anxiety

Question 1

what are the physical symptoms of anxiety?

Answer 1

sympathetic activation. diaphoresis, mydriasis, tachycardia, tremor. GI/GU inc. diarrhea and urinary frequency. hyperventilation: dizziness and syncope. numbness and tingling in the extremities and around mouth. restlessness, irritability, trouble concentrating, worrisome

Question 2

what are the different types of disorders?

Answer 2

GAD, panic disorder (with or without agoraphobia), specific phobia or social anxiety disorder, OCD, acute stress and PTSD.

Question 3

diagnosis

Answer 3

must occur for >6 months. interfere with normal functioning, significant distress.

Question 4

GAD general (pop, demographics, etc.)

Answer 4

common 3-5% pop. women more than men, half begin prior to adulthood. tends to get worse over time.

Question 5

GAD

Answer 5

excessive worry, occurring more days than not for at least 6months. at least one event per activity. find it difficult not to worry. associated with at least three of the symptoms.

Question 6

symptoms of GAD

Answer 6

restlessness, easily fatigued, difficult to concentrate, irritable, muscle tension, sleep disturbance.

Question 7

panic attack (within the panic disorder)

Answer 7

an abrupt surge of intense fear or discomfort peaks within min that is unexpected. at least four of the symptoms.

Question 8

symptoms of panic attack.

Answer 8

palpitations/pounding heart/accelerated rate, sweating, shaking, trembling, sensation of shortness of breath, choking feeling, chest pain/discomfort, nausea, dizziness/lightheadedness, chills or heat, parenthesis, derealization, fear of losing control, fear of dying.

Question 9

panic disorder itself

Answer 9

recurrent unexpected attacks. at least one attack then one month with concern about additional attacks or consequences, with a significant maladaptive change in behavior related to the attacks.

Question 10

PD with agoraphobia

Answer 10

fear or anxiety about at least 2 of the following: public transportation, open spaces, enclosed spaces, standing in a crowd, outside (home alone). fear of not be able to leave a situation, situation almost always produces fear and anxiety, at least 6months. fear and anxiety must be out of proportion of the actual threat.

Question 11

treatment for PD

Answer 11

cognitive behavioral therapy with systematic desensitization or flooding. psychodynamics.

Question 12

medication for PD

Answer 12

for emergency use benzo. for long term use SSRI, SNRI, immediately or long-acting benzo.

Question 13

phobia

Answer 13

at least 6 months, signif. impairment. fear or anxiety about situation or object. that thing always produces fear. fear/anxiety is out of proportion.

Question 14

social anxiety disorder

Answer 14

phobia. at least 6 months, sig impair, fear or anxiety about social situations in which one may be negatively scrutinized. social situation provokes fear. avoidance, out of proportion.

Question 15

first line treatment for phobia?

Answer 15

flooding/systematic desensitization. psychodynamics.

Question 16

treat for SAD

Answer 16

CBT, assertiveness training, group therapy.

Question 17

medication for SAD

Answer 17

ssri, snri, MAOi

Question 18

how do we treat performance anxiety?

Answer 18

use beta blockers such as propanolol

Question 19

OCD

Answer 19

presence of obsessions and compulsions. time consuming and cause sign distress. are not substance related.

Question 20

obession?

Answer 20

recurrent thoughts, images, urges. they are intrusive and unwanted and cause the person distress. the person will try to ignore or neutralize by performing some act (this is an ego defense mechanism). this is also the compulsion.

Question 21

compulsion

Answer 21

repetitive behavior that the person performs in response to an obsession. they are usually a set of rules that the person must follow. this typically undoes or reduces anxiety

Question 22

what happens if you stop the compulsion?

Answer 22

causes great anxiety and distress.

Question 23

comorbidities?

Answer 23

33% also have MDD. 66% of people with tourettes will have OCD. suicide is high.

Question 24

treatment for OCD

Answer 24

CBT. exposure and response prevention.

Question 25

pharma for OCD?

Answer 25

SSRI, TCA, antipsychotics.

Question 26

do benzos work for OCD?

Answer 26

no they do not work.

Question 27

what other diseases look like OCD?

Answer 27

tourettes, temporal lobe epilepsy, obessive compulsive personality disorder.

Question 28

PTSD

Answer 28

exposure to actual or threatened traumatic event. death, serious injury, sexual violence. symptoms must be present for 1 month.

Question 29

does the person have to be directly affected by the event to get PTSD?

Answer 29

no. can be direct, but also indirect through witnessing, learning of a family member, directly experiencing related or horrific details of the event.

Question 30

intrusion syndrome?

Answer 30

secondary criterion for PTSD. reliving of events. digressing memories, dreams, flashbacks. psychological distress that symbolizes or resembles an aspect of the traumatic event.

Question 31

other associations with PTSD?

Answer 31

avoidance. if the patient avoids things that resemble, r causes memories.

Question 32

negative features of PTSD

Answer 32

if the patient loses cognition over the event. for example dissociative amnesia, exaggerated beliefs, expectations, paranoid stances, distortion of thoughts, memories. negative emotional states such as depression or irritability. feeling of detachment from others. inability to experience positive emotions.

Question 33

alterations of arousal and behavior in PTSD

Answer 33

irritable or angry outburst verbal or physical aggression toward others or objects. reckless and self-destructive behavior. hyper vigilance. exaggerated startle response. problems with concentration. sleep disturbances.

Question 34

acute stress disorder

Answer 34

same exact as PTSD only 3 days to one month after event.

Question 35

comorbid wirth PTSD/ASD

Answer 35

depressive disordes, substance, other anxiety disorders, bipolar, personality

Question 36

treatment for PTSD

Answer 36

crisis intervention. support/grounding, validation of feelings. CBT, etc.

Question 37

medications for PTSD

Answer 37

SSRI, TCA, MAOi, anticonvulsant, clonidine.