Anxiety and Obsessive-Compulsive Disorders

Question 1

Data collected by the Global Burden of Disease Study indicate that ______ disorders are the most prevalent mental disorders worldwide

Answer 1

anxiety

Question 2

Characteristics of Separation Anxiety Disorder

Answer 2

• developmentally & inappropriate fear or anxiety about being separated from attachment figures

Question 3

A diagnosis of Separation Anxiety Disorder requires _____ of _____ criteria to met

Answer 3

3 of 8

Question 4

For a diagnosis of Separation Anxiety Disorder, symptoms must last for at least _______ for children & adolescents or _____ for adults and cause significant distress or impaired functioning.

Answer 4

4 weeks; 6 months

Question 5

Separation anxiety disorder often develops after exposure to a stressful event, such as…?

Answer 5

parental divorce or the death of a relative or a pet

Question 6

School refusal is primraily associated with what disorder?

school refusal may manifest as this disorder

Answer 6

separation anxiety disorder

Question 7

Children with school refusal often complain of physical symptoms. Give examples. cry, plead, bargain, or exhibit panic symptoms when the time to go to school approaches

may also cry, plead, bargain, or exhibit panic symptoms when it’s time to go to school

Answer 7

headache, nausea, stomachache

Question 8

Preferred treatments for separation anxiety disorder

x3

Answer 8

(A) CBT
(B) psychoeducation, exposure, relaxation techniques, and cognitive restructuring
(C) parent training

Question 9

Characteristics of specific phobia needed for a diagnosis.

hallmark criteria & duration of time

Answer 9

fear, anxiety, avoidance, and/or intense distress; 6 months

Question 10

Name the 5 specifiers for specific phobia

Answer 10

1) animals
2) natural environment
3) blood-injection-injury
4) situational
5) other: situations cause comiting, choking, catching an illness

Question 11

Explain Mowrer’s (1947) two-factor theory

explanation for the development of specific phobia

Answer 11

• phobic reactions due to combo of classical & opeant conditioning
• Classical: fear is initially leanred when a neutral stimulus is paired with an aversive event
• Operant: fear is maintained when avoidance behaviors are reinforced by a reduciton in fear
• Result: conditioned response is not extinguished due to lack of opportunity to experience conditioned stimulus without unconditioned stimulus

Question 12

Preferred treatment for specific phobia

Answer 12

Exposure Response Prevention (ERP)

Question 13

Name the 2 types of Exposure Response Prevention

both types can be conducted in vivo or in imagination

Answer 13

1) Flooding
2) Graded (graduated) exposure

Question 14

Described the sequence of interventions in ERP graded exposure

Answer 14

1) construct a list of about 10 situations that cause anxiety (ranging from eliciting lowest to highest level of anxiety)
2) client confronts each item until anxiety subsides

clients report more comfort with this type of ERP = less likely to drop out prematurely

Question 15

Most type of ERP is as effective as in vivo for fear of heights?

Answer 15

virtual reality exposure

Question 16

Your client meets criteria for specific phobia, blood-injection-injury subtype. What other interventions might you need to pair with ERP? Why?

client T.G.

Answer 16

• applied tension
• reaction to feared stimulus rsults in brief initial increase in heart rate and blood pressure, followed by a decrease in heart rate and blood pressure, which causes the person to faint.

Question 17

A diagnosis of Social Anxiety Disorder requires persistent symptoms** lasting at least**..?

Answer 17

6 months

Question 18

First-line treatment for Social Anxiety Disorder?

Answer 18

• CBT
• antidepressants (SSRIs and SNRIs)

Question 19

Research shows - for adults with social anxiety disoder, guided internet-delivered CBT is (less effective, similarly effective, or more effective) than face-to-face CBT.

Answer 19

similarly effective

Question 20

Research shows - for children & adolescents with social anxiety disoder, what form of CBT has beneficial effects?

Answer 20

school-based CBT

Question 21

Criteria for Panic Disorder

Answer 21

• recurrent, unexpected panic attacks
• at least 1 attack, followed by 1+ month of persistent concern about additional attacks, their consequences, or significant maladaptive change in behavior related to attack

Question 22

What physical health issues mimick panic attack symptoms and must be ruled out before diagnosis is given?

Answer 22

• hypothyroidism
• cardiac arrhythmia

Question 23

First-line treatment for panic disorder?

