmorphia

- with level of insight (absent, poor, good or fair)

15
Q

What are the interventions for OCD

A

Therapy:

  • exposure and response prevention
  • thought stopping (replacing thoughts with other thoughts to reduce anxiety)
  • relaxation techniques
  • cognitive restructuring

Psychopharmacology:
- antidepressants (SSRIs to include fluoxetine, fluvoxamine, paroxetine and sertraline) or tricyclics (clomipramine)

16
Q

What are the risk factors for PTSD

What is the onset to remission for males and females

A

Risk factors;

  • prior dx of ASD (acute stress disorder)
  • extent, duration and intensity of the traumatic event
  • environmental factors
  • onset to remission for women is 4 years compared to 1 year for men
17
Q

Explain acute stress disorder

A
  • sx must be at least 3 days and up to 1 month after the even exposure
  • experienced directly or indirectly, witnessed or confronted with an event involving actual or threatened death or serious injury, or threat to the physical integrity of self or others
  • doesn’t include e-media, tv, movie or picture exposure unless its work related
18
Q

What are the moods associated with acute stress disorder

A
  • intrusion, negative mood, dissociative, avoidance, arousal
19
Q

Explain intrusion and negative mood

A

Intrusion:
- distressing memories, dreams, dissociative reactions, marked psychological and or physiological distress in response to internal or external cues

Negative mood:
- persistent inability to experience positive emotions

20
Q

explain Dissociative and avoidance behaviors

A

Dissociative:
- depersonalization or derealization, event amnesia not related to organic causes

Avoidance:
- efforts made to distressing memories, thoughts or feeling or external reminders that are associated with the event

21
Q

explain arousal

A

sleep disturbance, irritability or anger outbursts, hypervigilance, difficulty concentrating or exaggerated startle response

22
Q

Explain PTSD

A
  • must have sx for at least 1 month
  • experienced, directly or indirectly, witnessed or confronted with an event involving actual or threatened death or serious injury, or threat to the physical integrity of self or others
23
Q

What are the re-experiencing that PTSD patients experience

A
  • recurrent and intrusive recollections (repetitive play in children with themes of the trauma)
  • recurrent dreams (frightening dreams without recognizable content in children)
  • dissociation: acting or feeling the event were recurring (re-enactment in young children)
  • intense psychological distress at exposure to internal and external cues that resemble the event
  • marked physiological reactions to internal or external cues that symbolize the event
24
Q

What falls under reactivity for PTSD patients

A
  • difficulty falling or staying asleep
  • irritability or anger outbursts
  • difficulty concentrating
  • hypervigilance
  • exaggerated startle response
  • reckless or self destructive behavior
25
Q

What are the interventions for PTSD patients

A

Therapy:

  • individual and group therapy
  • community support groups

Psychopharmacology:
- SSRIs to include sertraline (zoloft) and paroxetine (paxil)