Anxiety Disorders Flashcards
Types of Anxiety Disorders
- Generalized Anxiety Disorder
- Panic Disorder
- Specific Phobia
- Agoraphobia
- Social Anxiety Disorder
Lifetime prevalence of an anxiety disorder + risk factors
25%
Women > men
Genetics!!! 4-8x risk w/ first degree relative
more prevalent among lower SES
Panic Disorder Treatment
Psychotherapy & Medications
- Relaxation and breathing exercises
- Identifying the catastrophizing cognitions
- Systematic desensitization therapy!
- hierarchy of things that might cause you panic
- goal = unlearn behavioral response
Medications for Panic Disorder
SSRIs -reduce severity and frequency of panic attacks
- Prozac
- Paxil
- Zoloft
Benzos
- Xanax
- Klonopin** longer acting, less addictive
Specific Phobias
Consistent anxiety for 6 + months
- avoided or endured with difficulty
- Extreme/out of proportion
Categories (75% fear >1 stimulus)
- animals
- nature (lightening, heights)
- Situational (public speaking)
- Needle stick
Risk Factors for developing Specific phobias
2x greater risk in females
Temperament –> some people are just more neurotic
Environment –> traumatic encounter with stimulus
Genetics!!
Specific phobia treatment
Exposure therapy! Goal to extinguish response
- Systemic desensitization; learning to relax while facing fear
- Modeling: watch someone else handle it
- Flooding: lots of images of fear…overwhelms the body and desensitizes patient ot that exposure
- Applied tension technique: increases blood pressure and heart rate so wont faint while getting needle stick
Are medications useful in treatment of specific phobias?
No! They are just a temporary fix!
Agoraphobia definition
Anxiety about 2 or more…
- public transportation
- open spaces
- closed spaces
- crowds
- lines
- being outside the home alone
Fear of inability to escape, no available help
Agoraphobia Prevalence
Females
Peaks in late adolescence and early adulthood
-average onset is 17 yo
Agoraphobia Treatment
Similar to phobia & panic disorder
- exposure therapy
- desensitization therapy
Remission is rare without treatment
Social Anxiety Disorder Diagnosis
Anxious in social situations- afraid of being rejected
- consistent, lasting 6+ months
- focused on avoiding such events
- NOT comforted by others*
Can be specific to performance only –ex: public speaking
Social Anxiety Etiology
Behavioral – negative social experience
Cognitive – high standards for personal performance
Genetic predisposition
When is social anxiety most prevalent?
75% onset between ages 8 & 15
MC in females, BUT men seek treatment more often
Prevalence will decrease with age
Social Anxiety Treatment
Psychotherapy
- CBT = challenge unrealistic/incorrect thoughts
- Exposure therapy
- Relaxation exercises
Meds:
- Luvox
- Paxil
- Zoloft
- Effexor
Generalized Anxiety Diagnosis
Excessive & uncontrollable worry occurring more days than not for 6+ months across multiple domains/activities
At least 3:
- restlessness
- easily fatigued
- poor concentration
- irritability
- tension
- sleep disturbance
GAD Etiology
Biological –> GABA deficiency (amygdala)
Emotional/cognitive
- Strong response to negative/threatening emotional stimuli
- High degree of negative cognitions
Psychodynamic –> unresolved, unconscious conflicts
What is the age onset for GAD?
Later onset than the other anxiety disorders, broad range
PPl often say they have been anxious their entire life
Is GAD more prevalent in men or women?
Women 2x as likely
GAD is ______% likely to occur with another diagnosis
50-90%
- panic disorder
- MDD
- substance use
Genetic component
GAD Treatment
CBT
- confronting issues you worry about the most
- challenging negative thoughts
- developing coping strategies
Meds
- Xanax
- Lexapro
- Cymbalta
- Paxil
- Effexor
When might you think the patient has a medical issue going on rather than anxiety?
- Onset after 35 yo
- No personal or family hx of anxiety disorder
- No childhood hx of anxiety
- No triggering life event
- Poor response to medications
