ANXIETY AND OCD Flashcards
What are common features of anxiety disorders?
persistent, common, undiagnosed and untreated. Acts as a common predictor to the future mental health challenges
What is anxiety?
future-oriented emotion characterized by feelings of apprehension and lack of control over upcoming events that could be potentially threatening.
What are the symptoms of anxiety?
Physical: anxious arousal; increased heart rate, palpitations, sweating, increase in respiration, nausea, dry mouth
Cognitive: Anxious apprehension; worry of the future events, diff concentrating, self-critical thoughts, thoughts of incompetency, thoughts of bodily injuries.
Behavioural: avoidance behaviours bring temporary relief ; lack of eye contact, fidgeting, stuttering, nail biting, clenched jaw etc.
______ is the present-oriented worry and is a response to a real time danger or threat to ourselves
Fear
__________ is future oriented worry that has no real basis or perceived threat. It is a general fear to what may happen in the future
Anxiety
_____ is when you feel sudden intense fears and it comprises of both emotional and physical aspects but it is an oversenstivity and your brain misinterpreting somthing to be dangerous when its not
Panic
When you persistently feel uncontrollable and intense worry or fear and negative emotion over the future by purposely avoiding certain situations that might trigger it, is termed as ____
Anxiety disorder
In what cases is anxiety normal?
adaptive and developmental stage related
What are the boundaries between appropriate form of anxiety and abnormally excessive kind
- prolonged anxiety
- intense/exaggerated and unreasonable anxiety levels
- disabling such that it impairs everyday functioning
- distressing
What are the characteristics associated to anxiety?
- chronic negative feedback loop
- difficulty maintaing and initiating friendships
- substance abuse
- social withdrawal
- interferes with academics
6.low self esteem - loneliness
Hoe does school refusal manifest itself
- occurs between ages 5-11
- impacts 2 to 5% kids
- occurs during
- refusal to attend school or difficulty attending a whole day of classes
- transition periods like kindergarten, middle/hgh school or after school breaks
One form of maladaptive behavior can be viewed as a way to adapt or cope in new situations
T/F?
TRUE
1.What are the characteristic of Separation Anxiety disorder?
2.What is the prevalence rate and comorbidity in SAD?
- Onset and course
- Disabling excessive anxiety or distress over separation from home or attachment figures. Anxiety or nightmares.
Worry about harm to caregivers or some event causing harm to caregivers
Somatic/physical complaints include stomachaches, headaches, rapid heartbeat, dizziness and nausea - prevalence is 4-10% among youth. mOST children GO ON TO DEVELOP ANXIETY AFTER SAD and half develop depressive disorder. School rfusal is highly common among children. Prevalent among boys and girls equally.
- SAD is reported t a very early age and has a young age of onset (7-8 years). SAD varies as a function of stress and transitions in the chikds life. However, they tend to lose out on friends but are skilled socially.
School performance declines due to school absences resulting from refusal to attend school. SAD persisting in adulthood impacts relationships and might lead to panic or depressive disorders.
What is a specific phobia?
Phobia of specific situation or object that is age inappropriate and tends to persist and is also irrational it is called. specific phobia.
Exposure to thr situation or object implies fear or anxiety.
- The fear should persist for atleast 6 months
- experience extreme fear or dread
- physiological symptoms
- fear is out of proportion
- 20% youths experience it
- higher risk of developing a phobic disorder exhibited by parent
- comorbidity and its mostly anxiety
- more common in girls than boys especially blood phobias
- 7 to 9 years of age during onset
What is Generalized anxiety disorder? Define its characterstics.
What is the prevalence and comorbidity?
onset and course of development
It is an apprehensive expectation- minor or major and includes a a wide range of issues that are either minor or major
- the anxiety can be episodic or continuous and is uncontrollable
- self-concious and critical which leads to interpresonal problems and avoidance of those whom they perceive critical
- have high standards for slef which leads to them being critical of themselves. They are perfectionists and seek assurance from outside/others
- physical symptoms of GAD include muscle tension,, headaches nausea
- there is an intolerance for uncertainty
- difficulty concentrating, irritability, cant fall asleep, restlessness
- chronic worry as a cognitive avoidance
- least common anxiety disorder
- prevalence rate of 3-6% among youth
- equally common in boys and girls but older adolescent females have a slight higher prevalence
- higher rate of anxiety disorders
- MDD and GAD are highly occurring disorders
- most common among children referred to anxiety clinics
- young children: comorbidity exists with SAD and conduct problems
- older children: comorbidity with specific phobias, social anxiety, mdd, imired social adjustment and low self esteem and increased risk of suicide - ONSET: early adolescence
- high rates of symptoms in older adolescents suggests higher levels of anxiety and depression
- if follw-up casess of GAD symptoms continued tpo persist and even got severe after 2 years of initial assessment
- full remission is highly unlikely among GAD cases
- ONSET: early adolescence
What is social anxiety disorder?
prevalence/comorbidity?
