Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatry > Anxiety Disorders > Flashcards

Anxiety Disorders Flashcards

1
Q

When do anxiety disorders tend to begin and how do they progress over a lifetime?

A

Tend to begin early teens or early 20s, waxing and waning over the course of a lifetime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the adaptive function of anxiety?

A

An alerting signal which helps prevent consequences

-> helps motivate and improve performance in moderate doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the two components of anxiety and what is it critical to determine?

A
  1. Physiological sensations - i.e. palpations
  2. Feeling of nervousness or fright

Important to determine which comes first and causes the other symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the neurochemical model of the etiology of anxiety?

A

Anxiety comes from activation of the autonomic nervous system, either primarily or secondary to a learned stimulus
-> causes release of NE, 5-HT, and GABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the neuroendocrine model of anxiety etiology? Best piece of evidence?

A

HPA axis dysregulation accounts for anxiety

Cortisol levels are overly suppressed in PTSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the genetic model of anxiety? What is one type of anxiety where this holds true?

A

Higher rate of concordance between monozygotic vs dizygotic twins

Finding: Specific phobias were more likely to occur within a family (although all these specific phobias may be different)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the psychodynamic model of anxiety and was it ever supported?

A

Anxiety is viewed as a signal of danger in the unconscious -> never supported (id vs superego idea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the behavioral vs cognitive-behavioral anxiety model?

A

Behavioral - anxiety is a conditioned response to specific environment stimuli

Cognitive-behavior - adds on to the behavioral model by saying cognitive distortions / automatic thoughts guide our response to these environmental stimuli -> we overestimate the danger and underestimate the coping skills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How are agora and specific phobias treated with therapy? OCD?

A

Agora / specific phobias - Exposure with graded desensitization

OCD - Exposure plus response prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are a couple types of medications which are known to precipitate anxiety?

A

Corticosteroids (also in inhalers)
Oral contraceptives

Others which are obvious dont be an idiot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What should you always give a patient who comes in with anxiety and what do you tell them?

A

Always give them a definitive diagnosis and some reading material to go over later when they are at home

Tell them side effects of the drugs and to come back in 7-10 days to make sure they’re adherent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the diagnostic criteria groups for panic disorder?

A
  1. Recurrent panic attacks
    or
  2. At least 1 month of persistent concern of having another panic attack, causing behavioral change

Typical other DSM criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If you have a panic attack do you have panic disorder? What is it often comorbid with?

A

No, must be recurrent or associated with significant worry / behavioral change

Better than 50% will have depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What part of the brain is responsible for anticipatory anxiety? What types of anxiety manifestations do the following brain areas cause: prefrontal cortex? brain stem?

A

Amygdala / limbic system

Prefrontal cortex is responsible for avoidance behaviors

Brain stem: autonomic symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What types of diseases are typically on the differential diagnosis for anxiety / panic disorders?

A

Cardiovascular / respiratory dysfunction to cause the physiological symptoms, endocrine dysfunction for stress hormones, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What, in general, are the diagnostic criteria for agoraphobia?

A

Fear of public spaces where escape might be difficult or help unavailable for greater than 6 months.

Anxiety is out of proportion to the actual threat posed, and thus these situations are avoided or endured with extreme anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the pharmacotherapeutic interventions for panic disorder and agoraphobia / specific phobias?

A

Panic disorder - SSRIs are first line

Agoraphobia / panic disorders - exposure therapies, no pharmacotherapeutics indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the most common type of anxiety disorder and a very classic subtype?

A

Specific phobia disorder - causes panic attacks during exposure or anticipation of exposure

Blood-illness-injury phobia is classic -> vaso-vagal passing out due to shots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What, in general, is social anxiety disorder? What is the normal age of onset?

A

A fear or avoidance of social / interactional situations which lasts more than 6 months, can be as small as eating / using bathroom in public

Typically in teen years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What two things are frequently co-morbid with social anxiety disorder?

A
  1. Depression

2. Alcohol dependence

21
Q

What response is intensified in social anxiety disorder? Can they tell accurately between emotions?

A

Activation of brain areas in response to harsh faces

-> they are able to tell between different emotions just as well

22
Q

What, in general, is generalized anxiety disorder?

A

Excessive anxiety and worry more days than not for at least 6 months

-> Requires associated physiological / psychological symptoms

23
Q

What is the requirement for something to be considered a triggering event for PTSD?

A

Exposure to death, serious or sexual violence via:
Direct experience, witnessing experience, learning of the experience from someone close to them, experiencing repeated / extreme exposure to aversive details of trauma

24
Q

What are the four core features of PTSD? How long must they be present?

A

More than 1 month

  1. Intrusive symptoms -> i.e. memories, nightmares, physiologic response
  2. Avoidance behavior -> avoidance of triggers
  3. Negative mood / cognitions -> includes forgetting important aspects / distorted cognitions
  4. Hyperarousal symptoms -> exaggerated startle, irritable behavioral, sleep problems
25
Q

What are two important specifiers of PTSD?

