Anxiety Disorders Flashcards
Definition: developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached
separation anxiety disorder
Definition: consistent failure to speak in specific social situation in which there is an expectation for speaking (school, social settings) despite speaking on other situations
Symptoms: poor educational or occupational achievement
selective mutism
Definition: marked fear or anxiety about specific object or situation that almost always provokes immediate fear or anxiety
Subtypes: animal (spider, snakes, insects, dogs), natural environment (height, storms, water), situations (blood-injection-injury, airplanes, elevators, enclosed spaces)
Symptoms: active avoidance of object or object endured with intense fear or anxiety which is out of proportion to the actual danger posed, causes significant impairment
specific phobia anxiety
Social Anxiety Disorder
Definition: marked fear or anxiety about one or more
__ situations in which the individual is exposed to possible __ by __. Individual fear that they will __ in a way or show anxiety symptoms that will be __ evaluated by others (humiliated or embarrassed) and will lead to __
Symptoms: avoid or endured with intense anxiety social situations, __, __, __
Complications: under-employment, poor relationships
Social Anxiety Disorder
Definition: marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. Individual fear that they will act in a way or show anxiety symptoms that will be negatively evaluated by others (humiliated or embarrassed) and will lead to rejection
Symptoms: avoid or endured with intense anxiety social situations, blushing, sweating, tremor
Complications: under-employment, poor relationships
Panic Disorder
Definition: recurrent ____ panic attacks (at least 4 of __, __, __, __, feeling of __, __ pain, __, __/lightheadedness, __, __, fear of losing __, fear of __, __, __, __ flashes)
AND
followed by ___month of either persistent concern or worry about additional panic attacks/consequences OR significant maladaptive change in behaviour related to the attacks
Symptoms: palpitations, accelerated HR, sweating, trembling, shaking, SOB, feeling of choking, chest pain, N/V, dizziness, chills, paresthesia, derealization, fear of during, fear of losing control.
Symptoms peak at 10min
Management: make sure they’re not having a heart attack or stroke.
Can precipitate agoraphobia
Panic Disorder
Definition: recurrent unexpected panic attacks (at least 4 of palpitations, sweating, trembling, SOB, feeling of choking, chest pain, nausea, dizziness/lightheadedness, derealization, depersonalization, fear of losing control, fear of dying, chills, numbness, hot flashes)
AND
followed by 1month of either persistent concern or worry about additional panic attacks/consequences OR significant maladaptive change in behaviour related to the attacks
Symptoms: palpitations, accelerated HR, sweating, trembling, shaking, SOB, feeling of choking, chest pain, N/V, dizziness, chills, paresthesia, derealization, fear of during, fear of losing control.
Symptoms peak at 10min
Agoraphobia
Definition: intense fear about at least ____ different types of situations for ____+.
Situations include: using public transportation, being in open space, being in enclosed places, standing in line/being in a crowd and being outside of the home alone
Symptoms: provoking situations avoided or endured with intense fear or anxiety, fear or anxiety is out of proportion to actual danger, substantial functional impairment
Agoraphobia
Definition: intense fear about at least two different types of situations for 6mo+.
Situations include: using public transportation, being in open space, being in enclosed places, standing in line/being in a crowd and being outside of the home alone
Symptoms: provoking situations avoided or endured with intense fear or anxiety, fear or anxiety is out of proportion to actual danger, substantial functional impairment
GENERALIZED ANXIETZY DISORDER
Definition: excessive anxiety and worry about a number of events or activities/existing in a number of different ____, occurring more days than not for ____mo+. The anxiety is hard to control and impacts social/occupation
Symptoms: at least 3 of the following- restlessness/on edge, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance
Definition: excessive anxiety and worry about a number of events or activities/existing in a number of different domains, occurring more days than not for 6mo+. The anxiety is hard to control and impacts social/occupation
Symptoms: at least 3 of the following- restlessness/on edge, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance
Investigations/questionnaire of GAD
GAD-7
key substances that are linked to substance-induced anxiety disorder
Definition: panic attacks or anxiety development during or soon after substance intoxication or withdrawal or after exposure to the medication
Etiology: alcohol, caffeine, cannabis, hallucinogens, inhalant, opioids
Cannabis use is associated with development of schizophrenia and psychosis, starting cannabis earlier in life increases the likelihood and can cause more impairment.
Cannabis can increase the symptoms of mania and hypomania in bipolar individuals → increased risk of developing depression, and depression is a risk factor for developing problem cannabis use.
mechanism of anxiety
Mechanism: ___ stress + __ factors + __ factors→__ overdrive→increased ___→brain is “hijacked” by the __→neuronal ___ (decrease dendritic arborization, spinal density and loss of discrete populations of cells) + neuronal and __ loss (particularly in __ cortex) + decreased neuronal birth in the ___ (brain-derived neurotrophic factor) → chronic anxiety
*therefore imperative to diagnose and treat as soon as possible.
mechanism of anxiety
Mechanism: chronic stress + genetic factors + physical factors→cortisol overdrive→increased inflammation→brain is “hijacked” by the amygdala→neuronal atrophy (decrease dendritic arborization, spinal density and loss of discrete populations of cells) + neuronal and glial loss (particularly in prefrontal cortex) + decreased neuronal birth in the hippocampus (brain-derived neurotrophic factor) → chronic anxiety
*therefore imperative to diagnose and treat as soon as possible.
which gender is more affected by anxiety disorders
F>M
what countries have a higher prevalence of anxiety
high income countries
Differentiating anxiety disorders:
o __: recurrent, unexpected panic attacks in the absence of triggers
o __: marked, unreasonable fear or anxiety about a situation
o __ __: marked, unreasonable fear or anxiety about a specific object/situation
o __ __ disorder: marked, excessive or unrealistic fear or anxiety about social situations in which there is possible exposure to scrutiny by others
o __ __ disorder: excessive anxiety and worry (apprehensive expectation) about multiple events or activities
o Panic: recurrent, unexpected panic attacks in the absence of triggers
o Agoraphobia: marked, unreasonable fear or anxiety about a situation
o Specific phobia: marked, unreasonable fear or anxiety about a specific object/situation
o Social anxiety disorder: marked, excessive or unrealistic fear or anxiety about social situations in which there is possible exposure to scrutiny by others
o Generalized anxiety disorder: excessive anxiety and worry (apprehensive expectation) about multiple events or activities
how can ADHD mimic anxiety?
ADHD can mimic anxiety (worrying about performance deficits because of their ADHD, excessive mind-wandering, feeling overwhelmed, feeling restless, sleep problems, avoiding situations due to ADHD symptoms, sleep problems)
ASRS: The adult ADHD self-report scale symptom checklist. 18 questions. If 4 or more marks appear in the shaded boxes within part A, then the patient has symptoms highly consistent with ADHD adult and further investigation is warranted. The ASRS is validated as a screening tool.
checklist/screening tool used to diagnose adult ADHD
The adult ADHD self-report scale symptom checklist. 18 questions. If 4 or more marks appear in the shaded boxes within part A, then the patient has symptoms highly consistent with ADHD adult and further investigation is warranted. The ASRS is validated as a screening tool.