Marked and persistent fear of tf social or performance requirements(speaking or interacting with others) that expose them to negative evaluations or causing offence or exposing them to scrutiny. They tend to avoid such situations and exposure to such fears causes anxiety. The fear is out of proportion to actual danger.
- sad, lonley, socially fearful, inhibited and highly emotional
- interferes with daily functioning signifcantly, intense anxirty, marked distress
- desire social contact but the fear pf embarrassment is so intense that they are unable to from relationships
- somatic symptoms: sweating, upset stomach, nausea, rapid heartbeat,
- develops after puberty that is after age t=10 mostly
-lifetime prevalence of 6 to 12%
- female:male = 2:1.
- females experience higher SAD as they are more concerned about their relationships and anticipated evaluation as well as social competence
- SAD is overlooked as shyness is common and children are not likely to inform despite being severely distressed
- Co-morbid disorders include GAD, specific phobias, major depression (20%)
- aggression and emotional outbursts due to the belief of being scrutinized and self-critical nature
- what sre the implications: relationship diff, educational diff, poor quality of life
-
- develops after puberty that is after age t=10 mostly
why does SAD prevalence increase with age?
- cognitive development
- heightened self-consciousness
- bullied individuals are at a higher risk of developing this
- peaks in adolescence and early adulthood
______ is the fear of speaking in situations or anxious reaction to public speaking impacting work achievement or educational aspects
selective mutism
Whst do we need to rule out to assess for selective mutism?
- discomfort or lack of knowledge of the spoken language
- not explained by communication disorder
- not explained as a symptom or manifestation of another disorder like ASD, Schizophrenia, PTSD or other psychotic disorders
What are the characteristics of selective mutism?
- interference with emotional, social and academic development
- used as a safety net to protect self from embarrassment
- acute or rapid
- Young onset
- rate: 0.03 % to 1%
- overlaps with SAD
- 40% parents had it
_____ is an unusual ritual of thought and doubt
OCD
What are bsession?
Persistent and intrusive thoughts, urges or images casing significant anxiety. Such thoughts are irrational and tend to to recurrent/ time consuming
What are compusions?
They are ritualized behaviours that are performed as a result of obsessive thoughts that are intrusive. They are performed to neutralize the thoughts. Thye are purposeful and intentional. For ex: Te obsession with germs can make a child wash hands repeatedly
What is the most common compulsion?
cleaning
What is the prevalence rate of OCD among children?
1-2.5%
M>F during childhood
M=F during adolescence
What is the age of onset?
Bomodal onset i.e. spikes around 10–11 years of age and the again in early adulthood.
Onset is usually before puberty and is unlikely after 30.
What are the most common co-morbidities with OCD
ADHD, Anxiety, depressive disorders, Tic disorders, disruptive behaviour disorders, tourettes
What is the developmental perspective on compulsions?
- helps reduce anxiety by insisting on sameness and heightens feelings of mastery of control
- organizes a sense of efficacy in the environment by repeating behaviours, enacting rituals
- this insistence on sameness during transitions and maintaining routines increases around 2.5 years of age
Difference B/W OCD and worry
OCD - intrusive thoughts that do not let u shift focus whereas worry is more about futuristic events and are focused on improbable or unrealisitc events
What is exposure therapy?
involes exposing the individual to thw phobic stimuli as many individuals continue to have the fear due to simple avoidance. They are not aware how their phobia is exisiting simply due to lack of facing the phobia.
What is the exposure and response prevention for OCD?
This process involves repeated exposure to obsession in a systematic fashion w/o performing compulsions such that it no longer causes distress
______ is the process of getting used to something through repeated exposure that it no longer seems scary
habituation
What is SUDS
subjective units of distress
What are the characteristic associated to anxiety?
- cognitive disturbances - percepton of on-threats as threats
- intelligence and academic acheivement
- anxious vigilance or threat related attentional biases
- cognitive errors and biases - physical symptoms
- social and emotional deficits
- anxiety and depression; negative affectivity and positive affectivity
_____ is the process of selectively attending to info that is potentially threateninh
anxious vigilance
What are the predispositions of anxiety?
- neurobiological differences - overactive stress response system. The underlying vulnerability to anxiety can be localized to systems in the brain circuits involving brain stems, limbic system, HPA axis, frontal cortex
- Temperament
- behavioural inhibition: inhibiting rather than engaging in behaviour. Quiet, shy, timid and withdrawing
- hyper vigilant - state of neurological arousal in response to novel situations even talking to new adults - moderate biological vulnerability to anxiety disorders
- Parenting practices of anxious children involves -
- intrusie parental control
- lack of psychological autonomy granting
- overprotection
- low parental expectations
-
- intrusie parental control
what factors are contributing to anxiety / OCD provocation in children?
- Family modelling
- Behavioural reinforcement
3.family reinfoe
