Albasi- Anxiety Disorders Flashcards
What is anxiety?
A feeling of apprehension and fear that can be concrete or imagined.
What is the Yerkes Dodson Curve?
Anxiety to a point increases engagement to optimize performance. After that it is dentrimental.
What are types of Panic Disorders?
Agoraphobia
Specific Phobia
Social Phobia
Anxiety disorders
Hoarding disorder, body dysmorphic disorder (flaws), trichotillomania (hair pulling), excoriation (skin picking) are all examples of what type of disorder?
OCD
What are examples of trauma and stress related disorders?
PTSD
Reactive attachment disorder
What is a panic attack?
A BRIEF episode of INTENSE FEAR that is accompanied by physical symptoms. It often occurs repeatedly and unexpectedly.
PAs are the hallmark of panic disorder. This occurs when fight or flight response becomes inappropriately aroused.
What are symptoms of panic attacks?
Heart racing
chest pains
dizziness, lightheadedness, nausea
difficulty breathing
What is agoraphobia?
Anxiety from leaving home or being in public places.
Are panic disorders more common in men or women? What is the age of onset?
Panic disorders are 4 times more common in women than men.
Age of onset is late teens to early thirties.
What is the prevalence of panic disorders in the general population?
5%
What is social anxiety?
An intense fear of becoming humiliated in social situations.
What is the prevalence of social phobia? When is the typical onset?
Prevalence 3-13%
Usually during childhood (16)
What percent of people report excessive fear of public speaking?
20%
What are specific phobias?
Persistent fear that is excessive or unreasonable caused by the presence of anticipation of a specific obj/situation. Pt. usually realizes that the fear is excessive.
What is the prevalence of specific phobias?
More prevalent in women than men
5-12%
What are simple phobias?
Arachnophobia Ophidiophobia Acrophobia NOsophobia Thanatophobia Pogonophobia Caligynephobia Melanophobia PHilophobia ARachibutyrophobia
What are obsessions?
Unwanted, recurrent and disturbing thoughts that a person can’t suppress that can cause overwhelming anxiety.
Contamination, violent images, fear of harming self/others, forbidden sexual thoughts/impulses
What are compulsions?
Repetitive, ritualized behaviors that the person feels driven to perform to alleviate the anxiety of obsessions.
Checking, cleaning, counting, collecting, arranging, repeating
What is the diagnostic criteria for OCD?
Recurrent obsessions or compulsions that are severe enough to be time consuming (take more than 2 hr/day)
Individual recognizes that this is excessive/unreasonable.
What is the prevalence of OCD and when is the age of onset?
2-3%
Usually childhood, but treatment is sought later
What causes PTSD?
Exposure to a terrifying even in which physical harm was threatened or occurred.
Assaults, disasters, wars, car accidents, witnessing trauma
What are sx of PTSD?
Re-experiencing, avoidance, heightened awareness
What is the prevalence of PTSD and what is the age of onset?
4%
3-58% in at risk individuals
can develop at any age including childhood
What is the Behavioral Model of Anxiety and how does it relate to the 2 factor learning theory?
A neutral stimulus is paired with an anxiety provoking stimulus (traumatic event). Later, the neutral stimulus provokes anxiety response and avoidance behavior. Avoidance behavior is reinforced by the reduction of anxiety.
How does the 2 stage operant conditioning model relate to OCD?
Obsession: Pairing mental stimuli w/ anxiety provoking thoughts
Compulsion: neutral behaviors become associated w/ anxiety reduction and thereby are reinforced
What are the genetic factors related to panic disorders?
Higher rates among 1st and 2nd degree relatives
20-50% vs 2-8% in control
What are the genetic factors related to social phobia?
Greater concordance in monozygotic twins
Family aggregation
What NT are related to anxiety disorders?
GABA- main target
5HT
NE
CRH
Adenosine- caffeine blocks and increases risk of anxiety
Neuropeptides- can increase or decrease anxiety
Lactate/CO2- reduce threshold of pain
What is seen in a PET scan of a brain with panic disorder?
High activity in temporal cortex during lactate-induced anxiety attacks
Hippocampus and amygdala
What is seen in a PET scan of a brain with OCD?
5HT and DA involvement
Increased metabolic activity in head of caudate nucleus and orbital gyrus and frontal cortex
Effective tx associated w/ reduced metabolic activity in caudate nucleus
What are tx options for patients w/ anxiety disorders?
Behavior therapy
CBT
Pharmacological tx
What is behavior therapy?
Exposure to anxiety provoking stimuli
response prevention
exposure and stress inoculation training
What is CBT?
Identify triggers–look at cognitive patterns, education
Behavioral experiments
Stop safety behaviors
What is pharmacological tx for anxiety disorders?
TCA (imipramine)
SSRI (Fluoxetine)
Benzodiazepines (Alprazolam, Xanax)
What are SSRIs good for and not good for?
Good for tx of anxiety disorders
Not good for Substance Use Disorders
