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Never-Ending Road to Licensure > Anxiety Disorders and Obsessive-Compulsive Disorder > Flashcards

Anxiety Disorders and Obsessive-Compulsive Disorder Flashcards

1
Q

Separation Anxiety Disorder criteria

A
  1. Fear of separation from attachment figures
  2. 3+ symptoms (distress related to separation, school avoidance, physical symptoms related to separation)
  3. Symptoms 4+ weeks (children) or 6+ months (adults)
  4. Distress or impairment
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2
Q

Separation Anxiety Disorder etiology

A

Often develops after stressful event (divorce, death, etc.)

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3
Q

Separation Anxiety Disorder treatment

A
  1. CBT combined with parent training
  2. Getting child back to school is primary focus if applicable
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4
Q

Specific Phobia criteria

A
  1. Fear of specific object or situation
  2. Avoidance or endurance with distress
  3. Symptoms 6+ months
  4. Distress or impairment
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5
Q

Specific Phobia types

A
  1. Animal
  2. Natural environment (lightning, heights)
  3. Blood-injection-injury
  4. Situational (elevators, bridges)
  5. Other (vomiting, choking)
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6
Q

Specific Phobia prevalence

A

Rates are 2x higher in girls than boys (depending on type)

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7
Q

Specific Phobia onset

A

Usually in childhood (mean age = 10 yo)

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8
Q

Mowrer’s two-factor theory and Specific Phobia

A

Combination of classical and operant conditioning:
1. Classical = onset, neutral stimuli becomes anxiety-provoking
2. Operant = maintenance, avoidance is reinforcing

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9
Q

Specific Phobia treatment

A

ERP

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10
Q

ERP

A
  1. Can be in vivo* or in imagination
  2. Can be therapist-led* or self-guided
  3. Flooding or graded/graduated
  4. Lower attrition with graded exposure
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11
Q

Virtual reality and ERP

A
  1. Some evidence that VR is similar to in vivo
  2. Especially useful for heights and flying
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12
Q

Treatment for blood-injection-injury phobia

A

Best when ERP is paired with tensing/relaxing muscles to prevent fainting

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13
Q

Social Anxiety Disorder criteria

A
  1. Fear of 1+ social situations involving exposure to scrutiny (mostly due to symptoms)
  2. Avoidance or endurance with distress
  3. Out of proportion
  4. Symptoms 6+ months
  5. Distress or impairment
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14
Q

Social Anxiety Disorder treatment

A

Children:
1. CBT*
2. School-based CBT

Adults:
1. CBT and antidepressants* (SSRIs and SNRIs)
2. Evidence that guided internet-based CBT is similar to in-person CBT

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15
Q

Panic Disorder criteria

A
  1. Unexpected panic attacks
  2. 1+ month of concern about additional attacks or effects of attack
  3. Not due to medical condition
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16
Q

Panic attack criteria

A
  1. Intense fear or discomfort
  2. Reaches peak within minutes
  3. 4+ symptoms (heart palpitations, sweating, nausea, dizziness, fear of death, paresthesia)
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17
Q

Panic Disorder medical condition rule-outs

A
  1. Hyperthyroidism
  2. Cardiac arrhythmia
18
Q

Panic Disorder treatment

A
  1. Cognitive-behavioral* (interoceptive exposure with relaxation)
  2. Antidepressants (imipramine) or benzodiazepines, with high relapse rates at discontinuation
19
Q

Agoraphobia criteria

A
  1. Fear in 2+ situations
  2. Fear or avoidance related to escape when symptomatic
  3. Out of proportion
  4. Fear/avoidance, need for companion, or endurance with distress almost always
  5. Symptoms 6+ months
  6. Distress or impairment
20
Q

Agoraphobic situations

A
  1. Public transportation
  2. Open spaces
  3. Enclosed spaces
  4. Crowds or lines
  5. Being alone outside the home
21
Q

Agoraphobia treatment

A
  1. In vivo ERP*
  2. Usually graded, some evidence that flooding has better long-term outcomes
  3. Some evidence that pairing ERP with relaxation is not more effective (key is tolerating distress)
22
Q

