Anxiety D/O Flashcards
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
worrying about
What delineates a disorder for anxiety is the _______, _______, ______ and ________ as well as how it impacts a pts _____ and _______ functioning
frequency, duration, intensity, and timing
social and professional functiong
In classical conditioning the ________ comes first while in operant conditioning ________ comes first
Stimulus
behavior
Classical conditioning is [Active/Passive] learning
Operant conditioning is [Active/Passive] learning
Passive
Active
Separation d/o affects __% of children and ___-___% of adults
4% children
1-2% adults
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
4 weeks, 6 mo
CBT, SSRI, BZD
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
females <30 y/o]
major depression and substance abuse
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
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
GAD tx
CBT is the mainstay for therapeutic tx; Combined therapy and medication work best
Pure behavior therapies: relaxation training, re-breathing exercises, meditation
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
25 y/o
humiliation/embarrassment
slowly, chronic
____% of pts w/ SAD will develop a substance use d/o
_____% will meet criteria for another psychiatric d/o (depression)
~12.5% [1/8]
~ 50
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
12 y/o
6 mo
T/F
Specific phobias tends to ↓ intensity/subside as one ages
True
Tx for SAD
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
Tx for specific phobias and SAD
Behavior therapy including exposure and flooding therapy has been shown to be very effective
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
5% W, 2% M
10 min
Last 5-20 min
Are panic attacks exclusive to panic d/o?
No, they can occur in many different psychiatric conditions
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
4 pf 13 sx
1 month of worry
Major depression and alcohol use
____% of pts will develop sx of panic d/o before ____ y/o, mid-20s is when most pts present
80% before 30 y/o
Panic d/o tx
Medication + psychotherapy
Fluoxetine, paroxetine, sertraline, venlafaxine
Pts who respond well to meds tend to have milder sx
CBT specifically Panic Control Therapy (PCT)
Obsessive Compulsive D/O Lifetime prevalence is ____%, Male = Females (_______ tend to present slightly earlier) Begins in _____ to ______
2-3%
Males
late teens-early 20s
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
gradual to sudden
repetitive, intentional
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
prognosis
85%, 10%
____-____% of pt w/ OCD also have recurrent major depression
________ is often co-existing d/o
70-80%
Tourette’s Syndrome
OCD tics can be _____ or _____ tics
Tics are worse when pt is stressed, improved w/ antipsychotics
vocal or motor
OCD Tx
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
