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UMass Global DSM 5-TR PSYU 510 /Advancement Exam > Anxiety Disorders > Flashcards

Anxiety Disorders Flashcards

Learn criteria, codes, specifiers, and rule outs.

1
Q

This classification of disorders involves a disproportionate fear response and maladaptive behaviors to avoid the cause with symptoms generally lasting more than 6 months.

A

Anxiety Disorders

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2
Q

The essential feature of this disorder is developmentally inappropriate, excessive, and persistent fear or anxiety concerning separation from attachment figures or home with at least 3 of the following: recurrent excessive distress when anticipating or experiencing separation; persistent and excessive worry about losing attachment figures or possible harm to them; persistent and excessive worry about an untoward event that causes separation; persistent reluctance or refusal to go out because of fear of separation; persistent and excessive fear of or reluctance about being alone; persistent reluctance or refusal to sleep away from home or go to sleep w/o attachment figure; repeated nightmares involving the theme of separation; repeated complaints of physical symptoms when separation occurs or is anticipated. The fear, anxiety, or avoidance is persistent, 4 weeks in children or adolescents and 6 months in adults.

A

Separation Anxiety Disorder

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3
Q

What is the diagnostic code for Separation Anxiety Disorder?

A

F93.0

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4
Q

Separation Anxiety Disorder Differential Diagnosis

This disorder features excessive worry or fear about many different events or activities, whereas fear of separation is predominate in separation anxiety disorder.

A

Generalized Anxiety Disorder (F41.1)

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5
Q

Separation Anxiety Disorder Differential Diagnosis

While the fear of separation may cause a panic attack, this disorder is marked by unexpected panic attacks accompanied by fears of future panic attacks resulting in maladaptive changes in behavior.

A

Panic Disorder (F41.0)

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6
Q

Separation Anxiety Disorder Differential Diagnosis

This disorder involves the avoidance of places and situations that provoke disproportionate fear or anxiety, and the possibility of panic symptoms may prevent escape or that help may not be accessible.

A

Agoraphobia (F40.00)

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7
Q

Separation Anxiety Disorder Differential Diagnosis

In this disorder, the child or adolescent may avoid school and home but not because of anxiety.

A

Conduct Disorder (F91.x)

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8
Q

Separation Anxiety Disorder Differential Diagnosis

In this disorder, places and situations w/o attachment figures are avoided due to fear of being judged negatively.

A

Social Anxiety Disorder (F40.10)

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9
Q

Separation Anxiety Disorder Differential Diagnosis

This disorder may involve fear of separation from loved ones, but the central symptoms concern intrusions about, and avoidance of memories associated with an event that caused separation.

A

Posttraumatic Stress Disorder (F43.10)

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10
Q

Separation Anxiety Disorder Differential Diagnosis

This disorder involves worry about specific medical illnesses for the individual, not for their loved ones as in separation anxiety disorder.

A

Illness Anxiety Disorder (F45.21)

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11
Q

Separation Anxiety Disorder Differential Diagnosis

The reluctance to leave home may be associated with these disorders, but it is due to lack of motivation or desire to engage with the outside world.

A

Depressive and Bipolar Disorders

Note: Individuals with separation anxiety disorder may become depressed during separation or in anticipation of separation.

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12
Q

Separation Anxiety Disorder Differential Diagnosis

Children or adolescents may express opposition at being separated from attachment figures, but this disorder involves persistent defiance in contexts other than separation.

A

Oppositional Defiant Disorder (F91.3)

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13
Q

Separation Anxiety Disorder Differential Diagnosis

This disorder involves intense longing, sorrow, and preoccupation over the loss of a loved one rather than the possibility of separation.

A

Prolonged Grief Disorder (F43.8)

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14
Q

Separation Anxiety Disorder Differential Diagnosis

While unusual perceptual experiences may temporarily occur in separation anxiety disorder, they are a persistent key feature in these disorders.

