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MSII: Behavioral Science > Anxiety (13 & 14) > Flashcards

Anxiety (13 & 14) Flashcards

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1
Q

Name some physical manifestations of anxiety?

A

Sympathetic NS (diaphoresis, mydriasis, tachycardia, tremor)

GI/GU symptoms (diarrhea, increase urine frequency)

Hyperventilation (dizziness, syncope, parasthesia)

Numbness and tingling

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2
Q

Name the main classes of anxiety disorders?

A

Generalized anxiety disorder

Panic disorder (w/ or w/o agoraphobia)

Phobia/ Social Anxiety Disorder

OCD

Acute stress disorder

PTSD

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3
Q

When diagnosing anxiety…symptoms must:

A

1- Be persistent (generally >6mo)

2- Interfere with normal functioning

3- Cause significant distress

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4
Q

What are the neurobiological changes/ factors associated with anxiety?

A

Decreased serotonin and GABA

Increased NE and Glutamate

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5
Q

What are some psychosocial factors associated with anxiety?

A

Traumatic events/ extreme stressors

Maladaptive coping skills/ personality traits

Learned?

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6
Q

What is the gender bias of anxiety?

A

Women > Men

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7
Q

What is the DSM-V criteria for Generalized Anxiety Disorder (GAD)?

A

Excessive anxiety/worry, occurring more days than not for 6 months about at least one event

It is difficult to control the worry.

At least 3 additional symptoms

Causes significant impairment

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8
Q

What are the additional symptoms of GAD?

A

Restlessness, easy fatigue, difficulty concentrating, irritability muscle tension, sleep disturbance

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9
Q

Prognosis of GAD?

A

Gets worse without treatment

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10
Q

What are the main treatments for GAD?

A

1- CBT

2- Antidepressants (SSRI, SNRI)

3- Buspirone (5HT1 angonist)

4- Benzo

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11
Q

What is the DSM-V criteria for panic attacks?

A

An abrupt, surge of intense fear of discomfort, peaks within minutes, that is unexpected

Must have 4 or more of the following symptoms:

Palpitations, pounding/racing heart, sweating, shaking, SOB, choking feeling, Nausea, dizziness, chills/heat, parasthesias, derealization, fear of losing control/ death

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12
Q

What is the DSM-V criteria for Panic Disorder?

A

1- recurrent unexpected panic attacks

2- 1 or more attacks followed by 1 (more more) month of at least one of the following–> concern about additional panic attacks/ consequences OR significant maladaptive change in behavior related to attacks

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13
Q

What are the DSM-V criteria for Agoraphobia?

A

1- Fear/ anxiety about 2 or more: using public transit, being in open spaces being in enclosed spaces, standing in line or a crowd, being outside home

2- fear of not being able to escape

3- Situation almost always produces anxiety

4- avoids situations

5- Fear/ anxiety out of proportion to acutal danger

6- >6 mo

7- causes signifcant impairment

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14
Q

Prognosis with panic disorder?

A

Chronic and recurring

Increased risk of depression and suicide

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15
Q

Treatment for panic disorder?

A

1- CBT

2- systematic desensitization

3- Fast acting benzo (emergency)

4- SSRI/ SNRI (1st line for long term)

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16
Q

DSM-V criteria for phobia diagnosis?

A

1- >6mo

2- Causes significant impairment

3- marked fear for a specific object/ situation

4- object/ situation ALWAYS produces the fear

5- actively avoids the situation/ object

6- Fear is out of proportion

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17
Q

What are the criteria for social anxiety disorder diagnosis?

A

1- >6mo

2- causes significant impairment

3- marked fear when exposed to social situation w/ possible scrutiny with others

4- fear of acting in ways that will be negatively scrutinized

5- social situation provokes fear

6- Fear out of proportion

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18
Q

What is performance only social anxiety disorder?

A

Fear is restricted to public speaking or performing and does not generalize to other social aspects of life

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19
Q

Treatment for specific phobias?

A

1- Flooding

2- Systematic desnsitization

3- CBT

4- Benzos?

20
Q

What is the treatment for social phobia?

