Anxiety D/O

Question 1

Fear is awareness of danger or an immediate threat. It is the emotional and physiological response to this threat while Anxiety is ____ ____ or anticipation of a future threat

Answer 1

worrying about

Question 2

What delineates a disorder for anxiety is the _______, _______, ______ and ________ as well as how it impacts a pts _____ and _______ functioning

Answer 2

frequency, duration, intensity, and timing

social and professional functiong

Question 3

In classical conditioning the ________ comes first while in operant conditioning ________ comes first

Answer 3

Stimulus

behavior

Question 4

Classical conditioning is [Active/Passive] learning

Operant conditioning is [Active/Passive] learning

Answer 4

Passive

Active

Question 5

Separation d/o affects __% of children and ___-___% of adults

Answer 5

4% children

1-2% adults

Question 6

Children need _____ weeks of sx before they can be dx with separation d/o and adults need _____.
Tx is usually _____ but drugs such as ____ and ____ have been shown to be helpful w/ therapy

Answer 6

4 weeks, 6 mo

CBT, SSRI, BZD

Question 7

Generalized anxiety D/O usually affects [males/females] < ____y/o. They worry excessively about life circumstances. This is generally a chronic d/o that fluctuates in severity with _____ and ______ being common comorbidities

Answer 7

females <30 y/o]

major depression and substance abuse

Question 8

For a child: in addition to anxiety and worry, there only needs to be (#) ____ of the additional sx to make a dx of GAD
In an adult there needs to be (#) ____ of the additional sx

Answer 8

1 in children; 3 in adults

These sx are

• restlessness/feeling keyed up or on edge
• easily fatigues
• difficulty concentrating or mind going blank
• irritable
• muscle tension
• sleep disturbance

Question 9

GAD tx

Answer 9

CBT is the mainstay for therapeutic tx; Combined therapy and medication work best

Pure behavior therapies: relaxation training, re-breathing exercises, meditation

Question 10

Social Anxiety d/o usually begins during adolescence, before ____y/o
There is fear of _______ in social settings, being observed by others
It tends to develop _____, is [chronic/acute], and is usually not clearly linked to a precipitating event and does not subside with age

Answer 10

25 y/o
humiliation/embarrassment
slowly, chronic

Question 11

____% of pts w/ SAD will develop a substance use d/o

_____% will meet criteria for another psychiatric d/o (depression)

Answer 11

~12.5% [1/8]

~ 50

Question 12

Specific phobias tend to begin in childhood, < ___ y/o
Must last at least ___mo (not transient)
Irrational, excessive fear objects, places, situations that are well circumscribed

Answer 12

12 y/o

6 mo

Question 13

T/F

Specific phobias tends to ↓ intensity/subside as one ages

Answer 13

True

Question 14

Tx for SAD

Answer 14

Meds: fluoxetine, paroxetine, sertraline (SSRIs) and venlafaxine (SSNRI). MAOIs and BZDs also effective but first-line med have better side effect profiles

β-Blocker: effective short-term tx of performance anxiety, not effective for SAD

Question 15

Tx for specific phobias and SAD

Answer 15

Behavior therapy including exposure and flooding therapy has been shown to be very effective

Question 16

Panic Attack happen to ___% women, ___% men in their lifetime

Usually begin suddenly and usually peak in ___ mins, most last somewhere from ____mins
Panic attacks are part of the dx criteria for panic d/o

Answer 16

5% W, 2% M

10 min
Last 5-20 min

Question 17

Are panic attacks exclusive to panic d/o?

Answer 17

No, they can occur in many different psychiatric conditions

Question 18

Panic D/O
Must have ____ of 13 sx
Recurrent, unexpected panic attacks w/ at least ___mo of worry about having more panic attacks

_______ and ______ d/o are the most common psychiatric comorbidities

Answer 18

4 pf 13 sx
1 month of worry
Major depression and alcohol use

Question 19

____% of pts will develop sx of panic d/o before ____ y/o, mid-20s is when most pts present

Answer 19

80% before 30 y/o

Question 20

Panic d/o tx

Answer 20

Medication + psychotherapy

Fluoxetine, paroxetine, sertraline, venlafaxine
Pts who respond well to meds tend to have milder sx
CBT specifically Panic Control Therapy (PCT)

Question 21

Obsessive Compulsive D/O Lifetime prevalence is ____%, Male = Females (_______ tend to present slightly earlier) Begins in _____ to ______

Answer 21

2-3%
Males
late teens-early 20s

Question 22

OCD onset is _____ and ______
Pts are plagued by intrusive thoughts (obsessions)
Compulsions occur to distract or relieve anxiety the pt feels due to their obsessions
Compulsions are _____, ______ and highly stereotyped/ rigid, very time consuming or cause significant distress

Answer 22

gradual to sudden

repetitive, intentional

Question 23

Whether or not a pt has insight into their OCD is a marker for ______
____% of pts will suffer a chronic course, ____% a deteriorating course
Pt usually report worsening sx when they are stressed

Answer 23

prognosis

85%, 10%

Question 24

____-____% of pt w/ OCD also have recurrent major depression

________ is often co-existing d/o

Answer 24

70-80%

Tourette’s Syndrome

Question 25

OCD tics can be _____ or _____ tics

Tics are worse when pt is stressed, improved w/ antipsychotics

Answer 25

vocal or motor

Question 26

OCD Tx

Answer 26

CBT mainstay = Exposure and Response Prevention (ERP) therapy

SSRIs are effective → Fluoxetine, Paroxetine Sertraline
Effective dosage is ~2x as that used for depression and may take 3-4 mos to have a clear effect