Albasi- Anxiety Disorders

Question 1

What is anxiety?

Answer 1

A feeling of apprehension and fear that can be concrete or imagined.

Question 2

What is the Yerkes Dodson Curve?

Answer 2

Anxiety to a point increases engagement to optimize performance. After that it is dentrimental.

Question 3

What are types of Panic Disorders?

Answer 3

Agoraphobia
Specific Phobia
Social Phobia
Anxiety disorders

Question 4

Hoarding disorder, body dysmorphic disorder (flaws), trichotillomania (hair pulling), excoriation (skin picking) are all examples of what type of disorder?

Answer 4

OCD

Question 5

What are examples of trauma and stress related disorders?

Answer 5

PTSD

Reactive attachment disorder

Question 6

What is a panic attack?

Answer 6

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.

Question 7

What are symptoms of panic attacks?

Answer 7

Heart racing
chest pains
dizziness, lightheadedness, nausea
difficulty breathing

Question 8

What is agoraphobia?

Answer 8

Anxiety from leaving home or being in public places.

Question 9

Are panic disorders more common in men or women? What is the age of onset?

Answer 9

Panic disorders are 4 times more common in women than men.

Age of onset is late teens to early thirties.

Question 10

What is the prevalence of panic disorders in the general population?

Answer 10

5%

Question 11

What is social anxiety?

Answer 11

An intense fear of becoming humiliated in social situations.

Question 12

What is the prevalence of social phobia? When is the typical onset?

Answer 12

Prevalence 3-13%

Usually during childhood (16)

Question 13

What percent of people report excessive fear of public speaking?

Answer 13

20%

Question 14

What are specific phobias?

Answer 14

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.

Question 15

What is the prevalence of specific phobias?

Answer 15

More prevalent in women than men

5-12%

Question 16

What are simple phobias?

Answer 16

Arachnophobia
Ophidiophobia
Acrophobia
NOsophobia
Thanatophobia
Pogonophobia
Caligynephobia
Melanophobia
PHilophobia
ARachibutyrophobia

Question 17

What are obsessions?

Answer 17

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

Question 18

What are compulsions?

Answer 18

Repetitive, ritualized behaviors that the person feels driven to perform to alleviate the anxiety of obsessions.

Checking, cleaning, counting, collecting, arranging, repeating

Question 19

What is the diagnostic criteria for OCD?

Answer 19

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.

Question 20

What is the prevalence of OCD and when is the age of onset?

Answer 20

2-3%

Usually childhood, but treatment is sought later

Question 21

What causes PTSD?

Answer 21

Exposure to a terrifying even in which physical harm was threatened or occurred.

Assaults, disasters, wars, car accidents, witnessing trauma

Question 22

What are sx of PTSD?

Answer 22

Re-experiencing, avoidance, heightened awareness

Question 23

What is the prevalence of PTSD and what is the age of onset?

Answer 23

4%
3-58% in at risk individuals
can develop at any age including childhood

Question 24

What is the Behavioral Model of Anxiety and how does it relate to the 2 factor learning theory?

Answer 24

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.

Question 25

How does the 2 stage operant conditioning model relate to OCD?

Answer 25

Obsession: Pairing mental stimuli w/ anxiety provoking thoughts
Compulsion: neutral behaviors become associated w/ anxiety reduction and thereby are reinforced

Question 26

What are the genetic factors related to panic disorders?

Answer 26

Higher rates among 1st and 2nd degree relatives

20-50% vs 2-8% in control

Question 27

What are the genetic factors related to social phobia?

Answer 27

Greater concordance in monozygotic twins

Family aggregation

Question 28

What NT are related to anxiety disorders?

Answer 28

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

Question 29

What is seen in a PET scan of a brain with panic disorder?

Answer 29

High activity in temporal cortex during lactate-induced anxiety attacks
Hippocampus and amygdala

Question 30

What is seen in a PET scan of a brain with OCD?

Answer 30

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

Question 31

What are tx options for patients w/ anxiety disorders?

Answer 31

Behavior therapy
CBT
Pharmacological tx

Question 32

What is behavior therapy?

Answer 32

Exposure to anxiety provoking stimuli
response prevention
exposure and stress inoculation training

Question 33

What is CBT?

Answer 33

Identify triggers–look at cognitive patterns, education
Behavioral experiments
Stop safety behaviors

Question 34

What is pharmacological tx for anxiety disorders?

Answer 34

TCA (imipramine)
SSRI (Fluoxetine)
Benzodiazepines (Alprazolam, Xanax)

Question 35

What are SSRIs good for and not good for?

Answer 35

Good for tx of anxiety disorders

Not good for Substance Use Disorders