A

Psychotic Disorders

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15
Q

Separation Anxiety Disorder Differential Diagnosis

This disorder is characterized by an indiscriminate tendency to rely on others, not just attachment figures.

A

Dependent Personality Disorder (F60.7)

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16
Q

Separation Anxiety Disorder Differential Diagnosis

Individuals with this disorder fear abandonment by others and struggle with identity, self-direction, interpersonal functioning, and impulsivity.

A

Borderline Personality Disorder (F60.3)

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17
Q

In children, separation anxiety is highly comorbid with these 2 anxiety disorders:

A
  1. Generalized Anxiety Disorder
  2. Specific Phobia
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18
Q

In adults, disorders commonly comorbid with separation anxiety generally fall in these 4 disorder classifications:

A
  1. Anxiety Disorders
  2. Depressive Disorders
  3. Bipolar Disorders
  4. Personality Disorders (specifically Cluster C)
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19
Q

Reticence to speak, not due to ability, in situations where speaking is expected, interfering with functioning; duration at least 1 month.

A

Selective Mutism

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20
Q

What is the diagnostic code for Selective Mutism?

A

F94.0

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21
Q

Selective Mutism Differential Diagnosis

If an immigrant child is in the process of learning a new language, there is typically a short period of time when they do not speak known as a:

A

“silent period.”

If not speaking in both languages persists over time in several settings, a diagnosis of selective mutism may be warranted.

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22
Q

Selective Mutism Differential Diagnosis

When the speech disturbance is not restricted to specific social situations, and the capacity to speak is in question, these general disorders regarding speech should be considered.

A

Communication Disorders

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23
Q

Individuals may have difficulty in social communication or speak inappropriately in social situations when these 3 types of disorders are present:

A
  1. Neurodevelopmental Disorders (Autism Spectrum Disorder, Intellectual Developmental Disorder)
  2. Schizophrenia
  3. Other Psychotic Disorders
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24
Q

Selective Mutism is most commonly comorbid with this class of disorders:

A

Anxiety Disorders

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25
Q

This disorder elicits an almost immediate, disproportionate fear response to specific objects or situations which the individual actively avoids or tolerates with excessive anxiety. Symptoms persist for more than 6 months.

A

Specific Phobia

26
Q

Specific Phobia diagnostic codes are based on the phobic stimulus and all codes that apply should be used. List the codes for the following:
Animal
Natural Environment
Blood-injection-injury
Situational
Other

A

Animal: F40.218
Natural Environment: F40.228
Blood-injection-injury: F40.23x (F40.230 blood; F40.231 injection/transfusion; F40.232 other medical care; F40.233 injury)
Situational: F40.248
Other: F40.298

27
Q

Social situations are avoided or endured with great anxiety for fear of negative evaluation, fear of behaving in ways deemed inappropriate, or fear of presentation scrutiny. Symptoms persist for at least 6 months.

A

Social Anxiety Disorder (SAD)

28
Q

What is the diagnostic code for Social Anxiety Disorder?

What is the specifier associated with this disorder?

A

F40.10

Performance only: if the fear is restricted to speaking or performing in public.

29
Q

SAD Differential Diagnosis

Social Anxiety Disorder is often comorbid with, but should also be differentiated from disorders in this general classification:

A

Anxiety Disorders

30
Q

SAD Differential Diagnosis

Concern about being negatively evaluated because they feel they are not worthy of being liked may be symptomatic of this disorder which is often comorbid with SAD:

A

Major Depressive Disorder (F32.x or F33.x)

31
Q

SAD Differential Diagnosis

Preoccupation with perceived defects or flaws in physical appearance may cause anxiety and avoidance of social situations but is the key characteristic of this disorder.

A

Body Dysmorphic Disorder (F45.22)

32
Q

SAD Differential Diagnosis

An individual may fear social rejection or offending others but lack insight regarding the actual threat posed by the social situation to the extent that they believe the threat is real. They may be suffering from this disorder.

