Anxiety Disorders Flashcards
Anxiety is an emotion or effect and deals with an internal state of _____
fear
Anxiety disorder is more common than depressive disorders. What are some risk factors
- female
- younger age
- single/divorced
- low socioeconomic status
- poor social support
- low education
- whites >ethnic minorities
- childhood maltreatment
- stressful life events
what is the median age at onset for panic disorder
23
what is the median age at onset for agoraphobia
18
what is the median age at onset for social anxiety disorder/social phobia
15
median age of onset for generalized anxiety disorder
30
median age of onset for specific phobia
15
median age of onset for separation anxiety disorder
16
_____ anxiety disorder is developmentally inappropriate and excessive anxiety occurring upon separation from significant attachment figures. The onset is usually in childhood, and is rarer in adolescence and has a genetic link with _____ disorder
Separation; panic
How do you treat Sep AD
- Psychotherapy: Graded exposure; starts with attachment figure next to them and gradually separating
- Cognitive Behavioral Therapy - Medication: SSRI
- Parent/Family Intervention; High maternal emotional over involvement is connected with SepAD
What is selective mutism
Failure to speak. It happens in certain social situations. Gets categorized in social anxiety disorder. Gets frequently diagnosed in kindergarten or first grade.
What are treatment options for selective mutism
- Psychotherapy: graded exposure
- Behavioral rewards: School, parents
- Family: encouraged not to speak for patient
What is criteria for specific phobia
Fear of a specific object or situation. The fear/anxiety lasts for 6 months or more and causes significant distress or impairment in social occupational or other important areas of functioning.
Specific phobia is common in children and older adults. _____ speaking fear is a form of social anxiety disorder. Some develop specific phobia following _____ event.
Public; traumatic
What are treatment options for specific phobia
- Psychotherapy: Cognitive behavioral therapy
2. Medication: Benzodiazepines as needed
What is common about social anxiety disorder
- fear about 1 or more social situations: having conversation, giving a speech
- kids miss school
3.
Core feature of SAD is ____ of negative evaluation. Median age of onset is in late ____ and is often co morbid with major _____ disorder. Avoidant personality disorder may be a co-morbidity.
fear; teens; depressive
What is the etiology of SAD
multifactorial;
- parental modeling and innate temperament
- modest heritability
- anxiety circuitry
what are treatment options for SAD
- Psychotherapy; cognitive behavioral therapy and mindfulness and acceptance based therapies.
- MEdication; SSRIs and SNRI, benzodiazepines, and MAOIs, beta adrenergic blockers (helpful for performance but not effective if used everyday), and atypical antipsychotics
A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes and which four or more of the symptoms can occur:
- palpitations, pounding heart
- sweating
- trembling/shaking
- shortness of breath
- chest pain
- nausea
- feeling dizzy
- chills or heat sensations
- paresthesias (numbness)
- derealization
- fear of losing control or going crazy
- fear of dying
T/F Panic attack in and of itself is a mental disorder
false; it can occur in context of any anxiety disorder, as well as other mental disorders and some medical conditions.
The disturbance of panic disorder is not attributable to the physiological effects of a substance or by another mental disorder or in response to traumatic events or in regards to sep from attatchment figures
know this
What is involved in anxiety disorders
amygdala
How do you treat panic disorder treatment
- Psychotherapy: CBT and Panic focused psychodynamic psychotherapy
- Medication: SSRI, Venlafaxine, Benzodiapenines, or TCAs
Agorophobia was previously under _____ disorder
panic
Agorophobia is marked fear or anxiety about two or more of the following five situations
- using public transportation
- Being in open spaces
- Being in enclosed places
- standing in line or being in a crowd
- being outside of the home alone.
What do people with agoraphobia experience fear or avoid certain situations
Thoughts that escape might be difficult or help might not be available in the event of dev panic like symptoms or other incapacitating or embarrassing symptoms.
T/F The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder
True
DSM 5 separated agoraphobia bc it could arise ______ of panic disorder
independent
What is generalized anxiety disorder
- Excessive anxiety and worry, occurring more days than not for at least 6 months, about a number of events or activities
- Ind finds it difficult to control the worry
What are some symptoms of generalized anxiety disorder
- restlessness or feeling keyed up or on edge
- being easily fatigued
- difficulty concentrating or mind going blank
- irritability
- muscle tension
- sleep disturbance
* Only 1 item is required in children
T/F The disturbance of GAD is not better explained by another mental disorder
True
What is GAD characterized by
- Chronic nervousness, somatic symptoms and worries; multifocal and pervasive worries
- initial insomnia common
- often comorbid with major depressive disorder
- Later modal onset of age when compared with other anxiety disorders
What is the etiology of GAD
- Genetic influence for personality trait neuroticism
2. COMT gene may be involved
What is GAD treatment
- Psychotherapy: CBT, and Psychodynamic psychotherapy
2. MEdication: SSRIs, Buspirone (only used for GAD), TCAs, Benzodiazepines, and Pregabalin
What are Other anxiety disorder categories
- substance/medication induced anxiety disorder
- anxiety disorder due to a mother medical condition
- other specified anxiety disorder
- unspecified anxiety disorder
What are DSM 5 Criteria for substance/medication induced anxiety disorder
- panic attacks or anxiety
2. The disturbance is not better explained by an anxiety disorder that is not subtance/medication induced.
What is the DSM 5 criteria for anxiety disorder due to another medical condition
- panic attacks or anxiety
- Evidence from hx, pe, or lab findings that the disturbance is the direct pathophysiological consequence of another medical condition.
- The disturbance is not better explained by another mental disorder
What are other specified anxiety disorder DSM 5 criteria
Causes distress or impairment but that do not meet the full criteria for any of the disorders in the anxiety disorders diagnostic class.
What are ex of other specified anxiety disorder
- limited symptom attacks
- generalized anxiety not occurring more days than not
- cultural concepts of distress
what is the criteria for an unspecified anxiety disorder
This is used in situations in which the clinician chooses not to specify the reason that the criteria are not met for a specific anxiety disorder, and includes presentations in which there is insufficient info to make a more specific diagnosis. ER settings
What is the map for treating and managing anxiety disorders
- Identify anxiety symptoms
- Differential diagnosis
- Identify specific anxiety disorder
- Treatment
If someone has a specific phobia you would treat them by _____ or ____ as needed
CBT; benzodiaepines
For sep anxiety, panic disorder, or agoraphobia you would treat by ______, antidepressants, or _____
CBT; benzodiazepines, or atypical antipsychotics