Answer 23

1) comprehensive cognitive-behavioral intervention - introceptive exposure (breathe through a straw) w/ relaxation
2) antidrepressant (imipramine) and benzo

Question 24

Criteria for Agoraphobia? What are these situations?

Answer 24

1) fear or anxiety in 2 of 5 situations, lasting at least 6 months
* standing in line or being in a crowd
* being outside the home alone
2) avoidance due to concern that escape will be difficult or help unavailable
3) situation always elicits fear or anxietyess and is actively avoided, require the presence of a companion, or endured with intense distr

Question 25

First-line **treatment** for Agoraphobia

Answer 25

In vivo ERP * most commonly used: graded exposure * most effective long-term: intense (non-graded) exposure

Question 26

# ``` ``` Research shows that these treatments are **not effective** for Agoraphobia. Why not? ## Footnote combination of interventions

Answer 26

* combining in vivo ERP with applied tension * breathing retraining * CBT * because learning to tolerate high levels of fear and anxiety is a key contributor to effectiveness

Question 27

Children and adolescents experiencing symptoms of GAD tend to overworry about what?

Answer 27

catastrophic events and their consequences in sports and school

Question 28

Adults experiencing symptoms of GAD tend to overworry about what?

Answer 28

their health and safety

Question 29

Data collected by the World Health Organization indicates that the most common comobid disorder for GAD is what? Followed, in order, by what other disorders?

Answer 29

1. MDD 2. social anxiety disorder 3. specific phobia 4. PTSD

Question 30

Name 5 risk factors associated with GAD

Answer 30

1. family history of GAD 2. temperment dimensions of behavioral inhibition 3. meuroticism 4. harm avoidance 5. exposure to childhood trauma or chronic stress

Question 31

GAD is associated with abnormalities in what subcortical brain areas?

Answer 31

* ventrolateral & dorsolateral prefrontal cortex * anterior cingulate cortex * posterior parietal cortex * amygdala * hippocampus

Question 32

Evidence shows GAD is associated with reduced connectivity between what regions of the brain? What does this suggest about the brain?

Answer 32

* between regions of the prefrontal cortex and anterior cingulate cortex and the amygdala * suggesting weak top-down control of amygdala reactivity

Question 33

Most effective treatment for GAD

Answer 33

* CBT * SSRIs and SNRIs

Question 34

What medication can be prescribed to people with GAD who don't respond to antidepressants?

Answer 34

anxiolytic busprione (Buspar) or benzos

Question 35

What has research shown about the effectiveness of combining CBT with motivational interviewing for treating GAD? OCD?

Answer 35

* most consistently found it is effective for treating more severe symptoms of GAD * combined treatment is a promising but unproven approach

Question 36

How long must someone experience compulsions per day to meet criteria for OCD?

Answer 36

more than 1 hour per day

Question 37

Purpose of **specifiers** for OCD

Answer 37

to indicate the person's level of insight into the veracitty of their beliefs and the presence of tics

Question 38

(Males or Females) have an earlier age of onset of OCD. (Males or Females) have a slightly higher childhood prevalience of OCD. (Males or Females) have a slightly higher prevalence of OCD in adulthood.

Answer 38

1. Males 2. Males 3. Females

Question 39

% of people with OCD who have comnorbid psychiatric disorders? Most common? Followed, in order, by what other disorders?

Answer 39

* 90% * most common: an anxiety disorder * followed by: a depressive or bipolar disorder, an impulse control disorder, and a substance use disorder

Question 40

What neurotransmitter is associated with OCD? What brain areas?

Answer 40

* (low) serotonin * (elevated activity in) caudate nucleaus, orbitofrontal cortex, cingulate gyrus, & thalamus

Question 41

First-line **treatment** for OCD?

Answer 41

1. ERP aka exposure and ritual prevention * involves preventing engagement in ritualistic behaviors when exposed to anxiety-arousing thougts, objects, or situationss 2) SSRI or tricyclic clomipramine | combined treatment when ERP or meds alone are ineffective or symptoms ar

Question 42

Recent research has provided evidence for these treatments as effective for treating OCD

Answer 42

CBT & ACT for OCD

Question 43

**Criteria** for Body Dysmorphic Disorder

Answer 43

* preoccupation with perceived flaw or defect in physical appearance not observable by others * repetitive behaviors or mental acts (e.g., mirror picking, skin picking) * MAY have a) sough medical treatment to correct defect/flaw and/or b) many ideas or delusions of reference (i.e., other people are mocking them or taking special nitive of them bc of physical appearance)