A

1- CBT

2- Assertiveness training/ Group therapy

3- SSRI/ SNRI

4- MAOI

21
Q

Treatments for performance anxiety?

A

Beta Blockers (propronolol)

22
Q

What are the criteria for OCD diagnosis?

A

Criteria A: The presence of Obsessions and Compulsions

Criteria B: The obsession and compulsions must be either time consuming or cause significant distress

23
Q

What is an obsession?

A

Recurrent/ persistent thoughts urges and/ or images

They are intrusive and unwanted

24
Q

What is a compulsion?

A

Repetitive behavior or activity that the patient performs in response to an obsession or as a set of rules that must be strictly adhered to

25
Q

T/F: A compulsion typically undoes or reduces anxiety

A

True

26
Q

Is OCD more common in women or men?

A

Same in each

27
Q

What is the prognosis of OCD?

A

Long and variable course

1/3 are cured, and a large amount have moderate improvement while 20-40% remain ill or worsen

28
Q

What illness is usually seen with OCD?

A

Tourette’s Syndrome

29
Q

What type of psychotherapy is used to treat OCD?

A

CBT

ERP (Exposure and Response Prevention)

ACT (Acceptance and Commitment Therapy)

30
Q

What Rx are used to treat OCD?

A

1st Line: SSRI

2nd Line: Clomipramine (a TCA)

3rd Line: antipsychotics, other antidepressants

31
Q

What needs to be on the differential diagnosis for OCD?

A

1- Tourette’s Syndrome

2- Temporal Lobe Epilepsy

3- Obsessive Compulsive Personality Disorder

32
Q

What is the most common thing that could cause PTSD?

A

Death of a loved one

33
Q

What is most likely thing to cause PTSD?

A

Assault

34
Q

What are the greatest variables associated with PTSD? (4)

A

Proximity, harm by another human, severity, repititino

35
Q

What is criterion A for PTSD diagnosis?

A

Exposure to actual or threatened traumatic even (death, serious injury, sexual violence)

36
Q

How long must symptoms be present for PTSD diagnosis?

A

More than 1 month

37
Q

What are some modes of exposure in PTSD?

A

1- Directly experiencing events

2- Witnessing events as occur to others

3- Learning that a family member/ friend experienced such an event

4- Directly experiencing repeated/ extreme exposure to horrific details of an event

38
Q

What is criterion B for PTSD diagnosis?

A

> 1 “intrusion Symptom” associated with an event:

Distressing memories, distressing dreams/ nightmares, psychological distress from exposure to clues that symbolize the event, psychological reactions to exposure to external cues

39
Q

What is criterion C for PTSD diagnosis?

A

Avoidance of stimuli associated with traumatic events

40
Q

What is criteria D for PTSD diagnosis?

A

Negative changes in cognition and mood with the associated event. Need 2 or more of the following:

  • dissociative amnesia or repression
  • exaggerated beliefs
  • blame
  • negative emotional state
  • inability to experience positive emotions
41
Q

What is criterion E for PTSD diagnosis?

A

Alterations in arousal/ reactivity (>2 of the following):

  • Irritable behavior/ angry outbursts
  • Reakless/ self-destructive behavior
  • Hypervigilance
  • Exaggerated startle response
  • Problems with concentration
  • Sleep dusturbance
42
Q

What is the criteria for acute stress disorder?

A

Same criteria for PTSD, just persists for 3 days - 1 month

43
Q

When is the best time to treat PTSD/ ASD?

A

The earlier the treatment begins, the better

44
Q

What are some co-morbidities seen with PTSD and ASD?

A

Depressive disorders

Substance related disorders

Other anxiety disorders

Bipolar disorders

Personality disorders`

45
Q

How is PTSD and ASD treated with psychotherapy?

A

CBT, Eye-Movement Desensitization and Reprocessing (EMDR), Support groups/ Family therapy

46
Q

What are some Rx used to treat PTSD and ASD?

A

1st line: SSRI

2nd line: TCAs, atypical antipsychotics

3rd line: MAOi, Trazodone, propranolol

47
Q

What can prazosin treat?

A

Nightmares

MSII: Behavioral Science (24 decks)

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