anxiety and OCD Flashcards
What do anxiety disorders share according to DSM-5-TR?
Features of excessive fear and anxiety and related behavioral disturbances
This is outlined on page 215 of DSM-5-TR.
What is the most prevalent category of mental disorders worldwide?
Anxiety disorders
Data from the Global Burden of Disease Study.
What characterizes Separation Anxiety Disorder?
Developmentally inappropriate and excessive fear or anxiety about being separated from attachment figures
Symptoms include excessive distress, reluctance to go to school, and physical complaints.
What is the minimum duration of symptoms for diagnosing Separation Anxiety Disorder in children?
At least four weeks
For adults, symptoms must last at least six months.
What often triggers Separation Anxiety Disorder?
Exposure to a stressful event
Examples include parental divorce or the death of a relative or pet.
What is school refusal often a manifestation of?
Separation Anxiety Disorder
It may also be due to social anxiety disorder or other disorders.
What is the preferred treatment for Separation Anxiety Disorder?
Cognitive-behavior therapy (CBT)
Effectiveness increases when combined with parent training.
What is the initial treatment goal for children with school refusal?
Getting the child back to school
This helps reduce risks of social isolation and academic failure.
What is a Specific Phobia?
Intense fear of or anxiety about a specific object or situation
Accompanied by avoidance or enduring with intense distress.
What is required for the diagnosis of Specific Phobia?
Fear or anxiety must be out of proportion to actual danger, persistent for at least six months, and cause significant distress or impairment
There are various types of specific phobias.
What is the mean age of onset for Specific Phobia?
About 10 years of age
Specific phobia is about twice as common in girls than boys.
What does Mowrer’s two-factor theory explain?
The development of specific phobias through classical and operant conditioning
It involves conditioned stimuli and avoidance behavior.
What is the treatment for Specific Phobia?
Exposure and response prevention
This involves exposing clients to feared objects or situations while preventing avoidance responses.
What are the two types of exposure used in treatment for Specific Phobia?
Flooding and graded (graduated) exposure
Both can be conducted in vivo or in imagination.
What is flooding in the context of treating Specific Phobia?
Immediately exposing a client to their most feared object or situation until anxiety subsides
This is aimed at extinguishing the anxiety response.
What does graded exposure involve?
Constructing a list of situations that cause anxiety, starting from low to high anxiety levels
Each item is confronted until anxiety subsides.
What is more effective, in vivo exposure or exposure in imagination?
In vivo exposure
Especially effective for fears like acrophobia and fear of flying.
What is the effectiveness of exposure combined with another intervention for blood-injection-injury subtype?
Increases when combined with applied tension
This helps prevent fainting by increasing blood pressure.
What is Social Anxiety Disorder (Social Phobia)?
Characterized by fear or anxiety in social situations where scrutiny by others may occur.
It involves fear of negative evaluation, avoidance of situations, and excessive fear relative to actual threat.
What are the diagnostic criteria for Social Anxiety Disorder?
Fear or anxiety must be persistent (at least six months) and cause significant distress or impaired functioning.
Symptoms include avoiding situations or enduring them with intense fear.
What are the first-line treatments for Social Anxiety Disorder?
Cognitive behavior therapy and antidepressant medications (SSRIs and SNRIs).
Cognitive behavior therapy includes techniques like cognitive restructuring and exposure.
What is the effectiveness of guided internet-delivered cognitive behavior therapy for adults?
It is equivalent to face-to-face cognitive behavior therapy in terms of symptom reduction.
This has been supported by research including Andersson et al. (2014) and Esfandiari et al. (2021).
What is Panic Disorder?
Involves recurrent unexpected panic attacks, with persistent concern about additional attacks or significant behavioral change.
Panic attacks are defined as abrupt surges of intense fear or discomfort.
What constitutes a panic attack according to DSM-5-TR?
An abrupt surge of intense fear or discomfort that reaches a peak within minutes, involving at least four of 13 symptoms.
Symptoms include heart palpitations, sweating, dizziness, and fear of dying.
What is the treatment approach for Panic Disorder?
Comprehensive cognitive-behavioral intervention, including panic control treatment, which combines interoceptive exposure with relaxation techniques.
Interoceptive exposure involves exposing the person to panic symptoms.
What is Agoraphobia?
Marked fear or anxiety in at least two of five situations, such as using public transportation or being in crowds.
