Anxiety and dissociative disorders Flashcards
What are the major anxiety disorders?
- Panic disorder
- social phobia
- obsessive compulsive disorder
- generalized anxiety disorder
- simple phobia
- PTSD
What are the 3 main symptoms with anxiety disorders?
- arousal (tonic, paroxysmal, mixed)
- negative expectations (interpretation of situations as ominous or overwhelming)
- avoidance (of situations perceived as dangerous)
What is the course of onset of panic disorder?
Onset: early teens through age 40
chronic, relapsing
What is the course of onset of social phobia/ social anxiety disorder?
bimodal onset: age 5 or early adolescence
Chronic, may remit with positive social experience
What is the course of onset of simple phobia?
onset: animals (7yo), blood (9yo), situations (2-7yo and early 20s)
may remit with experience
What is the course of onset of PTSD?
any age, after trauma
may begin at variable intervals
intensity waxes and wanes with experience
What is the course of onset of OCD?
males: 6-15 yo, females: 20-29 yo (esp post-partum)
onset gradual, 5% episodic, 15% severely deteriorate
Waxes and wanes with stress
What is the course of onset of generalized anxiety disorder?
mid teens to mid 20s
may occur after onset of chronic illness
duration >6 mo
Epidemiology of panic disorder
Prev: 1-3% community
3-8% in primary care
F>M (2:1)
Epidemiology of social phobia/ social anxiety disorder
Prev: 3-4% severe, performance anxiety more common
F>M, 3:2
Epidemiology of simple phobia
Prev: 11% (MC anxiety disorder)
blood, injury, injection phobias
M>F
Epidemiology of PTSD
Prev: 8%, varies by exposure risk
with equal exposure to trauma, females more likely than males to develop PTSD
Epidemiology of OCD
Prev: 2% in peds (0.3-1%)
childhood onset: M>F
adult: M=F
Epidemiology of GAD
Prev: 5%
F>M, 2:1
What is anticipatory anxiety? Who has it?
fear of having an attack
panic disorder pts
What is avoidance? Who does it?
avoidance of situations where panic is likely to occur or help is unavailable
What is a panic attack?
discrete period of intense fear or discomfort during which multiple symptom develop abruptly and reach a peak within 10 minutes
Whats the difference between social phobia and simple phobia?
Social phobias are fears due to anticipation of humiliation/ rejection in social situations
Simple phobia is fear of responses or cues during a frightening experience, environment, situations, etc, but not necessarily social
Explain the endocrine dysfunction involved with PTSD
- low urinary cortisol, high NE metabolite excretion
- partly reversible shrinkage of hippocampus
Contrast PTSD and ASD
ASD: immediate reaction to trauma that involves dissociation and lasts for only up to 1 mo
PTSD: Lasts longer than 1 mo, not always as immediate
Describe OCD based on the 3 main symptoms of intrusion, arousal, and avoidance
Intrusive: obsessive thoughts, fears of contamination or danger, sometimes unjustified guilt
Arousal/Compulsions: acts or behaviors done to neutralize the fear of doing something wrong or making a mistake. (may not be related to obsessions)
How long must symptoms of GAD go on before a diagnosis can be made?
more than 6 months
What are the symptoms of GAD?
worries about health, safety, access to resources, threats to other people
Arousal/ autonomic dysfunction: muscle tension, head and back aches, sighing, difficulty concentrating
Can lead to avoidance of risk or novelty, constriction of behavior
What is dissociation?
disruption, loss of absebce of the usual integration of mempry, consciousness and personal identity
