Anxiety Disorders Flashcards
What is a Provisional Descriptor
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.
How do you write a provisional descriptor
Insert “provisional” after the name of the SPECIFIC DIAGNOSIS. Not the category.
What is an Unspecified Diagnostic Descriptor
When patient has definitely NOT met criteria for a SPECIFIC disorder, but has met criteria in a given category.
How to write an unspecified descriptor?
Insert “Unspecified” before the name of the diagnosed category
Prior History vs. In Remission
Which one is Drug Addiction?
Prior History: Prior WILL NEVER occur again
In Remission: Is likely to recur, but is currently controlled
Drug Addiction is always “in remission”
What is a common theme for all Anxiety Disorders
When is it abnormal?
How long do you have symptoms for:
Inappropriate Anxiety:
Abnormal when:
- Excessive in duration (more than 6 months)
- Elicited by inappropriate/no cues
- Excessive in intensity
What is the difference in definition between Fear and Anxiety
Fear: Imminent threat
Anxiety: Anticipation of a threat
What is a Panic Disorder
How long do you have symptoms for:
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
What is a Panic Attack
What is the Pneumonic?
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
What is Agorophobia
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
What makes someone Agorophobic (key element of diagnosis)
Situations above are feared/avoided because of thoughts that escape might be difficult or help might not be available
Agorophobia AND PD
Agorophobia only
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
Specific Phobia
Excessive/disproportionate persistent fear of ONE specific object or situation. Causes marked distress/impairment and isn’t accounted for by a different disorder
What are some subtypes of Specific Phobia
There are 4.
Animal Environmental (hurricanes/tornadoes/water/heights/storm) Situational (airplanes/elevators) Blood-Injection-Injury Other
Social Anxiety Disorder
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
Performance Only Social Anxiety Disorder
Fear is restricted to speaking or performing in public
Generalized Anxiety Disorder
Symptoms:
How long do you have symptoms for:
Persistent uncontrolled anxiety for more than 6 months
Sym: Restless, on edge, no sleep, irritability, fatigue, decrease concentration, muscle tension
Separation Anxiety Disorder
Situations where they experience marked distress
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
Selective Mutism
How long must you have symptoms for:
Criteria:
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
What are 2 differentials for Anxiety Disorders
- Due to another medical condition (hyperthyroidism)
2. Substance-Induced (caffeine, alcohol)
How are anxiety problems learned?
Give 2 examples
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
What are the areas of the brain associated with Anxiety? Three
- Amygdala-initiates fear
- Prefrontal Cortex-inhibits amygdala when fear is no longer necessary
- Hippocampus-track context in which a fear response is learned and help suppress fear when it is safe
Treatment: Best to worse
Why is it each bad/good for you and what does it do
- CBT: Modify thoughts (cognitive) to extinguish emotion (behavioral)
- 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)