Fear is due to concern that escape will be difficult or help unavailable.
What is the first-line treatment for Agoraphobia?
In vivo exposure and response prevention, commonly using graded exposure.
Intense exposure may also be effective with better long-term effects.
What are the diagnostic criteria for Generalized Anxiety Disorder (GAD)?
Excessive anxiety and worry about multiple events occurring most days for at least six months, with difficulty controlling worry.
Symptoms must include at least three: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance.
What are common comorbid disorders for GAD?
Major depressive disorder, social anxiety disorder, specific phobia, and PTSD.
Data from the World Health Organization indicates these common comorbidities.
What are some risk factors for GAD?
Family history of anxiety disorders, behavioral inhibition, neuroticism, harm avoidance, childhood trauma, and chronic stress.
These factors influence the likelihood of developing GAD.
What neuroimaging findings are associated with GAD?
Abnormalities in the ventrolateral and dorsolateral prefrontal cortex, anterior cingulate cortex, amygdala, and hippocampus.
Reduced connectivity between prefrontal cortex regions and the amygdala suggests weak control of amygdala reactivity.
What is the most effective treatment for GAD?
Cognitive-behavior therapy, potentially combined with pharmacotherapy.
First-line drugs include SSRIs and SNRIs; buspirone or benzodiazepines may be used for non-responders.
True or False: Combining motivational interviewing with cognitive-behavior therapy has shown consistent effectiveness for GAD.
True.
This combination is especially effective for severe symptoms.
Fill in the blank: The DSM-5-TR defines a panic attack as an abrupt surge of intense fear or discomfort that reaches a peak within _______.
minutes.
This definition emphasizes the sudden onset of panic attacks.
What is included in the DSM-5-TR under obsessive-compulsive and related disorders?
Obsessive-compulsive disorder, body dysmorphic disorder, and other disorders with shared diagnostic validators
Diagnostic validators include symptoms, comorbidity, and treatment response.
Define Obsessive-Compulsive Disorder (OCD).
Involves recurrent obsessions and/or compulsions that are time-consuming or cause significant distress or impaired functioning
Obsessions are intrusive thoughts, urges, or images; compulsions are repetitive behaviors or mental acts.
What are obsessions in OCD?
Recurrent and persistent thoughts, urges, or images experienced as intrusive and unwanted
They cause marked anxiety or distress.
What are compulsions in OCD?
Repetitive behaviors or mental acts performed to reduce anxiety or prevent undesirable situations
They are excessive or not realistically connected to their goal.
What specifiers are used in OCD diagnosis?
Indicate the person’s level of insight into beliefs and the presence of tics
Who has an earlier age of onset for OCD, males or females?
Males
What is the prevalence rate of OCD in childhood?
Higher in males than females
What is the prevalence rate of OCD in adulthood?
Higher in females than males
What percentage of individuals with OCD have comorbid psychiatric disorders?
About 90%
What is the most common comorbid disorder with OCD?
Anxiety disorder
List other common comorbid disorders with OCD.
- Depressive or bipolar disorder
- Impulse control disorder
- Substance use disorder
What brain areas are linked to OCD?
- Caudate nucleus
- Orbitofrontal cortex
- Cingulate gyrus
- Thalamus
What is the first-line evidence-based intervention for OCD?
Exposure and response prevention (ERP)
What does exposure and response prevention (ERP) involve?
Exposing patients to anxiety-arousing stimuli and preventing ritualistic behaviors
What treatments may be most effective for OCD?
Combination of ERP with an SSRI or clomipramine
Especially when ERP or SSRI alone has been ineffective.
What is Body Dysmorphic Disorder?
Preoccupation with a perceived defect or flaw in physical appearance that is not observable or appears minor to others
What behaviors do individuals with Body Dysmorphic Disorder often perform?
Repetitive behaviors or mental acts such as mirror checking or skin picking
What must be present for a Body Dysmorphic Disorder diagnosis?
Significant distress or impaired functioning due to the preoccupation
What kind of treatment do people with Body Dysmorphic Disorder often seek?
Medical treatment to correct the perceived defect or flaw
What belief may many individuals with Body Dysmorphic Disorder hold?
Ideas or delusions of reference
True or False: Individuals with Body Dysmorphic Disorder believe that others are mocking them because of their appearance.
True
