Anxiety and Obsessive-Compulsive Disorders Flashcards
Data collected by the Global Burden of Disease Study indicate that ______ disorders are the most prevalent mental disorders worldwide
anxiety
Characteristics of Separation Anxiety Disorder
- developmentally & inappropriate fear or anxiety about being separated from attachment figures
A diagnosis of Separation Anxiety Disorder requires _____ of _____ criteria to met
3 of 8
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.
4 weeks; 6 months
Separation anxiety disorder often develops after exposure to a stressful event, such as…?
parental divorce or the death of a relative or a pet
School refusal is primraily associated with what disorder?
school refusal may manifest as this disorder
separation anxiety disorder
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
headache, nausea, stomachache
Preferred treatments for separation anxiety disorder
x3
(A) CBT
(B) psychoeducation, exposure, relaxation techniques, and cognitive restructuring
(C) parent training
Characteristics of specific phobia needed for a diagnosis.
hallmark criteria & duration of time
fear, anxiety, avoidance, and/or intense distress; 6 months
Name the 5 specifiers for specific phobia
1) animals
2) natural environment
3) blood-injection-injury
4) situational
5) other: situations cause comiting, choking, catching an illness
Explain Mowrer’s (1947) two-factor theory
explanation for the development of specific phobia
- 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
Preferred treatment for specific phobia
Exposure Response Prevention (ERP)
Name the 2 types of Exposure Response Prevention
both types can be conducted in vivo or in imagination
1) Flooding
2) Graded (graduated) exposure
Described the sequence of interventions in ERP graded exposure
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
Most type of ERP is as effective as in vivo for fear of heights?
virtual reality exposure
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.
- 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.
A diagnosis of Social Anxiety Disorder requires persistent symptoms** lasting at least**..?
6 months
First-line treatment for Social Anxiety Disorder?
- CBT
- antidepressants (SSRIs and SNRIs)
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.
similarly effective
Research shows - for children & adolescents with social anxiety disoder, what form of CBT has beneficial effects?
school-based CBT
Criteria for Panic Disorder
- 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
What physical health issues mimick panic attack symptoms and must be ruled out before diagnosis is given?
- hypothyroidism
- cardiac arrhythmia
First-line treatment for panic disorder?
1) comprehensive cognitive-behavioral intervention - introceptive exposure (breathe through a straw) w/ relaxation
2) antidrepressant (imipramine) and benzo
Criteria for Agoraphobia? What are these situations?
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
First-line treatment for Agoraphobia
In vivo ERP
* most commonly used: graded exposure
* most effective long-term: intense (non-graded) exposure
```
~~~
Research shows that these treatments are not effective for Agoraphobia. Why not?
combination of interventions
- 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
Children and adolescents experiencing symptoms of GAD tend to overworry about what?
catastrophic events and their consequences in sports and school
Adults experiencing symptoms of GAD tend to overworry about what?
their health and safety
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?
- MDD
- social anxiety disorder
- specific phobia
- PTSD
Name 5 risk factors associated with GAD
- family history of GAD
- temperment dimensions of behavioral inhibition
- meuroticism
- harm avoidance
- exposure to childhood trauma or chronic stress
GAD is associated with abnormalities in what subcortical brain areas?
- ventrolateral & dorsolateral prefrontal cortex
- anterior cingulate cortex
- posterior parietal cortex
- amygdala
- hippocampus
Evidence shows GAD is associated with reduced connectivity between what regions of the brain? What does this suggest about the brain?
- between regions of the prefrontal cortex and anterior cingulate cortex and the amygdala
- suggesting weak top-down control of amygdala reactivity
Most effective treatment for GAD
- CBT
- SSRIs and SNRIs
What medication can be prescribed to people with GAD who don’t respond to antidepressants?
anxiolytic busprione (Buspar) or benzos
What has research shown about the effectiveness of combining CBT with motivational interviewing for treating GAD? OCD?
- most consistently found it is effective for treating more severe symptoms of GAD
- combined treatment is a promising but unproven approach
How long must someone experience compulsions per day to meet criteria for OCD?
more than 1 hour per day
Purpose of specifiers for OCD
to indicate the person’s level of insight into the veracitty of their beliefs and the presence of tics
(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.
- Males
- Males
- Females
% of people with OCD who have comnorbid psychiatric disorders? Most common? Followed, in order, by what other disorders?
- 90%
- most common: an anxiety disorder
- followed by: a depressive or bipolar disorder, an impulse control disorder, and a substance use disorder
What neurotransmitter is associated with OCD?
What brain areas?
- (low) serotonin
- (elevated activity in) caudate nucleaus, orbitofrontal cortex, cingulate gyrus, & thalamus
First-line treatment for OCD?
- 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
Recent research has provided evidence for these treatments as effective for treating OCD
CBT & ACT for OCD
Criteria for Body Dysmorphic Disorder
- 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)
