Anxiety Disorders Flashcards
what happens when you walk around the corner and see a bear
fear
vague discomfort associated with meeting new people/going to a new job
anxiety
who has a higher prevalence of anxiety disorders? men or women? poor or rich?
women; prevalence decreases with higher socioeconomic status
- Characterized by rapid onset panic attacks that have no cause (no triggers)
- Acute, intense attack of anxiety coupled with feelings of impending doom
- Attacks can range from several times a day to several times a year
- Often associated with agoraphobia and other phobic anxiety disorders
panic disorder
i. A. Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur:
1. Palpitations, pounding heart, or accelerated heart rate.
2. Sweating.
3. Trembling or shaking.
4. Sensation of SOB or smothering.
5. Feeling of choking.
6. Chest pain or discomfort.
a. Usually present thinking they are having a heart attack
7. Nausea or abdominal distress.
8. Feeling dizzy or faint
9. Chills or hot flushes.
10. Parasthesias (tingling)
11. Derealization or depersonalization.
a. Don’t feel like themselves, but feel like they are playing themselves as an actor/not really themselves
12. Fear of losing control or going crazy.
13. Fear of dying.
ii. B. At least one of the attacks has been followed by 1 month (or more) of one or both of the following:
1. Persistent control or worry about additional panic attacks or their consequences.
2. A significant maladaptive change in behavior relating to the attacks (like not going out in public because you are afraid you will have one).
panic disorder
what is the onset for panic disorder?
late adolescence
a. Fear or anxiety associated with open or public spaces from which escape might be difficult
b. Develops as a result of panic disorder; person is terrified to think they might have an attack in such an exposed environment
c. Almost always want to be accompanied by friend or family member when going anywhere
d. Extreme cases don’t leave home
e. Most cases follow onset of panic disorder
f. Prognosis is poorer if not preceded by panic disorder
agoraphobia
A. Marked fear or anxiety about two (or more) of the following five situations:
1. Using public transportation.
2. Being in open spaces.
3. Being in enclosed spaces.
4. Standing in line or being in a crowd.
5. Being outside of the home alone.
B. The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms.
agoraphobia
- A strong persistent fear of being judged by others, or embarrassed.
- Could be anything; not wanting to eat in front of someone, or use a public restroom.
- Social anxiety disorder also known as Social Phobia(and even shy bladder).
social anxiety disorder
A. Marked fear or anxiety about one or more social situations in which the person is exposed to possible scrutiny by others.
B. The person fears that they will act in a way or show anxiety symptoms that will be negatively evaluated.
C. The social situations almost always provoke fear or anxiety.
social anxiety disorder
Strong persistent fear of an object or situation
specific phobia
who is specific phobia more prevalent in?
2x more prevalent in women; except the fear of blood, injection - this is equal
What is the order of preavlance of specific phobias:
- blood/injection
- other
- animal
- situational
- natural environment
- Animal Type
- Natural Environment Type (storms, heights, water).
- Blood/Injection/Injury Type
- Situational Type (airplanes, elevators).
- Other Type (clowns, vomiting, etc.).
A. Marked fear or anxiety about a specific object or situation (i.e. flying, heights, animals, seeing blood).
B. The phobic object or situation almost always provokes immediate fear or anxiety.
C. The phobic object or situation is actively avoided or endured with intense fear or anxiety.
D. The fear or anxiety is out of proportion to the actual danger.
E. The fear is persistent, typically lasting 6 months or more.
specific phobia
fear of heights
agoraphobia
fear of surgical operations
tomophobia
fear of water
hydrophobia
fear of everything
pantophobia
fear of the number 4
tetraphobia
fear of clowns
coulrophobia
fear of asians
sinophobia
fear of vomiting as a result of air sickness
aeronausiphobia
fear of dirt and germs
mysophobia
fear of opinions
allodoxaphobia
fear of strangers
xenophobia
fear of animals
zoophobia
fear of sexual abuse
agraphobia
fear of beautiful women
caligynephobia
fear of body odors
bromidrophobia
fear of hospitals
nosocomephobia
- A long-term condition that causes a person to feel anxious about a wide range of situations and concerns, not just one specific event.
- Persons feel anxious most days and have difficulty remembering the last time they felt relaxed.
- ‘Physical symptoms can include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes’.
generalized anxiety disorder
what is the average onset of GAD?
31
A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
B. The individual finds it hard to control the worry.
C. The anxiety and worry are associated with 3 (or more) of the following 6 symptoms:
1. Restlessness or feeling on edge.
2. Being easily fatigued.
3. Difficulty concentrating.
4. Irritability.
5. Muscle tension.
6. Sleep disturbances.
generalized anxiety disorder
- Can result from either recreational or prescription drugs.