A

Delusional Disorder (F22)

33
Q

SAD Differential Diagnosis

An individual may have social anxiety and social communication deficits along with inadequate age-appropriate social relationships and diminished social communication capacity if they have this disorder.

A

Autism Spectrum Disorder (F84.0)

34
Q

SAD Differential Diagnosis

This personality disorder is more comorbid with social anxiety disorder than any other anxiety disorder. Individuals have a broader avoidance pattern, higher rates of impairment, a strong and pervasively negative self-concept, see rejection as a global evaluation of the self as being of little worth, and since childhood have not felt like they fit in.

A

Avoidant Personality Disorder (F60.6)

35
Q

An abrupt surge, from a calm state or an anxious state, of intense fear or intense discomfort that reaches a peak within minutes and during which time at least 4 symptoms are present. This is not a disorder but can be a specifier for many disorders or medical conditions.

A

Panic Attack Specifier

36
Q

There are 13 symptoms listed for a panic attack in DSM-5-TR. Name as many as you can.

A
  1. Palpitations, pounding heart, accelerated heart rate.
  2. Sweating.
  3. Trembling or shaking.
  4. Sensations of shortness of breath or smothering.
  5. Feelings of choking.
  6. Chest pain or discomfort.
  7. Nausea or abdominal distress.
  8. Feeling dizzy, unsteady, light-headed, or faint.
  9. Chills or heat sensations.
  10. Paresthesias (numbness or tingling).
  11. Derealization or depersonalization.
  12. Fear of losing control or “going crazy.”
  13. Fear of dying.
37
Q

Recurrent unexpected panic attacks; at least 1 attack followed by 1 month of persistent concern or worry about additional attacks and/or significant maladaptive change in behavior related to panic attacks.

A

Panic Disorder

38
Q

The diagnostic code for Panic Disorder is:

A

F41.0

39
Q

Panic Disorder Differential Diagnosis

Panic attacks judged to be a direct physiological consequence of another medical condition, of which there are many to be determined by appropriate medical professionals and exams.

A

Anxiety Disorder due to Another Medical Condition

40
Q

Panic Disorder Differential Diagnosis

Panic attack is judged to be a direct physiological consequence of a substance. Intoxication with central nervous system stimulants or cannabis and withdrawal from central nervous system depressants can precipitate a panic attack.

A

Substance/Medication-Induced Anxiety Disorder

41
Q

Panic Disorder Differential Diagnosis

Panic attacks as a symptom of other anxiety disorders are expected and thus do not meet the criteria for Panic Disorder. Panic attacks occur expectedly to specific triggers.

A

Other Mental Disorders with Panic Attacks as an associated feature

42
Q

Significant anxiety of at least 2 scenarios: using public transportation, being in open spaces, being in enclosed spaces, being in a crowd, being alone outside one’s home. Scenarios are avoided for fear of being trapped, experiencing panic, or not being able to get help. Scenarios almost always elicit distress and anxiety, require the individual to be accompanied, or are endured while experiencing intense fear. Symptoms persist for at least 6 months.

A

Agoraphobia

43
Q

What is the diagnostic code for Agoraphobia?

A

F40.00

44
Q

Agoraphobia Differential Diagnosis

If the fear and anxiety is limited to one type of scenario and does not involve fear of panic symptoms this disorder may be better suited.

A

Specific Phobia, situational type. (F40.248)

45
Q

Agoraphobia Differential Diagnosis

If the focus is on fear of detachment from significant others or the home environment and not a fear of panic symptoms or other incapacitating symptoms in a scenario, this disorder may be better suited.

A

Separation Anxiety Disorder (F93.0)

46
Q

Agoraphobia Differential Diagnosis

The focus of the fear is negative evaluation rather than panic symptoms in social situations.

A

Social Anxiety Disorder (F40.10)

47
Q

Agoraphobia Differential Diagnosis

When criteria for this disorder are met, agoraphobia should not be diagnosed if the avoidance behaviors associated with panic attacks do not extend to avoidance of 2 or more agoraphobic situations.

