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Child Psychopathology 3373 > Anxiety Disorders > Flashcards

Anxiety Disorders Flashcards

1
Q

core characteristics of anxiety

A

strong negative emotion, tension, apprehension, a sense of fear/dread
- anticipating future danger
- anxiety is expected in situations that may affect safety or wellbeing (it’s normal)
- but excessive, persistent, debilitating anxiety signals dysregulation of the anxiety response system (too much anxiety is bad)
- it may occur in response to specific stimuli or as a generalized state of worry

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2
Q

symptoms of anxiety

A

physical: abdominal pain, nausea, vomiting, sweating, dizzy, inc. heartrate, dry mouth, blushing

cognitive: worrying, poor concentration, blanking out, self-critical thoughts, thoughts of being scared/hurt, etc

behavioral: avoidance (most common), crying, screaming, trembling voice, nail biting, shaking, avoidance of eye contact, twitching, etc

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3
Q

anxiety

A

future-oriented emotional state, feelings of apprehension and lack of control; no danger present

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4
Q

fear

A

present-oriented, immediate emotional reaction to current danger

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5
Q

panic

A

unexpected physical symptoms in the absence of threat/danger

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6
Q

associated characteristics of anxiety

A

cognitive - avg intelligence, probs w/ attention, memory, concentration, cognitive biases, less adaptive coping strategies

physical/health - sleep problems and less risk-taking behaviors

social - lower social competence, problematic peer and sibling interactions, more loneliness (lower self report of self esteem, more shy)

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7
Q

sex and age differences in anxiety

A
  • 10-15% of school-aged children have at least 1 anxiety disorder
  • specific phobia, social anxiety, and separation anxiety are more common during childhood and adolescence
  • no sex diff in preschool
  • for school-aged and older, most anxiety disorders are common in girls (persists into adulthood)
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8
Q

comorbidity

A
  • comorbidity among anxiety disorders and between anxiety disorders and other disorders (depression) makes diagnosis hard
  • combos usually persist into adulthood
  • anxiety also co-occurs w/ ADHD, eating disorders, and substance use disorders
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9
Q

what factors cause anxiety (just list)

A

biological
individual
environmental

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10
Q

biological factors

A
  • heritability is moderate (.35) and nonspecific (parent has social anxiety, you are now on path to anxiety, but could be diff type)
  • over/underactivity of neural circuits, structural abnormalities, right-left asymmetries
  • altered serotonin and norepinephrine functioning
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11
Q

individual factors

A
  • tend to focus on temperament in childhood an personality in adulthood
  • behavioral inhibition is a risk factor only (children afraid to try new things)
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12
Q

environmental factors

A

overprotective parenting, critical parenting, parent modeling of anxious behavior and avoidant coping increases risk
- children learn from modeled behavior
- some parents reinforce child’s anxiety by allowing avoidance behaviors (stay home from school and miss test)

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13
Q

4 types of interventions for anxiety

A

behavior therapy
CBT
family interventions
medications

  • exposure to source of anxiety is main approach
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14
Q

behavior therapy

A
  • graded exposure to fear (make list least feared to most and start talking it through, rate distress SUDS)
  • flooding: prevent avoidance behaviors, exposure in prolonged and repeated doses
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15
Q

CBT

A
  • modify maladaptive thoughts to decrease symptoms (if scared of panic attack - spin in circle and tell self i’m okay)
  • coping cat ages 7-13: decrease negative thinking, increase active problem solving
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16
Q

family interventions

A
  • children view selves as less competent, parent’s perspective of child may change
  • greater parental involvement in modeling and reinforcing coping techniques
17
Q

medications

A
  • SSRIs can be used
  • not first pick, try CBT first
  • for some CBT doesn’t work, or anxiety is too severe and need medication to be able to do therapy
18
Q

core characteristics of separation anxiety

A
  • excessive, prolonged anxiety about being away from home/parents (when developmentally inappropriate)
  • reluctance/refusal to attend school or sleep alone, clingy, physical complaints
  • typical at 7/8 mos of age; declines after 2yrs old, but expected during transition to school or after major stressor
19
Q

sex and age differences of separation anxiety

A

sex: community samples more girls; clinical boys and girls same

age: avg age of onset = 7-8yrs (but 70% or more who develop disorder do so before age 4)

20
Q

comorbidity of separation anxiety

A

majority of children have another disorder, usually anxiety, but 1/2 develop comorbid depression. substance use disorder may be found in adolescents

21
Q

etiology of separation anxiety

A

biological factors: genetics, neurological factors, inhibited temperament

environmental factors: highly involved parents (overprotective), occurrence of major life stressor is important (moving, death/illness in family, new school)

22
Q

outcomes of separation anxiety

A
  • SAD may develop suddenly or gradually
  • course: some have brief probs, symptoms come/go, for others symptoms are chronic
  • chronic course is more likely when older age at onset, parental psychopathology, marital distress, comorbid diagnoses in childhood
23
Q

core characteristics of social anxiety

A
  • intense fear of social situations thar involve possible scrutiny by others and risk of evaluation or embarrassment
  • individuals tend to be unassertive, make less eye contact, seem shy, may find it hard to go to school or activities
  • many cases overlooked because shyness common
24
Q

sex and age differences in social anxiety

A

sex: community 2X more girls; clinical no diff

age: onset is often in late childhood or early adolescence (80% who develop do so by age 18)

25
Q

comorbidity of social anxiety

A

co-occurrence of another disorder is common; 1/5 have comorbid depression, substance use probs may also develop
- in boys/men - higher rates of ODD, CD, and substance use disorders
- girls/women - higher rates of another anxiety or depression

26
Q

etiology of social anxiety

A

often develops after a highly stressful event, but may develop gradually
- biological predispositions likely interact w/ individual and/or environmental factors

27
Q

outcomes of social anxiety

A
  • course is variable; some have remission, some have symptoms come/go, for others symptoms are chronic
  • adults may experience impairments in education, employment, social, and relationship domains
  • rates of long-lasting remission is very low
28
Q

anxiety in preschoolers (5 points)

A
  • most prevalent diagnosis in preschoolers, they cause impairment in young children and their families
  • the most significant barrier to ID and intervention: widespread belief among adults that children will outgrow symptoms (not true!!!)
  • anxiety in young children presents as specific disorders as it does for other ages (separation, social, specific phobia, GAD, etc)
  • less able to describe internal experiences, so it is shown through behavior
  • some symptoms are misinterpreted as irritability and/or defiance
29
Q

prevalence of anxiety in preschoolerrs

A

about 20% have an anxiety disorder - very high rates
- no sex diff in this age group

30
Q

etiology in preschoolers

A

bio and environ. factors contribute, but environment makes stronger contribution
- more likely to a) have parent w/ anxiety or depression; b) have parent who is younger and less education/income; c) have experienced recent stressor

31
Q

interventions for preschoolers

A
  • parent who is empathic, firm, and encourages exposure to fear is good
  • CBT w/ more parent involvement is first used, meds only considered really if no access to CBT, or if child doesn’t respond to it
32
Q

selective mutism core characteristics

A

children don’t speak in some situations and speak normally in others. not speaking is a way to avoid intense anxiety associated w/ social interactions
- also shows little/no eye contact, tantrums, sleep problems, stomach aches, nausea

33
Q

comorbidity in selective mutism

A

most common comorbid diagnosis is social anxiety disorder; higher rates of other anxiety disorders, depression, OCD also occur, may have speech/language problems

Child Psychopathology 3373 (9 decks)

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