Generalized Anxiety Disorder criteria

A
  1. Excessive worry about multiple stimuli
  2. Difficult to control
  3. 3+ symptoms (adults) or 1+ symptoms (children)
  4. Symptoms most days for 6+ months
  5. Distress or impairment
23
Q

Generalized Anxiety Disorder symptoms

A
  1. Restlessness
  2. Fatigue
  3. Difficulty concentrating
  4. Irritability
  5. Muscle tension
  6. Sleep disturbance
24
Q

Generalized Anxiety Disorder v. non-pathological anxiety

A
  1. Uncontrollable
  2. Larger number of stimuli
  3. More likely to report somatic symptoms
25
Q

Generalized Anxiety Disorder worry stimuli (age)

A

Children:
1. Catastrophic events
2. Competence in sports, school

Adults:
1. Health
2. Safety

26
Q

Generalized Anxiety Disorder co-morbidities

A
  1. MDD*
  2. Social anxiety disorder
  3. Specific phobia
  4. PTSD
27
Q

Generalized Anxiety Disorder etiology

A
  1. Family history
  2. Temperament (inhibition, neuroticism, harm avoidance)
  3. Childhood trauma or chronic stress
  4. Brain abnormalities
28
Q

Brain abnormalities linked to Generalized Anxiety Disorder

A
  1. vlPFC and dlPFC
  2. Anterior cingulate cortex
  3. Posterior parietal cortex
  4. Amygdala
  5. Hippocampus
  6. Reduced connectivity between PFC and anterior cingulate cortex/amygdala (weak control of amygdala response)
29
Q

Generalized Anxiety Disorder treatment

A
  1. CBT*
  2. Medications (SSRIs and SNRIs*, buspirone, benzodiazepine)
  3. Some evidence for combined CBT and MI
30
Q

Obsessive-Compulsive Disorder criteria

A
  1. Recurring obsessions and/or compulsions
  2. Time-consuming (1+ hours per day), distress, or impairment
31
Q

Obsessions definition

A
  1. Repetitive thoughts, urges, or images that are experienced as intrusive/unwanted
  2. Attempts to ignore or suppress
  3. Anxiety or distress
32
Q

Compulsions definition

A
  1. Repetitive behaviors or mental acts
  2. Response to obsession or rigid rule
  3. Goal is to reduce anxiety or distress or prevent bad outcome
  4. Excessive or not realistically connected to goal
33
Q

Obsessive-Compulsive Disorder specifiers

A
  1. Level of insight
  2. Presence of tics
34
Q

Obsessive-Compulsive Disorder prevalence (gender)

A

Males:
1. Earlier age of onset
2. Higher rates in childhood

Females:
1. Slightly higher rates in adulthood

35
Q

Obsessive-Compulsive Disorder co-morbidities

A
  1. Anxiety disorder*
  2. Depressive or bipolar disorder
  3. Impulse control disorder
  4. Substance use disorder

90% have co-morbidities

36
Q

Neurotransmitter abnormality linked to Obsessive-Compulsive Disorder

A

Low serotonin

37
Q

Brain abnormalities linked to Obsessive-Compulsive Disorder

A

Hyperactive:
1. Caudate nucleus
2. Orbitofrontal cortex
3. Cingulate gyrus
4. Thalamus

38
Q

Obsessive-Compulsive Disorder treatment

A
  1. ERP and medication*
  2. Some evidence for CBT for OCD
  3. Some evidence for ACT for OCD
39
Q

Obsessive-Compulsive Disorder medications

A
  1. SSRI
  2. Clomipramine

Ineffective as standalone for severe symptoms

40
Q

Body Dysmorphic Disorder criteria

A
  1. Preoccupation with flaw in appearance
  2. Flaw not observable or minor to others
  3. Compulsions related to flaw
  4. Distress or impairment
41
Q

Body Dysmorphic Disorder associated symptoms

A
  1. Seek to correct flaw medically
  2. Ideas/delusions of reference (others are mocking them, others are noticing the flaw)

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