Anxiety Disorders

Question 1

What is a Provisional Descriptor

Answer 1

If you know that they have it, but they haven’t showed all the signs of it, but you know they will.
Ex: Patient info is unavailable
Ex: To diagnose depression, you must have it for 14 days, but this person has only symptoms for 12/13 days.

Question 2

How do you write a provisional descriptor

Answer 2

Insert “provisional” after the name of the SPECIFIC DIAGNOSIS. Not the category.

Question 3

What is an Unspecified Diagnostic Descriptor

Answer 3

When patient has definitely NOT met criteria for a SPECIFIC disorder, but has met criteria in a given category.

Question 4

How to write an unspecified descriptor?

Answer 4

Insert “Unspecified” before the name of the diagnosed category

Question 5

Prior History vs. In Remission

Which one is Drug Addiction?

Answer 5

Prior History: Prior WILL NEVER occur again

In Remission: Is likely to recur, but is currently controlled

Drug Addiction is always “in remission”

Question 6

What is a common theme for all Anxiety Disorders

When is it abnormal?

How long do you have symptoms for:

Answer 6

Inappropriate Anxiety:

Abnormal when:

• Excessive in duration (more than 6 months)
• Elicited by inappropriate/no cues
• Excessive in intensity

Question 7

What is the difference in definition between Fear and Anxiety

Answer 7

Fear: Imminent threat
Anxiety: Anticipation of a threat

Question 8

What is a Panic Disorder

How long do you have symptoms for:

Answer 8

Recurrent and unexpected panic attacks-occur randomly for:
-more than 1 month, and the person shows either a fear of future panic attacks or a significant change in behavior related to the attacks-avoid exercising, need an escort just in case they do have a panic attack

Question 9

What is a Panic Attack

What is the Pneumonic?

Answer 9

Intense fear with somatic or cognitive symptoms such as:
PANICS:
-Palpitations (cardiac symptoms), Paresthesias, dePersonalization/derealization (feeling detached)
-Abdominal distress (GI symptoms)
-Nausea
-Intense fear of dying/losing control, -lIght headedness (feeling faint)
-Chest pain/Chills/Choking
-Sweating/Shaking (trembling)/Shortness of Breath

Question 10

What is Agorophobia

Answer 10

2 or more situations are feared/avoided

• Using public transportation
• Being in enclosed spaces
• Being in open spaces
• Standing in line or being in a crowd
• being outside of the home alone

Question 11

What makes someone Agorophobic (key element of diagnosis)

Answer 11

Situations above are feared/avoided because of thoughts that escape might be difficult or help might not be available

Question 12

Agorophobia AND PD

Agorophobia only

Answer 12

PD pts can avoid multiple places because they’re scared of having a panic attack and nobody being there to help

An older person avoids going anywhere in case incontinence strikes

Question 13

Specific Phobia

Answer 13

Excessive/disproportionate persistent fear of ONE specific object or situation. Causes marked distress/impairment and isn’t accounted for by a different disorder

Question 14

What are some subtypes of Specific Phobia

There are 4.

Answer 14

Animal
Environmental (hurricanes/tornadoes/water/heights/storm)
Situational (airplanes/elevators)
Blood-Injection-Injury
Other

Question 15

Social Anxiety Disorder

Answer 15

Excessive, persistent, unrealistic fear of social situations involving possible scrutiny by others due to fear of negative evaluation
Ex: Don’t answer phone, don’t talk to anyone, don’t go to school

Question 16

Performance Only Social Anxiety Disorder

Answer 16

Fear is restricted to speaking or performing in public

Question 17

Generalized Anxiety Disorder

Symptoms:

How long do you have symptoms for:

Answer 17

Persistent uncontrolled anxiety for more than 6 months

Sym: Restless, on edge, no sleep, irritability, fatigue, decrease concentration, muscle tension

Question 18

Separation Anxiety Disorder

Situations where they experience marked distress

Answer 18

Inappropriate and Excessive anxiety concerning separation from major attachment figures

• Don’t stay in school because they don’t want to be away
• Scared of losing or harm befalling major attachment figure

Question 19

Selective Mutism

How long must you have symptoms for:

Criteria:

Answer 19

Refusal to speak in specific situations even though you know HOW to speak
-Refusal to speak is based on anxiety
Symptoms for 1 month or more

Question 20

What are 2 differentials for Anxiety Disorders

Answer 20

1. Due to another medical condition (hyperthyroidism)

2. Substance-Induced (caffeine, alcohol)

Question 21

How are anxiety problems learned?

Give 2 examples

Answer 21

Through Classical Conditioning
1. Specific Phobia because its associated with a fear-producing stimulus
Ex: Scared of dogs because you were bitten by one
2. Panic Disorder-physical symptoms are associated with the full fear response
Ex: Tachycardia causes you to feel terror, tingling/emotions associated with anxiety

Question 22

What are the areas of the brain associated with Anxiety? Three

Answer 22

1. Amygdala-initiates fear
2. Prefrontal Cortex-inhibits amygdala when fear is no longer necessary
3. Hippocampus-track context in which a fear response is learned and help suppress fear when it is safe

Question 23

Treatment: Best to worse

Why is it each bad/good for you and what does it do

Answer 23

1. CBT: Modify thoughts (cognitive) to extinguish emotion (behavioral)
2. Anxiolytic Medications
   - Benzodiazepines (GABA agonists-recommended for short term use, inhibit neuronal firing-always sleepy, less of everything, withdrawal can lead to death
   - Antidepressants (MAO agonists)