36: Worry and Anxiety- Streyffeler

Question 1

the alert system that helps to keep us alive turns on quickly, but ____

Answer 1

shuts down more slowly

Question 2

fear system

Answer 2

amygdala –> hypothalamus –> release of stress hormones to blood stream

Question 3

a response to worried pts: the BATHE model

Answer 3

Background “tell me about the stressors in your life”
Affect “how do you feel about it”
Trouble “what troubles you most about it”
Handling “how are you handling or coping with it”
Empathy “that must be very difficult”

Question 4

who is the ‘affect regulator’

Answer 4

provider

Question 5

a response to a known and definite threat

Answer 5

fear

Question 6

a response to a threat that is sometimes known, but may also be unknown, internal, vague or conflictual

Answer 6

anxiety

anxiety that is severe, persistent and disabling and persists beyond developmentally appropriate periods of times = disorder

Question 7

one in ______ people meet the criteria for one disorder in their lifetime

Answer 7

four

more prevalent in women than men

prevalence increases with lower levels of socio-economic status

Question 8

3 As of anxiety disorders

Answer 8

anticipation/appraisal
arousal
avoidance

Question 9

avoidance leads to ***

Answer 9

anxiety

exposure leads to extinciton

Question 10

developmentally inappropriate, excessive and recurring fear related to separation from home and/or attachment figures

Answer 10

separation anxiety

adult- 6mos; child - 4wks

Question 11

primary complication in panic attack

Answer 11

fear of future attacks

Question 12

goals of panic attack interventions

Answer 12

• resolve or reduce panic attacks
• reduce general and anticipatory anxiety; and sensitivity to physical symptoms
• minimize avoidance behaviors
• treat any comorbidities

Question 13

panic disorder =

Answer 13

at least one panic attack followed by 1 mo of persistent worry of another attack, or maladaptive behavioral changes to avoid an attack

heart disturbances, SOB, chest pain, fear of dying, dizzy/lightheaded

Question 14

tx for panic disorder

Answer 14

cognitive-behavioral therapy

family therapy

Question 15

agoraphobia =

Answer 15

fear of (at least 2):
public transportation
open spaces
enclosed spaces
being caught in a crowd or line
being outside the home alone

Question 16

80% of diagnosed agoraphobia pts are

Answer 16

female

relief reinforces the avoidance and number of safe places narrows until pt is homebound

Question 17

social anxiety disorder

Answer 17

marked fear/anxiety of social situations involving exposure to the possible scrutiny of others; concern for acting in a way that is humiliating or embarrassing

most common fear is public speaking

Question 18

excessive anxiety/worry (more days than not) about a number of events or activities

Answer 18

gneralized anxiety disorder

including at least 3 of following
restlessness on edge
easily fatigued
difficulty concentrating or mind goes blank
irritability
muscle tension
sleep disturbance

often seek attention for somatic complaint

Question 19

suspicious anxiety

Answer 19

• onset of symptoms after age 35
• lack of a psychosocial history of anxiety
• no childhood issues related to anxiety
• lack of exacerbating life events
• lack of avoidance behaviors
• poor response to antianxiety medications