anxiety disorders Flashcards
is the emotional (and physiological) response to an imminent threat.
fear
is the anticipation, or worry/preoccupation with a future threat.
anxiety
Recurrent distress when anticipating or experiencing separation
Persistent and excessive worry about separation and/or harm/illness that will result to them as a result
Affects daily functioning, going to school, work, leaving the house, fear of being alone
Separation Anxiety Disorder
what symptoms present with separation anxiety
Recurrent physical symptoms when separation is imminent, recurrent nightmares
how long must symptoms be present for in separation anxiety
In children and adolescents, 4 weeks of symptoms, in adults 6 months or more
what is the cause of separation anxiety in kids
adults?
Usually parent is the focus for children,
in adults usually spouse or a friend
what is normal separation anxiety
experienced by babies. This is normal stage of development that begins around 9 months of age.
how may separation anxiety present in school aged kids
In pre-school/grade school may manifest as “illnesses” keeping the child at home or sneaking away from school to return home
Irrational, excessive fear of objects, places, situations
Must last at least 6 months (not transient)
Specific Phobia Disorder
Fear of humiliation or embarrassment in social settings, being observed by other people
Social anxiety disorder (SAD)
Specific Phobias & Social Anxiety Disorder tx
approved medications for SAD include: fluoxetine, paroxetine, sertraline (SSRIs) and venlafaxine (SSNRI)
MAOIs and benzodiazepines are also effective but first-line med have better side effect profiles
Beta-blockers are effective for short-term treatment of performance anxiety but not effective for SAD
Behavior therapy including exposure and flooding therapy has been shown to be very effective for both specific phobias and SAD
is medication effective for specific phobias
no
t/f Both specific phobias and SAD run in families;
true, Blend of genetics and learning most likely.
a collection of symptoms
They are not diagnosable as a discrete mental disorder
can occur in many different psychiatric conditions
usually begin suddenly and attacks usually peak in 10 minutes
Panic attacks
how long do most panic attacks last
Most last somewhere from 5-20 minutes
may cause generalized fear reactions to multiple things associated with social situations - starts as eating in a restaurant, then standing in line, then using public bathroom, then won’t go out at all
Social anxiety disorder (SAD)
Recurrent, unexpected panic attacks with at least 1 month of worry about having more panic attacks
Must have 4 of the 13 symptoms for a panic attack
Many of these symptoms could also be indicative of a serious medical condition
Panic Disorder
common comorbities that go with panic disorder
Major depression and alcohol use disorder are the most common psychiatric comorbidities
common age for panic disorder
before age 30, mid-20s is when most patients present
panic disorder tx
Medication in conjunction with psychotherapy
fluoxetine,
paroxetine,
sertraline
and venlafaxine
Cognitive behavioral therapy should also be employed, specifically Panic Control Therapy (PCT)
what must you rule out for panic disorder
hyperthyroidism, pheochromocytoma, hypoglycemia, SVT, angina, etc.
Worry excessively about life circumstances (job, health, finances, relationships)
Rates are higher in women and those under 30
The disorder is usually chronic with fluctuation in the severity of the symptoms
Generalized Anxiety Disorder
GAD tx
Combined therapy is best
Cognitive behavioral therapy is the mainstay for therapeutic treatment
paroxetine,
escitalopram,
venlafaxine
and buspirone
Pure behavior therapies include: relaxation training, re-breathing exercises, meditation
comorbities in GAD
substance use and major depression are common comorbidities
Compulsions occur to distract or relieve anxiety the patient feels due to their obsessions
obsession/compulsions are very time consuming or cause significant distress
obsessive compulsive disorder
are repetitive and intentional, and highly stereotyped/rigid
Compulsions
intrusive thoughts
obsessions
marker for OCD prognosis
Whether or not a patient has insight into their condition is a marker for prognosis
t/f of oc disorder
Most patients will suffer a chronic course (85%), a smaller percentage will have a deteriorating course (10%)
Patient usually report worsening symptoms when they are stressed
true
OC disorder age of onset
OC Disorder typically begins in late teens to early 20s
t/f OC disorder Onset is gradual to sudden
equal in male and females but males tend to present slightly earlier
true
t/f 70-80% of patient with OC disorder will not have recurrent major depression
false they do
OCD occurs more frequently in people with what?
neurological disorders like epilepsy, Sydenham’s chorea, Huntington’s disease and thus a neurobiological basis is likely.
Obsessive Compulsive Disorder tx
Medication and cognitive behavior therapy
SSRIs
fluoxetine,
paroxetine
and sertraline
Other classes of anti-depressants have not been effective
The effective dosage, however, is about 2x as that used for depression and it may take 3-4 months to have a clear effect
is the mainstay of tx for OC disorder
CBT is the mainstay, specifically Exposure and Response Prevention (ERP) therapy
t/f oc disorder and tourette’s are the same disorder
false they are not
but occur together often
