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Psych > Anxiety and dissociative disorders > Flashcards

Anxiety and dissociative disorders Flashcards

1
Q

What are the major anxiety disorders?

A
  • Panic disorder
  • social phobia
  • obsessive compulsive disorder
  • generalized anxiety disorder
  • simple phobia
  • PTSD
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2
Q

What are the 3 main symptoms with anxiety disorders?

A
  1. arousal (tonic, paroxysmal, mixed)
  2. negative expectations (interpretation of situations as ominous or overwhelming)
  3. avoidance (of situations perceived as dangerous)
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3
Q

What is the course of onset of panic disorder?

A

Onset: early teens through age 40

chronic, relapsing

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4
Q

What is the course of onset of social phobia/ social anxiety disorder?

A

bimodal onset: age 5 or early adolescence

Chronic, may remit with positive social experience

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5
Q

What is the course of onset of simple phobia?

A

onset: animals (7yo), blood (9yo), situations (2-7yo and early 20s)
may remit with experience

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6
Q

What is the course of onset of PTSD?

A

any age, after trauma
may begin at variable intervals
intensity waxes and wanes with experience

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7
Q

What is the course of onset of OCD?

A

males: 6-15 yo, females: 20-29 yo (esp post-partum)
onset gradual, 5% episodic, 15% severely deteriorate
Waxes and wanes with stress

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8
Q

What is the course of onset of generalized anxiety disorder?

A

mid teens to mid 20s
may occur after onset of chronic illness
duration >6 mo

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9
Q

Epidemiology of panic disorder

A

Prev: 1-3% community
3-8% in primary care
F>M (2:1)

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10
Q

Epidemiology of social phobia/ social anxiety disorder

A

Prev: 3-4% severe, performance anxiety more common

F>M, 3:2

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11
Q

Epidemiology of simple phobia

A

Prev: 11% (MC anxiety disorder)
blood, injury, injection phobias
M>F

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12
Q

Epidemiology of PTSD

A

Prev: 8%, varies by exposure risk

with equal exposure to trauma, females more likely than males to develop PTSD

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13
Q

Epidemiology of OCD

A

Prev: 2% in peds (0.3-1%)
childhood onset: M>F
adult: M=F

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14
Q

Epidemiology of GAD

A

Prev: 5%

F>M, 2:1

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15
Q

What is anticipatory anxiety? Who has it?

A

fear of having an attack

panic disorder pts

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16
Q

What is avoidance? Who does it?

A

avoidance of situations where panic is likely to occur or help is unavailable

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17
Q

What is a panic attack?

A

discrete period of intense fear or discomfort during which multiple symptom develop abruptly and reach a peak within 10 minutes

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18
Q

Whats the difference between social phobia and simple phobia?

A

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

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19
Q

Explain the endocrine dysfunction involved with PTSD

A
  • low urinary cortisol, high NE metabolite excretion

- partly reversible shrinkage of hippocampus

20
Q

Contrast PTSD and ASD

A

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

21
Q

Describe OCD based on the 3 main symptoms of intrusion, arousal, and avoidance

A

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)

22
Q

How long must symptoms of GAD go on before a diagnosis can be made?

A

more than 6 months

23
Q

What are the symptoms of GAD?

A

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

24
Q

What is dissociation?

A

disruption, loss of absebce of the usual integration of mempry, consciousness and personal identity

25
Q

What is normal dissociation?

A

commonly occurs, example: when a person is absorbed in a book and unaware of surroundings

26
Q

What is hypnosis?

A

dissociation induced by intense concentration

27
Q

What is pathologic dissociation?

A

dissociation that occurs repeatedly and out of context and results in impaired functioning, primarily in close personal relationships and stressful environments.

28
Q

What is dissociative fugue?

A

departs from usual activity with patchy loss of personal memory

  • may be subtly confused or in no distress
  • F>M, usually occurring after traumatic event
29
Q

What is dissociative amnesia?

A

inability to remember important stressful personal events

Can last minutes to years

30
Q

What is depersonalization?

A

detachment from one’s own body and emotions

-feels robotic, as though describing someone else

31
Q

What is derealization?

A

person sees self as separate from environment, as if in a movie

32
Q

What is dissociative identity disorder?

A

person has two or more subjectively felt identities, each typically expresses a different affect
-person is aware of being divided, but may not know all the state or that they operate independently

33
Q

What does dissociative fugue often occur in response to? How long can it last?

A

After a traumatic event, F>M

It can last hours to months

34
Q

How long does dissociative amnesia last?

A

Can last minutes to years

35
Q

Does depersonalization involve memory loss?

A

No

36
Q

Is depersonalization usually persistent or intermittent?

A

It can be both, depending on the patient and the situation

37
Q

Is derealization usually persistent or transient?

A

Transient, not necessarily a disorder

38
Q

What are some risk factors for pathologic dissociation?

A

severe family dysfunction, poor premorbid emotional, social, or occupational functioning
-childhood abuse

39
Q

What substance use can cause anxiety?

A

stimulant over use or intoxication

alcohol withdrawal

40
Q

What is given to treat stage fright?

A

propranolol

41
Q

Is OCD classified as an anxiety disorder?

A

not anymore. It is a disorder in its own right

42
Q

How does the onset of OCD between females and males compare?

A

Males onset: 6-15 yo

Female onset: 20-29 yo

43
Q

What is an example of a psychiatric disorder that can occur with pathologic dissocation?

A

schizophrenia

44
Q

What disorder is dissociative identity disorder very similar to?

A

borderline personality disorder

–may meet criteria for both

45
Q

What drugs can induce dissociative disorder?

A

ketamine, LSD

Psych (12 decks)

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