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Psych 1 > Anxiety > Flashcards

Anxiety Flashcards

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1
Q

Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least three of the following:

A

separation anxiety disorder

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2
Q

emotional response to real or perceived imminent threat

Surges of autonomic symptoms (fight or flight)

A

fear

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3
Q

anticipation of future threat

Diffuse, unpleasant, vague symptoms of apprehension

Muscle tension, hypervigilance, and cautious/avoidant behaviors

A

anxiety

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4
Q

Fear/anxiety about a specific object/thing
Which provokes immediate fear/anxiety
Phobic object is avoided or endured with intense fear/anxiety
Fear/anxiety is out of proportion to (OOPT) actual danger posed
Fear/anxiety is persistent (6 months)
Clinically significant distress or impairment
Not better explained by something else

A

specific phobia

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5
Q

Key feature is a phobic stimulus with

A

active avoidance

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6
Q

Suicide risk up to 60% more likely to attempt, possibly due to comorbidity of other anxiety DO or Personality DO

A

specific phobia

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7
Q

Behavioral tx:
Desensitization
Frequently used with medications

A

specific phobia

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8
Q

first line psychotherapy for specific phobia?

A

CBT… can use with pharmacology (better than monotherapy but NOT requried)

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9
Q

May be treated with SSRIs or SNRIs
Great in long term management
Decreased risk of tolerance or dependence
Consider typical IRBA and length of time for resolution with these medications

A

specific phobia

(propanolol for areas like performance anxiety)

(miscellaneous = gabapentin)

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10
Q

Fear/anxiety about a social situation where one is exposed to scrutiny by others
Fear of expressing anxiety symptoms that will be negatively evaluated
Social situations always provoke these feelings
Social situations are avoided or endured with anxiety
Fear/anxiety is OOPT actual threat posed by social situation
Symptoms are persistent
If comorbidity present, they are clearly unrelated or is excessive

A

Social Anxiety Disorder

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11
Q

Key feature is fear of a social situation where one may be scrutinized by others

A

social anxiety disorder

These individuals may inadequately assertive, submissive, or occasionally highly controlling

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12
Q

Non-pharmacologic for SAD?

same as specific phobia

A

Behavioral = Desensitization, Frequently used with medications

Psychological = Cognitive behavioral therapy (First-line psychotherapy; Combo of this and medications are better than monotherapy.This does not imply that both MUST be used together )

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13
Q

Medication for SAD?

same as specific phobia

A

May be treated with SSRIs or SNRIs
Great in long term management
Decreased risk of tolerance or dependence
Consider typical IRBA and length of time for resolution with these medications

Miscellaneous = Gabapentin; Propranolol for performance or test anxiety

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14
Q

Unexpected panic attack with at least 4 associated symptoms that are not culturally normal

A

Panic attack

(4 associated symptoms that are not culturally normal might include palpitations, sweating, trembling/shaking, SOB, feelings of choking, chest pn/discomfort, nausea/abd stress, dizziness/lightheaded/faint, paresthesias, derealization/depersonalization, fear of losing control, feeling of going crazy, fear of dying

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15
Q

A panic disorder attack is followed by at least one of these

A

Worrying about more panic attacks

Maladaptive change in behavior because of the panic attacks

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16
Q

Key feature is recurrent unexpected panic attacks

A

Panic Disorder

Abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four or more of a list of 13 physical and cognitive symptoms occur

No obvious cause or trigger
Expected or unexpected
Nocturnal panic attacks

17
Q

Relaxation training
Desensitization
Can work as well as medication

A

Non-pharmacologic/Behavioral Treatment for panic disorder

18
Q

psychological tx for panic disorder?

A

CBT

First-line psychotherapy
Combo of this and medications are better than monotherapy
This does not imply that both MUST be used together
Appear to respond as well to cognitive behavioral therapy as it does to medications

19
Q

First line meds for panic disorder?

A

ADs (SSRIs, SNRIs, TCA)

great in long term mgmt, decreased risk of tolerance/dependence)

consider typical IRBA and length of time for these meds

20
Q

Other med options or panic disorder?

A

Benzodiazepines
Much faster efficacy; beneficial in acute management
Much higher risk of dependence and withdrawal symptoms

Miscellaneous
Propranolol
improve the peripheral symptoms of anxiety without significantly affecting motor and cognitive performance
i.e. palpitations, tremors, etc…

21
Q

Marked anxiety in at least 2 of 5 situations
Avoids these situations because escape will be difficult or help will be limited
Agoraphobic situations always evoke anxiety and actively avoided, endured, or require a companion
OOPT actual danger
Persistent
Clinically significant or clearly excessive if another medical condition is present
Not better explained

A

agoraphobia

22
Q

“2 of 5 situations for agoraphobia” includes?

A

public trans

Being in open spaces (parking lots, marketplaces, etc.)

ENclosed spaces (shops, theaters, etc)

Standing in lines/crowds

Being otuside of the home alone

23
Q

Associated with considerable disability

More than 1/3 of these individuals live alone

A

Agoraphobia

24
Q

Requiring fears from two or more of the agoraphobic situations is a robust means for differentiating agoraphobia from specific phobias, particularly the situational subtype

A

check

25
Q

Non-pharmacologic

Peer support groups have been found to be helpful

A

Agoraphobia

26
Q

Meds for agoraphobia?

A

SSRIs
SNRIs
Gabapentin

27
Q

Excessive worry about multiple things, more days than not, for at least 6 months

Difficult to control the worry

At least 3 of 6 symptoms
Clinically significant

A

Generalized Anxiety Disorder

28
Q

At least 3 of 6 symptoms for GAD include?

A

restlessness/feeling on edge

being easily fatigued

difficulty concentrating/mind going blank

Irritability

muscle tension

sleep disturbances

29
Q

Key feature is the excessive worry about multiple things

The intensity, duration, or frequency of the anxiety and worry is out of proportion to the actual likelihood or impact of the anticipated event

A

generalized anxiety disorder

30
Q

Non-pharmacologic generalized anxiety disorder

A

Behavioral
Relaxation and desensitization techniques
Frequently used with medications

Psychological
Cognitive behavioral therapy
First-line psychotherapy
Combo of this and medications are better than monotherapy
This does not imply that both MUST be used together

31
Q

Antidepressants are first line medications (SSRI, SNRI, TCA)
Great in long term management
Can be anxiogenic
Decreased risk of tolerance or dependence
Consider typical IRBA and length of time for resolution with these medications

A

Generalized Anxiety Disorder

32
Q

Much faster efficacy; beneficial in acute management

Much higher risk of dependence and withdrawal symptoms

A

BZDs for GAD

Misc meds for GAD include = Buspirone, Gabapentin, Propranolol

33
Q

Tx for MILD GAD?

barely meets criteria, self-contorlled, not adversely affecting life, etc.

A

Behaviroal health, non-medication mgmt

follow up as needed, meds if needed… try to avoid BZDs

34
Q

Tx for mdoerate GAD…

mre than meets critera, mostly NOT self-controlled, may/may not affect lfie…

A

Start as low as possible….

Behavioral health always… consider meds at this poitn (try to avoid abortive meds if possible)

Consider work restriction suggestions

Reassess/readjust at f/u

35
Q

Severe GAD tx?

more than meets criteria, severe ssx, adversely affected lfie

A

Start low (behavioral referral always)

Work w/ subspecialist if possible

Consider daily meds/breakthrough, abortive med

36
Q

GAD and depression are similar… but?

A

someone with depression has to tell you they feel depressed…

Endorse depression

Psych 1 (9 decks)

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