- Sympathomimetics: Amphetamine, cocaine, caffeine, other CNS stimulants can cause anxiety disorder symptoms.
- 5-HT drugs such as LSD and MDMA (ecstasy)
substance-induced anxiety disorder
- Symptoms might occur during use (i.e. intoxication) or withdrawal (up to one month after cessation of use).
- Disorder will be further categorized depending on the prominent features, i.e. panic attacks, OCD, generalized anxiety, etc. Treatment focuses on stopping the substance abuse, of course..
substance-induced anxiety disorder
True or false - does Cognitive behavioral therapy precede medication?
True
Benzodiazepines can be used for what?
anxiety
fast acting drugs are better used for what?
insomnia
what are 2 fast acting drugs?
diazepam, triazolam
longer acting drugs are better used for what?
anxiety
what are 3 long acting drugs?
Alprazolam, lorazepam, chlordiazepoxide
True or false: SSRI’s are effective for long term? What is an example?
True; paroxetine
what is a serotonin agonist that is effective in anxiety?
buspirone
what is the prevalence of OCD?
equal in men and women; men more so in adolescence; more common in single people
what 2 components does OCD have?
Obsession: Recurrent or intrusive thought, feeling, idea or sensation.
Compulsion: Conscious, standardized, recurrent behavior.
A. Presence of obsessions, compulsions, or both.
- Obsessions are: Recurring and persistent thoughts, urges or images. Person tries to ignore/neutralize these thoughts with some other thought or action.
- Compulsions are: Repetitive behaviors.
OCD
what drugs are most effective in treating OCD?
5-HTa
-Persistent difficulty in discarding or parting with possessions, regardless of their actual value. This results in the accumulation of possession that congest and clutter active living areas.
hoarding
- Recurring pulling out of one’s hair, resulting in hair loss.
- Repeated attempts to decrease or stop hair pulling.
- Most common areas are scalp, eyelids and eyebrows, other body areas less common
trichotillomania
skin picking disorder
excoriation
A. Exposure to actual or threatened death, serious injury, or sexual violation in one or more of the following ways:
1. Directly experiencing the event.
2. Witnessing the events as they occur to others.
3. Learning the traumatic event has happened to friend or family member.
B. Presence of one or more of the following intrusion (unwanted) symptoms associated with the traumatic events, beginning after the events occurred:
1. Recurrent, involuntary, and intrusive or distressing memories of the events.
2. Recurrent distressing dreams.
3. Dissociative reactions (i.e. flashbacks).
4. 4/5. Intense or prolonged psychological or physiological distress at exposure to cues resembling the event.
PTSD
civil war also called?
soldier’s war
WWI also called?
shell shock
WW2 also called?
combat neurosis
Vietnam war also called?
PTSD
gulf war also called?
gulf war syndrome
- Lesser, temporal, version of PTSD
- The development of characteristic symptoms lasting from 3 days to one month following exposure to one or more traumatic events.
acute stress disorder
A. Exposure to actual or threatened death, serious injury, or sexual violation in one or more of the following ways:
a. Directly experiencing the event.
b. Witnessing the events as they occur to others.
c. Learning the traumatic event has happened to friend or family member.
The result of exposure results in symptoms in the following areas:
B. Symptoms are from the following categories:
1. Intrusion symptoms (recurring dreams, memories).
2. Negative mood.
3. Dissociative symptoms.
4. Avoidance symptoms.
e. 5. Arousal symptoms (sleep problems, concentration issues).
acute stress disorder
An emotional and behavioral reaction which develops within 3 months of a life stress, and lasts less than 6 months. The life stress is ‘serious’ i.e. divorce, moving, etc., but not life threatening. Symptoms include anxiety, depression, conduct problems, etc.
adjustment disorder
A. A pattern of behavior in which a child actively approaches and interacts with unfamiliar adults and exhibits at least two of the following:
1. Reduced or absent reticence in approaching and interacting with unfamiliar adults.
a. No reluctance or nervousness about approaching an adult whom they don’t know
2. Overly familiar verbal or physical behavior.
a. Ex) hugging an uncle they just met
3. Diminished or absent ‘checking back’ with adult caregiver after venturing away, even in unfamiliar conditions.
a. Ex) not checking back in a park they’ve never been with
4. Willingness to go off with an unfamiliar adult with minimal or no hesitation.
a. Ex) child goes off for ice cream with a stranger
C. The child has experienced a pattern of extremes of insufficient care as evidenced by at least 1 of the following:
1. Social neglect or deprivation.
2. Repeated changes of primary caregivers.
3. Rearing in unusual settings that limit opportunities for attachments.
disinhibited social engagement disorder