A
  1. With dissociative symptoms -> i.e. depersonalization

2. With delayed expression -> does not start until 6 months after event (i.e. holocaust victims until retirement)

26
Q

What are the noradrenergic and HPA findings in PTSD?

A

Noradrenergic - increased epinephrine concentrations in urine + downregulation of platelet alpha-2 receptors

HPA - low plasma / urinary cortisol, which cannot be stimulated easily with CRF and is enhanced suppression by dexamethasone (opposite of depression)

27
Q

What area of the brain which regulates affect is found to be hypoactivated in PTSD?

A

medial prefrontal cortex, including orbitofrontal cortex and anterior cingulate cortex

28
Q

What area of the brain is smaller in PTSD?

A

Hippocampus

29
Q

What is the first-line treatment for PTSD? Does debriefing following trauma help?

A

Trauma-informed CBT

Debriefing following trauma does not help

30
Q

How does acute distress disorder differ from PTSD? What is the treatment?

A

Acute stress disorder is from 3 days to 1 month after trauma, although it has the same symptoms
-> becomes PTSD after 1 month

Treatment unknown, just CBT

31
Q

What are the criteria for an adjustment disorder?

A

Emotional or behavioral symptoms in response to a stress occurring within 3 months of a stressor, which will not persist for more than 6 months after stress is removed.

  • > cause marked distress out of proportion to severity / intensity of stressor
  • > cause significant impairment
32
Q

What is important to include in an adjustment disorder diagnosis? What is one which you might not think of?

A

A specifier, like depressed mood, anxiety, mixed states

-> might not think of “disturbance of conduct” i.e. fighting, skipping school, vandalizing

33
Q

What condition is most comorbid with adjustment disorders?

A

Personality disorders or substance abuse

34
Q

Is adjustment disorders considered a trauma-related disorder?

A

Yes, oddly enough

35
Q

What is the very basic definition of obsessive compulsive order (criteria)?

A

Presence of obsessions, compulsions, or both which are time consuming or cause significant stress / impairment in function

36
Q

What is an obsession vs a compulsion?

A

Obsession - recurrent thought or urge which individual must try to suppress or neutralize

Compulsion - repetitive behavior or mental act (i.e. counting) which can be used to neutralize the obsession

37
Q

What are the important specifiers for OCD?

A

They relate to the patient’s insight:
Good / fair
Poor
Absent

How well the patient understands that their beliefs are not true. Absent = patient is completely convinced they are true

38
Q

What is one anxiety-related disorder where the male:female affected ratio is equal?

A

Obsessive-compulsive disorder

39
Q

What conditions are commonly co-morbid with OCD, and one unique one?

A

Anxiety disorders or mood disorders

Unique - up to 30% have co-morbid tic disorders, and with Tic can be used as a specifier for the OCD

40
Q

What is PANDAS?

A

Abrupt onset of OCD in children following Streptococcus infection (Group A Strep)
-> analogous to Syndenham’s chorea, due to autoimmune condition

41
Q

What two neurosurgeries can be used for OCD?

A

Cingulotomy - bilateral lesioning of the anterior cingulate gyrus between orbitofrontal cortex (seat of wisdom) and limbic system

Capsulotomy - anterior limb of internal capsule - relay between cortical structures and thalamus

42
Q

What mental disorder has an extremely high prevalence in dermatology patients and cosmetic patients? What is the treatment?

A

Body dysmorphic disorder

Treatment is CBT or SSRIs

43
Q

What are the diagnostic criteria for body dysmorphic disorder?

A
  1. Preoccupation with physical appearance flaws not observable or appear slight to others
  2. Has done repetitive actions like mirror checking or mental actions such as comparison
  3. Impairment of function, and not better explained by eating disorder
44
Q

What is one OCD-related disorder when the prevalence in men is more than women and its diagnostic criteria basically?

A

Hoarding disorder

  • > holding onto items regardless of value, accumulating as clutter in living areas which prevents their intended use.
  • > Causes distress to discard the items
45
Q

What OCD disorder has women FAR outnumbering men in terms of prevalence? What are the criteria?

A

Trichotillomania

Pulling out of one’s hair causing hair loss, with REPEATED attempts to decrease / stop.
-> was previously classified impulse-control disorder

46
Q

Why does hairpulling continue and when does it start?

A

Typically starts in 11-13 year olds and is lifelong

-> response to negative emotions and is positively reinforced because it feels good

47
Q

What dirty drug is good for treating trichotillomania and OCD?

A

Clomipramine - a tricylic antidepressant

48
Q

What is skin-picking disorder called? What are the criteria?

A

Excoriation -> basically same as trichotillomania

Must result in skin lesions, and must continue despite repeated attempts to decrease or stop

Psychiatry (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions