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anxiety disorder Flashcards

1
Q

Anxiety is a response to…

A

Anxiety is a response to danger or threat
*Fight/flight response – body’s automatic response
Same response whether perceived or actual threat

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2
Q

anxiety is a ___ state

A

feeling

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3
Q

as with any other disorder, for an anxiety disorder dx must include what?

A

dysfunction

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4
Q

most people with anxiety disorders will present with what type of symptoms?

A

physical

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5
Q

3 types of psychotherapy txt for anxiety

A

Cognitive-behavioral (MOST EFFECTIVE)
Supportive with problem-solving
Structured relaxation and stress management

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6
Q

3 types of pyschopharm txt for anxiety

A
  1. Antidepressant and antianxiety medications:
    - SSRIs, Buspirone
  2. Benzodiazepines (limited basis only!)
  3. Herbal remedies (passiflora, valerian) – mixed results
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7
Q

To diagnose an anxiety disorder, the individual must be experiencing what?

A

Difficulties functioning in at least one area of his/her life

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8
Q

4 types of anxiety disorders

A

Panic Disorder
Agoraphobia
Generalized Anxiety Disorder
Phobias

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9
Q

two types of phobias

A

Specific Phobia

Social Anxiety Disorder (Social Phobia)

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10
Q

when is pyschopharm used for txt?

A

only when symptoms are significantly interfering with functioning

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11
Q

panic disorder more common in men or women?

A

women

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12
Q

panic attacks vs panic attack disorder

A

when the fear of having a panic attack starts effecting functioning and life

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13
Q

panic attack symptoms develop fast or slow? how long for them tot peak?

A

develop abruptly, reach peak in minutes

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14
Q

DSM 5 Dx of panic attack disorder (kinda weeds)

A

Both (1) and (2)

  1. Recurrent unexpected panic attacks
  2. At least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:
    - -Persistent concern or worry about having additional attacks or their consequences
    - -A significant change in behavior related to the attacks (i.e. avoidance
  • Panic attacks are not due to direct physiological effects of a substance or a general medical condition
  • Panic attacks are not better accounted for by another mental disorder
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15
Q

3 txt options for panic attack disorder

A
  1. Patient education – identify the correct attributions
  2. Cognitive-behavioral psychotherapy
  3. Medications: Antidepressants (SSRIs, tricyclics, MAOIs)
    Benzodiazepines
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16
Q

what is agoraphobia? (for Dx)

A 
Marked fear or anxiety about two (or more) of the following 5 situations:
Using public transportation
Being in open spaces
Being in enclosed spaces
Standing in line or being in a crowd
Being outside of the home alone
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17
Q

with agoraphobia, a pt fears or avoids situations because why?

A

Individual fears or avoids these because escape might be difficult or help not available in the event of panic-like sxs

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18
Q

how long does agoraphobia usually last?

A

6 months +

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19
Q

Bill had an episode of palpitations, pounding heart, accelerated heart rate, sweating, trembling, shortness of breath, feelings of impending doom, and chest pain. It was his first such episode. We would say Bill has..

A

a single panic attack

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20
Q

who gets generalized anxiety disorder more? men or women

A

2/3 of pts are women, around age 20

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21
Q

what is generalized anxiety disorder?

A

worrying about rational and IRRATIONAL things

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22
Q

psychotherapy txt for generalized anxiety disorder

A

Supportive
Cognitive-behavioral
Biofeedback and relaxation (meditation- physical indication of whether they are relaxed)

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23
Q

4 types of meds for generalized anxiety disorder

A

SSRIs (paroxetine, venlafexine, escitalopram)
Imipramine
Benzodiazepines (not good choice)
Buspirone

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24
Q

what disorder is Most common but least disabling psychological d/o
Often begin in childhood, more in women than men.

A

phobias

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25
Q

are phobias genetically linked?

A

yes, tend to run in families

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26
Q

what is the 2 part management of phobias?

A
  1. Cognitive-behavioral therapy for specific phobias, social phobia
  2. Meds if necessary
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27
Q

medications for phobias. which would you use for social phobia? performance situations? infrequent events?

A

Paroxetine for social phobia
Beta blockers for performance situations
Benzodiazepines for infrequent events

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28
Q

True or False?

Phobias are always caused by a negative prior experience with the feared object.

A

False

29
Q

what are OCD disorders characterized by?

A

Common pattern of compulsive or driven repetitive behaviors

Cause significant distress or impairment

30
Q

what are the 5 types of OCD?

A 
Obsessive Compulsive Disorder
Body Dysmorphic Disorder
Hoarding Disorder
Trichotillomania
Excoriation
31
Q

what are the 3 comorbidities with OCD?

A

Comorbidity with eating d/o, other anxiety d/o, depression

32
Q

age of onset with OCD?

A

early adulthood - about age 20

33
Q

is OCD genetically linked?

A

yes, strong heritable component

34
Q

key differential Dx with OCD?

A

ruminations in depression - not the same as OCD

35
Q

what defines “obsessions”?

A

Recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted and that cause marked anxiety or distress
- Pt tries to suppress or neutralize them with some other thought or action (i.e. by performing a compulsion)

36
Q

what defines “compulsions”?

A 
repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (counting, praying, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly
-these are aimed at preventing or reducing distress or anxiety, or preventing some dreaded event or situation (but not connected in a realistic way)
37
Q

OCD: Studies indicate rates of full remission: __-___%

A

6-43%

38
Q

2 management options for OCD

A
  1. Cognitive-Behavioral Psychotherapy: Exposure with response prevention
  2. Medications: SSRIs OR Tricyclic: clomipramine
39
Q

Mary has many thoughts that her windows and doors are not secure and need to be checked. To lower her anxiety, she checks them many times a day. Her thoughts are an example of what?

A

The OBSESSIONS are the THOUGHTS

40
Q

what is body dysmorphic disorder?

A

Preoccupied with imagined or exaggerated physical defect in appearance
Becomes obsessed with the perceived defect

41
Q

for body dysmorphic disorder, at some point during the course of the d/o, the pt has performed …

A

performed repetitive behaviors or mental acts in response to the appearance concerns (i.e. mirror checking, excessive grooming, skin picking, reassurance seeking)

42
Q

body dysmorphic disorder is not better explained by…

A

Not better explained by concerns with body fat or weight in an individual whose symptoms meet dx criteria for an eating disorder

43
Q

3 treatment options of BDD

A 
1. Cognitive-behavioral therapy
Exposure with response prevention
Not covering up “defect” 
Avoiding compensatory behaviors
Cognitive restructuring
  1. meds: SRIs, SSRIs, Clomipramine (tricyclic antidepressant)
  2. Surgical and cosmetic treatment should not be encouraged. Rarely satisfied with the results
44
Q

what is hoarding disorder?

A

Compulsive hoarding. Need to retain stacks of unnecessary and seemingly useless possessions

45
Q

txt of hoarding disorder

A
  1. Behavior therapy: Focused on removing hoarded items from environment
  2. Cognitive behavioral therapy : Helping change the maladaptive beliefs about the need to accumulate and retain possessions
    * Hard to treat
    * Little data on pharmacotherapy
46
Q

what is trichotillomania?

A

Recurrent pulling out of one’s hair, resulting in hair loss, with repeated attempts to stop
MUST include significant distress or impairment in functioning
Believed to be used as a coping response to deal with stress or anxiety

47
Q

what is the first line txt for trichotillomania and excoriation disorder?

A

Habit-reversal therapy (HRT)

  • Self-monitoring
  • Awareness training
  • Stimulus control
  • Competing response training (counter-conditioning)
48
Q

what is excoriation disorder?

A

Compulsive or repetitive picking of the skin, resulting in skin lesions or sores that don’t completely heal
Repeated attempts to stop
Cause distress or impairment in functioning

49
Q

5 types of trauma/stressor related disorders

A 
Reactive Attachment Disorder (peds)
Disinhibited Social Engagement Disorder (peds)
Posttraumatic Stress Disorder
Acute Stress Disorder
Adjustment Disorders
50
Q

PTSD criteria A- what are the possible ways that someone has been exposed to a stressful event? (4 ways)

A

Exposure to actual or threatened death, serious injury, sexual violence in one (or more) of the following ways (traumatic event):

  • Directly experienced it
  • Witnessed it in person, as it occurred to others
  • Learned that it occurred to a close family member or friend (violent or accidental)
  • Experienced repeated or extreme exposure to aversive details of the event (tv, media does not count unless it is work-related)

*can’t be self- inflicted by watching something over and over.. like youtube videos

51
Q

what are PTSD criteria B- intrusion symptoms?

A

distressing dreams, memories, dissociative rxns (as if event was happening again), pysch distress or reactivity

52
Q

about ___ of population has experienced a traumatic event

A

1/3

53
Q

PTSD criteria C

A

avoidance of trigger stimuli

54
Q

PTSD criteria D

A

Negative alterations in cognitions and mood associated with the traumatic event.
aka blocking part of the memory out, negative outlook on the world, detachment from world.

55
Q

PTSD criteria E

A

Marked alterations in arousal and reactivity (hyperarousal) associated with the traumatic event, beginning or worsening after the event
aka: irritable, hypervigilant, sleep disturbance, etc.

56
Q

PTSD criteria F

A

duration over a month

57
Q

PTSD criteria G

A

clinically sig. distress or impairment of life

58
Q

PTSD criteria H

A

not attributed to other physiological effect or medication

59
Q

for a PTSD Dx -what must be met?

A

all criteria A-H

60
Q

what makes up the multidisciplinary team for PTSD pts?

A

Psychotherapist, psychiatric provider, substance abuse counselor, peer supportive counseling groups, family therapy

61
Q

2 part txt for PTSD

A 
1. Medication: Antidepressants, Antianxiety medications
(won't stop PTSD but will help support) 
2. Cognitive-behavioral treatment
-Prolonged exposure therapy
-Coping strategies
62
Q

what is acute stress disorder?

A

PTSD but symptoms occur within a month of event and resolve within that month, lasting at least 3 days.

*If symptoms persist for longer than 1 month and meet criteria for PTSD, then diagnosis of PTSD is given.

63
Q

what is the first line txt for PTSD?

A

prolonged exposure therapy

64
Q

Jim was in an active combat zone and came home 6 months ago. Since then, he has had nightmares of combat, thoughts about combat that pop into his head, and an occasional flashback of being back in the combat zone. These symptoms are:

A

The reexperiencing symptoms of PTSD.

65
Q

what are adjustment disorders?

A

Maladaptive reaction to a distressing life event or stressor.
- event didn’t reach intensity of a trauma. aka symptoms dont meet criteria for other disorders.

66
Q

adjustment disorder: Symptoms or behaviors are clinically significant, as evidenced by one or both of the following:

A
  1. Marked distress that is out of proportion to the severity or intensity of the stressor
  2. Significant impairment in functioning
67
Q

when do symptoms of adjustment disorder start?

A

within 3 months of start of stressor

68
Q

what are the 6 different manifestations of adjustment disorder? (kinda weeds)

A 
With depressed mood
	With anxiety
	With mixed anxiety and depressed mood
	With disturbance of conduct
	With mixed disturbance of emotions and conduct
	Unspecified
69
Q

“anxiety disorder” is a ______ vs “ generalized anxiety disorder” which is a ____.

A

anxiety disorder: category

generalized anxiety disorder: Dx.

clin med (88 decks)

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