Anxiety Disorders Flashcards
When kids worry about bad things happening to their parents, and as a result are reluctant to leave the home, fearing never seeing them again; Will often fake illness to avoid having to leave home. Look for a trigger!
Separation anxiety disorder
Treatment for separation anxiety disorder
Identifying trigger and using therapy to help the child understand the trigger and learn to cope; May need medication (anxiolytic or antidepressant), but ONLY in combo with behavioral psychotherapy and family therapy
Very common disorder (9% of pop); Presence of phobias involving objects or situations that invoke anxiety. Individual may have a restricted lifestyle as a result of this disorder.
Specific phobia
Treatment for specific phobia
Systematic desensitization (feared stimuli are paired with relaxation training) and flooding of the feared stimulus in massive exposure
What disorder can result from avoidant personality traits?
Social anxiety disorder (social phobia)
Patients will have a fear of speaking or performing in public (“stage fright”), public speaking, speaking in classrooms, eating or writing in public, urinating in public restrooms, and attending social events; May socially isolate themselves and have a low self-esteem
Social anxiety disorder
How do you treat social anxiety disorder?
CBT, pharmacotherapy (SSRI, buspirone, benzos, beta blockers for social phobias)
Recurrent, unexpected panic attacks of abrupt surges of intense fear and discomfort that peaks in 1 minute or so, and during which the patient experiences 4 of the 13 symptoms listed in the DSM (sweating, palpitations, chest pain, nausea); This person also has to exhibit either persistent concern or worry of the recurrence of these attacks, or a significant maladaptive change in behavior as a result of the disorder
Panic disorder
Excessive, poorly controlled anxiety about routine life circumstances that continues for more than 6 months, where the person finds it difficult to control the worry an the worry impairs daily functioning. The anxiety is associated with three or more symptoms of restlessness, easily fatigued, poor concentration, irritability, muscle tension, and sleep disturbance
Generalized anxiety disorder
Treatment for GAD
Medication based with antidepressant therapy as well as anxiolytics being very important, as well as some forms of behavioral therapy such as relaxation training and biofeedback
Is there a genetic component to OCD?
Yes
4th most common psychiatric diagnosis?
OCD
OCD is ____-mediated
Serotonin
Recurrent obsessions and/OR compulsions that are disruptive to the patient’s life, and greatly interferes with daily functioning (must be at least 1 hour/day per DSM)
Obsessive compulsive disorder
Do individuals recognize OCD as unreasonable and bothersome? What is this called?
YES - this is egodystonic
What other diagnoses are often associated with to OCD?
Tourette’s and ADHD
How do you treat OCD?
Seratonergic antidepressants at max dose, clomipramine, and behavioral therapies
A normal appearing individual has excessive preoccupation with an imagined physical defect. There may be a minor physical defect that is perceived with massive issue; there may be a co-morbid delusional disorder present
Body dysmorphic disorder
Treatment for body dysmorphic disorder
Seratonergic drugs (as used in OCD at max dose); CBT; antipsychotic medications may be used when there are delusions of psychotic proportions
Persistent difficulty in discarding or parting with possessions regardless of actual value, an accumulation of possessions that congests living areas, and it causes clinically significant distress or impairment; Insight may be good or poor - can be a delusional content
Hoarding disorder
Treatment for hoarding disorder
Same as OCD and body dysmorphia; CBT primarily
This is “Hair pulling” disorder, which is recurrent hair pulling that results in hair loss; there are attempts to decrease or stop the hair pulling - there is significant distress or impairment
Trichotillomania - Treatment the same as other anxiety disorders
Recurrent skin picking and there are attempts to decrease the skin picking which are often met with failure; this causes clinically significant distress or impairment
Excoriation Disorder - treatment the same as other anxiety disorders
Recurrent memories, recurrent dreams, feeling of recurrence, distress at re-exposure, physiological reactivity
“Intrusion” symptoms for PTSD 1+
Memories, thoughts, feelings; External reminders
Avoidance symptoms for PTSD 1+
Poor memory, self-concept, cause/consequences, emotional state, interest/participation, detachment, loss of positive emotions
Negative cognitions for PTSD 2+
Irritability, recklessness, hyper vigilance, exaggerated startle, poor concentration, sleep disturbance
Arousal symptoms for PTSD 2+
Most cases of PTSD resolve within?
3 months
Relieve the patient of intrusive recollections and decrease symptoms of anxiety and improve social relations and capacity for enjoyment
Mainstay of treatment for PTSD
What are the 3 mainstays of treatment for PTSD?
- Group physchotherapy, pharmacology, and not debriefing but immediate therapy/counseling may help stave off PTSD from developing
Anxiety related equivalent of brief-psychotic disorder; this is a disorder that is essentially early or acute PTSD: Has to last from 3 days to 1 month (Once it has lasted for more than 1 month, it reverts to PTSD)
Acute stress disorder
Environmental stressors such as interpersonal issues (divorce), occupation issues (job loss), and medical issues (cancer) can be very trying and cause anxiety, depression,, or behavioral symptoms (erratic actions) that interfere with function
Adjustment disorders
Do the symptoms of adjustment disorder ever remit?
yes, once the stressor resolves or new coping skills develop
The risk of developing an adjustment disorder depends on what two things?
Person’s coping skills and emotional strength
Patient presents with complaint of a “nervous breakdown”; unable to manage life problems, and is suffering from overwhelming anxiety or depression associated with life stressors. Patient had normal functioning before the onset of the stressor. MS exam shows anxiety, depression, or disturbed conduct.
Adjustment disorder
Adjustment disorder must occur within ____ months of the onset of a stressor
3
Adjustment disorder symptoms must resolve within ___ months of the termination of the stressor but may persist for longer period if they occur in response to long-term exposure
6
Treatment for adjustment disorder
Removing stressor if possible, engaging in CBT or psychodynamic psychotherapy; supportive psychotherapy
Do you use meds for adjustment disorder?
May be helpful adjunctively if patient suffers from anxiety, insomnia, depression, etc.
