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Disciplines Exam 1 > Anxiety Disorders > Flashcards

Anxiety Disorders Flashcards

1
Q

Which age group w/ Separation Anxiety Disorder are over-concerned about offspring and spouses?

A

Adults

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2
Q

12 month prevalence

Females to Males 2:1

A

Specific Phobias

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3
Q

What should you treat first w/ patients w/ specific phobias

A

Comorbid disorders (if present)

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4
Q

The disturbance causes clinically significant distress or impairement in functioning (academic, occupational, social)

A

Separation Anxiety Disorder

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5
Q

Benzodiazepines → can be utilized short term → screen for SUD (substance use disorder)

  • Lorazepam (Ativan) 30 minutes prior to boarding a plane
  • Diazepam (Valium) 30 to 45 minutes prior to MRI
A

Tx for Specific Phobias

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6
Q
  • Recurrent excessive distress when anticipating/experiencing separation from home or major attachment figure
  • Persistent and excessive worry about losing major attachment figures or possible harm to them (illness, injury, disasters, or death)
  • Persistent and excessive worry about experiencing an untoward event which separates (getting lost, being kidnapped, having accident, becoming ill)
  • Persistent reluctance or refusal to go out (due to fear of separation)
A

At least 3 of these = Separation Anxiety Disorder

(DSM Criteria 1)

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7
Q

Describe the genetic factor of Specific Phobias

A

1st degree relatives more likley to have phobia in same category (parent: dogs, child: spiders)

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8
Q
  • Developmentally inappropriate and excessive fear/anxiety of separation from whom individual is attached to
A

Separation Anxiety Disorder

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9
Q
  • unique propensity to vasovagal syncope
  • Brief elevation of heart rate (HR) and blood pressure (BP) followed by deceleration of HR and BP → CNS hypoxia → syncope
A

Blood injection injury phobia

(specific phobia)

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10
Q

2 Comorbidities of children w/ Separation Anxiety Disorder

A
  • Generalized Anxiety Disorder
  • Specific Phobia
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11
Q
  • Inborn response to threat or to the absence of people or objects that signify safety
  • Can result in cognitive (worry) and somatic (racing heart, sweating, shaking, freezing, etc.) symptoms.
A

Normal adaptive anxiety

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12
Q

May only express anxiety from Separation Anxiety Disorder when separation is experienced

A

Younger children

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13
Q

•Excessive attention and focus on all internal and external stimuli secondary to paranoid stance

A

Hypervigilance

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14
Q
  • anxiety that is excessive, impairs function.
A

Pathologic anxiety

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15
Q

At what age do infants develop stranger anxiety?

A

1 year

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16
Q

Onset may be as early as preschool age and at any time during childhood → may persist into adulthood

  • Adolescent onset is rare
  • Adult onset → many not recall childhood disorder but may recall symptoms
A

Separation Anxiety

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17
Q
  • Anxiety exceeds what would be expected for developmental level
  • is part of development
A

Separation Anxiety Disorder

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18
Q

•confronting stimulus in real world in a safe and controlled manner (MC and most effective)

A

In vivo exposure

(Tx for specific phobias)

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19
Q

**Comborbidities of adults w/ Separation Anxiety Disorder**

A

Wide range of other comorbidities

(Phobias, panic disorder, depression) + many more

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20
Q

reduction in physical and social functioning → risk of depression

A

Fear of falling in older adults can reduce mobility

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21
Q
  • The fear, anxiety, or avoidance is persistent and lasting at least ____ in children and adolescents
  • Typically lasting _____ or more in adults.

Separation Anxiety Disorder

A
  • 4 weeks in children/adolescents
  • 6 months or more in adults
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22
Q
  • Frequently associated with depression in older adults
  • Increased risk of developing other anxiety disorders, depressive and bipolar disorders, substance-abuse related disorders, somatic disorders, and personality disorders (particularly dependent PD)
A

Comorbidities of Specific Phobias

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23
Q

sympathetic arousal response

A

Situational, natural environment, and animal specific phobias

24
Q

•In children, may be expressed by crying, tantrums, freezing, or clinging.

A

Fear or anxiety of children w/ specific phobias

25
Q

•may substantially reduce dietary intake → individual avoids solid foods

A

Fear of vomiting and choking

26
Q

•Essential feature → fear or anxiety limited to the presence of a particular situation or object

A

Specific Phobias

27
Q
  • Repeated complaints of physical symptoms when separation from major attachment figures occurs or is anticipated.
    • headaches, stomachaches, nausea, vomiting (child or adults?)
    • palpitations, dizziness, feeling faint (rare in young children) (child or adults?)
A
  • Separation Anxiety Disorder
    • Children & Adults
    • Adults
28
Q

•Essential feature → excessive fear or anxiety concerning separation from home or attachment figures

A

Separation Anxiety Disorder

29
Q

Medication for children w/ Separation Anxiety Disorder

A

Fluoxetine (Prozac)

**Black Box Warning** (may develop depression –> suicidal)

30
Q
  • Usually develop in childhood
  • Developmental triggers
    • Traumatic event (attacked by animal, stuck in an elevator)
    • Observation of a traumatic event (watching someone drown)
    • Unexpected panic attack in the feared situation (while on a subway)
    • Many are unidentifiable
A

Specific Phobias

31
Q

What is the 1st line tx for children & adults w/ Separation Anxiety Disorder?

