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MHD > Anxiety > Flashcards

Anxiety Flashcards

1
Q

Fear vs Anxiety

A

Fear: emotional response to real or perceived threat
Anxiety: anticipation of future threat
anxiety disorders often have both

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2
Q

What causes anxiety to become pathological?

A
  1. Autonomy
  2. Intensity
  3. Duration
  4. Behavior-dysfunctional behaviors
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3
Q

Amygdala centered circuit:

A

fear, panic, phobia

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4
Q

Cortico-striatal-thalamic-cortical

A

worry, anxious misery, apprehension, expectation, obsessions

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5
Q

What are the neurotransmitters that are indicated in anxiety?

A
  1. Serotonin-raphe nuclei-low=aggression, impulsivity, depression, suicide attempts, self-injury, intrusive thoughts and repetitive behavior
  2. Ne-Locus ceruleus
    associated with orienting, selective attention, hypervigilance, mood and autonomic arousal
  3. GABA-increase gaba-alleviate anxiety
  4. glutamate-learning and memory
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6
Q

Male vs female anxiety

A

female

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7
Q

Panic Attack

A 
abrupt surge of intense fear that reaches a peak within 10 minutes and 4 or more occur
Palpitations
Paresthesias 
Abdominal Distress
Nausea
Intense fear of dying
I-lIghtheadedness
Chest pain
Chills
Chocking
C disConnectedness
Sweating
Shaking
SOB

4 or more four panic attack within 10 minutes

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8
Q

Panic Disorder

A

unexpected panic attacks with no identifiable trigger. at least one attack is followed for 1 month by anticipatory anxiety

  • worry about an additional attack or the consequences of an attack
  • significant maladaptive change in behavior related to the attack
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9
Q

Can panic attacks occur in any generalized anxiety disorder?

A

yes

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10
Q

What is the most common anxiety disorder comorbidity ?

A

agoraphobia: avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed

2nd most common: GAD

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11
Q

What is the most common non-anxiety comorbidity to anxiety?

A

major depression

Others:
alcohol>other substances
personality disorders-especially cluster C

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12
Q

What is the median age of onset of an anxiety disorder?

A

20-24

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13
Q

What are the symptoms of anxiety?

A

Physical symptoms:..
Affective: edginess to terror and panic; often viewed as irritability or restlessness
Cognitive: worry apprehension, poor concentration, mind blank, tense/jumpy, anticipate the worst
Behavioral: made an effort to diminish or avoid the stress; response can be checking behaviors, rituals, avoidance

–Without treatment: WAXING AND WANING

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14
Q

When are panic attacks and disorders risk factors for suicide?

A

diagnosis in the prior 12 months

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15
Q

What is the neurocircuitry model theory of anxiety?

A

abnormally sensitive fear network, centered in amygdala

GABA, serotonin, norepinephrine, implicated

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16
Q

What is first line for treatment of anxiety?

A

SSRI, SNRI
2nd line: TCAs, MAOI
while waiting for antidepressant effect: also treat with Benzo
Cognitive behavior therapy

17
Q

Agoraphobia

A 
fear or anxiety in at least 2 of the following situations for more than 6 months 
1. pubic transport
2. enclosed spaces
3. open spaces
4 standing in line
5. outside of the home alone

-onset late teens; late 20’s if no panic attacks/disorder
remission rare unless treated

18
Q

What is the treatment for agoraphobia?

A

systematic desensitization

19
Q

What is GAD, Specific Phobia, Social anxiety? How long do you have to have symptoms?
Female to male?
Comparison in prevalence
Age of onset?

A

GAD-excessive anxiety/ worry about many things-adults

Specific phobia-fear/anxiety about a specific situation or object-children

social anxiety-fear/anxiety from social situations where one is exposed to scrutiny/judgement by others; blushing-teens

> 6 months
F>M
Comorbidities: other anxiety disorders, depression, substance abuse disorders

Prevalence: specific> social> GAD

20
Q

What are the courses like for GAD, specific phobia, social phobia?

A

GAD-wax and wanted, tends to persist, full remission low

Specific- wax and wane; if persistent into adulthood, then full remission low

social-60% for years in adulthood=30% lasts

21
Q

How many phobias to specific phobias tend to have? What specific phobia does not have a childhood onset? What phobia is equal in males and females?

A

average 3
situational-not childhood onset
Males and females= in blood/injection/injury

22
Q

What two anxiety disorders use CBT and systemic desensitization?

A

agoraphobia and specific phobia

23
Q

What is separation anxiety?

A

concerning separation from home or attachment figure
M
fairly common
-majority of children-no anxiety disorders in lifetime
-can be seen adults

24
Q

What is selective mutism?

A

failure to speak in specific social situations

25
Q

What are 3 comorbidities with anxiety?

A
  1. depression-most common
  2. substance abuse
  3. personality traits/disorders-cluster c
26
Q

Adjustment disorder

A

emotional or behavior symptoms in response to an identifiable stressor occurring within 3 MONTHS

  • out of proportion distress
  • significant impairment

-once stressor is terminated symptoms do not persist for more than 6 months

27
Q

Acute stress disorder and PTSD are exposed to what?

A

exposure to actual or threatened death, injury, or sexual violence
-direct experience, witnessing, learning trauma occurred to close family member or friend, or repeated exposure to aversive details

28
Q

Acute stress disorder

A 
Intrusion symptoms
Negative mood
dissociative symptoms
avoidance symptoms
arousal symptoms
Duration 3days to 1 month
29
Q

PTSD

A 
Intrusion symptoms 
Negative alteration in mood and cognition 
avoidance symptoms 
arousal symtpoms
duration>1 month 
-50% recover in 3 months

F>M
Cocomrbi-mood disorders, anxiety disorder, substance abuse disorder (M>F)

Treatment:
antidep, no benzos

30
Q

OCD

A

Obsessions

  • recurrent and persistent thoughts, images or urges
  • intrusive and unwanted cuasing anxiety/stress

COmpulsions

  • repetitive behavior or mental acts
  • usually in response to obsession to reduce distress or prevent feared event

at least > 1 hour/day

F>M

Mean age 19 (males younger)

chronic waxing and waning over lifetime

Comorbid:

  1. anxiety disorder (usually anxiety then COD)
  2. mood disorder (OCD then Mood)
  3. Tic disorder (especially if OCD child)

Treatment: high dose SSRI
exposure therapy

31
Q

Body dysmorphic disorder?

A

preoccupied with minor or imagined defects in appearance leading to significant emotional distress

32
Q

Hoarding disorder

A

persistent difficulty parting with possessions, hoarding causes clinically significant distress

33
Q

trichotillomania

A

hair pulling

34
Q

excoriation disorder

A

skin picking

35
Q

Exposure therapy

A

phobias and OCD

MHD (81 decks)

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