A

Panic Disorder (F41.0)

48
Q

Agoraphobia Differential Diagnosis

If the fear, anxiety, or avoidance is restricted to trauma reminders and avoidance behavior does not extend to 2 or more agoraphobic situations, then one of these 2 disorders may be more appropriate.

A

Acute Stress Disorder (F43.0)
Posttraumatic Stress Disorder (F43.10)

49
Q

Agoraphobia Differential Diagnosis

Individuals may avoid leaving home due to apathy, loss of energy, low self-esteem, and anhedonia rather than fear of panic symptoms if this diagnosis is given.

A

Major Depressive Disorder (F32.x or F33.x)

50
Q

True or False: Whereas other anxiety disorders or PTSD frequently precede the onset of agoraphobia, depressive disorders and substance use disorders typically occur secondary to agoraphobia.

A

True

About 90% of individuals with agoraphobia also have other mental disorders.

51
Q

Inordinate worry, occurring more days than not, about a variety of scenarios; difficulty not worrying; at least 3 symptoms (1 lasting more than 6 months): agitation, tiredness, difficulty focusing, irritability, muscular tension, difficulty sleeping.

A

General Anxiety Disorder (GAD)

52
Q

What is the diagnostic code for General Anxiety Disorder (GAD)?

A

F41.1

53
Q

GAD Differential Diagnosis

GAD can be differentiated from other anxiety disorders by the generalized nature of the worry over many situations.
What criteria distinguish GAD from Social Anxiety Disorder?
What criteria distinguish GAD from Separation Anxiety disorder?

A

Social Anxiety Disorder (F40.10): fear of negative evaluation in social situations versus worry regardless of evaluation.

Separation Anxiety Disorder (F93.0): fear of separation from attachment figures versus worry about many concerns.

54
Q

GAD Differential Diagnosis

GAD may cause panic symptoms, but this disorder should not be diagnosed unless fear about panic attacks becomes the predominate worry and causes behavioral changes.

A

Panic Disorder (F41.0)

55
Q

GAD Differential Diagnosis

The individual’s worry is confined to their own illness.

A

Illness Anxiety Disorder (F45.21)

56
Q

GAD Differential Diagnosis

Worry focused on somatic symptoms is characteristic for:

A

Somatic Symptom Disorder (F45.1)

57
Q

GAD Differential Diagnosis

In GAD the focus is the excessiveness of the worry about future events. In ____________-___________ disorder the ______________ are inappropriate ideas that take the form of intrusive and unwanted thoughts, urges, or images that may become ______________.

A

Obsessive-Compulsive Disorder (F42.2)

Obsessions

Compulsions

58
Q

Panic attacks or anxiety that occurs concurrently with or following substance intoxication or withdrawal or following exposure to a medication; the substance/medication can cause severe anxiety.

A

Substance/Medication-Induced Anxiety

59
Q

Panic attacks or anxiety are the direct pathophysiological consequence of another medical condition; not explained better by another mental disorder; does not occur exclusively during delirium.

A

Anxiety Disorder Due to Another Medical Condition (F06.4)

Coding Note: F06.4 Anxiety Disorder due to (specific medical condition).

60
Q

Presentation of symptoms characteristic of an anxiety disorder causing significant distress or impairment in functioning, but do not meet the full criteria for anxiety disorders. Used when clinician chooses to communicate the specific reasons the full criteria are not met.

A

Other Specified Anxiety Disorder (F41.8)

61
Q

Presentation of symptoms characteristic of an anxiety disorder causing significant distress or impairment in functioning, but do not meet the full criteria for anxiety disorders. Used when clinician chooses not to communicate the specific reasons the full criteria are not met, as in there is insufficient information to make a complete diagnosis (emergency department settings).

A

Unspecified Anxiety Disorder (F41.9)

UMass Global DSM 5-TR PSYU 510 /Advancement Exam (2 decks)

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