A

Psychotherapy

  • Cognitive Behavioral Therapy (CBT)
    • Coping Cat (pediatric program 7-13 yrs)
  • Family therapy
32
Q

Is separation anxiety more common in males or females?

33
Q

•Indicates the development of secure attachment relationships

A

Separation Anxiety

34
Q

Which part of the brain activates the sympathetic nervous system, release of adrenaline?

A

Hypothalamus

35
Q

What are the 3 personality disorders associated w/ Separation Anxiety Disorder?

A
  • Social Anxiety Disorder (proximity/safety of main attachment figures)
  • Dependent PD (indiscriminate tendency to rely on others)
  • Borderline PD **(fear and abandonment by loved ones, problems w/ identity, interpersonal functioning, impulsivity)**
36
Q

•Not going away to college

A

Functional Challenges of:

Adolescents w/ Separation Anxiety Disorder

37
Q

Which part of the body releases cortisol for continued alertness?

A

Adrenal cortex

38
Q

Anxiety can become self-generating – symptoms reinforce the reaction

A

spiral effect

39
Q

•symptoms of anxiety are both a response to CNS state and a reinforcement of further anxiety

A

Sympathomimetic sxs

40
Q

•Typically there are periods of exacerbation and remission

A

Separation Anxiety

41
Q

Worries begin to emerge in which age group of children with Separation Anxiety Disorder?

  • Specific → accidents, kidnapping
  • Vague → not being reunited with attachment figures
  • Described as being intrusive, demanding, in need of constant attention

When separated may exhibit (social withdrawal, apathy, sadness)

A

Older children

42
Q

Specific Phobias typically last at least ___ months or more.

43
Q
  • Difficulty sleeping alone
  • School refusal → not attending / avoiding school
  • Not going to camp
A

Functional Challenges of:

Children w/ Separation Anxiety Disorder

44
Q
  • Almost always provokes immediate fear or anxiety.
    • Can vary w/ proximity
    • May occur in anticipation of or in actual presence
A

The feared object or situation

45
Q

Risk factors

  • Parental overprotectiveness
  • Parental loss or separation
  • Physical or sexual abuse
A

Specific Phobias

46
Q

2 risk factors for Separation Anxiety

A
  • Life stress (death of loved one, change of school, becoming parent)
  • Parental overprotection and/or intrusiveness
47
Q

1st line tx for Specific Phobias

A
  • CBT (cognitive behavioral therapy) w/ exposure leads to greatest reduction in sxs
    • Alters maladaptive thoughts/behaviors linked to emotional distress
    • Ex: Animal exposure
48
Q

•Anxiety caused by consciously recognized and realistic danger

49
Q

What is the recommended medication for adults w/ Separation Anxiety Disorder?

A

Selective Serotonin Reuptake Inhibitor (SSRI)

  • Sertraline (Zoloft), increase dosage after 6 weeks
50
Q
  • Persistent and excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings.
    • Children may display “clinging” and/or “shadowing” behavior
  • Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure.
A

Separation Anxiety

(DSM Criteria 2)

51
Q

•Feeling of apprehension caused by anticipation of danger, which may be internal or external

52
Q
  • Not leaving parental home
  • Not traveling
  • Need to continuously check on offspring / significant others
A

Functional Challenges of :

Adults w/ Separation Anxiety Disorder

53
Q
  • Virtual reality
  • Treatment gains w/ exposure therapy appear to be maintained for at least 1 year (continued self-exposure on a regular basis is important)
  • Repeated, graded, systematic confrontation of the feared stimulus to facilitate fear reduction
A

Tx for specific phobias

54
Q
  • ***What is the most prevalent anxiety disorder in children <12 yrs old?***
A

Separation anxiety disorder

55
Q

•confronting stimulus in imagination – useful when situation is costly (e.g. flying) or infrequent (e.g. storms)

A

Imaginal exposure

(tx for specific phobias)

56
Q

What 3 things are seen with borderline PD in patient’s w/ separation anxiety disorder?

A
  • Problems w/ identity
  • Problems w/ interpersonal functioning
  • Problems w/ impulsivity
57
Q

Which part of the brain reacts to threat?

Disciplines Exam 1 (13 decks)

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