Anxiety Disorders and Obsessive-Compulsive Disorder

Question 1

What disorders fall under the category of anxiety disorders in the DSM 5

Answer 1

Generalized Anxiety Disorder (GAD)
Panic Disorder
Agoraphobia
Specific Phobia
Social Anxiety Disorder (Social Phobia)
Separation Anxiety Disorder
Selective Mutism
Substance/Medication-Induced Anxiety Disorder
Anxiety Disorder Due to Another Medical Condition
Other Specified Anxiety Disorder
Unspecified Anxiety Disorder

Question 2

Changes from DSM IV to 5, for criteria for Anxiety Disorders
The chapter on anxiety disorders no longer includes ——————— and —————- as they have been put in their own chapters

Answer 2

The chapter on anxiety disorders no longer includes OCD and PTSD as they have been put in their own chapters

Question 3

Changes from DSM IV to 5, for criteria for Anxiety Disorders
For specific phobia and social anxiety disorder(Social Phobia), which requirement has been deleted?

Answer 3

A person recognizes the anxiety is unreasonable has been deleted. Anxiety must be out of the proportion to actual danger taking cultural factors into account.

Question 4

Changes from DSM IV to 5, for criteria for Anxiety Disorders
Social anxiety disorder now has a ———————- ——– specifier.

Answer 4

Changes from DSM IV to 5, for criteria for Anxiety Disorders
Social anxiety disorder now has a PERFORMANCE ONLY specifier.

Question 5

Changes from DSM IV to 5, for criteria for Anxiety Disorders
The specifier with panic attacks can now be included with all ———— ———

Answer 5

The specifier with panic attacks can now be included with all DSM - 5 DISORDERS.

Question 6

Changes from DSM IV to 5, for criteria for Anxiety Disorders
Panic disorder and ——— are no longer linked, they are considered two separate diagnosis when both are present.

Answer 6

Changes from DSM IV to 5, for criteria for Anxiety Disorders
Panic disorder and AGORAPHOBIA are no longer linked, they are considered two separate diagnosis when both are present.

Question 7

Changes from DSM IV to 5, for criteria for Anxiety Disorders
Separation anxiety and ——————– are included in the chapter on anxiety disorders. Separation anxiety no longer requires onset before age ——–

Answer 7

Separation anxiety and SELECTIVE MUTISM are included in the chapter on anxiety disorders. Separation anxiety no longer requires onset before age 18

Question 8

Q: What are Anxiety Disorders characterized by?

Answer 8

A: Anxiety Disorders are characterized by excessive fear, anxiety, and related behavioral disturbances, as per the DSM-5.

Question 9

Q: What is Separation Anxiety Disorder characterized by?

Answer 9

A: Separation Anxiety Disorder involves excessive fear or anxiety about being separated from attachment figures, lasting at least four weeks in children and six months in adults, with symptoms causing significant distress or impaired functioning.

Question 10

Q: What are common triggers for the development of Separation Anxiety Disorder?

Answer 10

A: It often develops after stressful events such as parental divorce, death of a relative, or loss of a pet, which can disrupt attachment bonds and trigger excessive fear of separation (APA, DSM-5).

Question 11

Q: How does Separation Anxiety Disorder manifest in school-age children?

Answer 11

A: School refusal is a common manifestation, where children express physical symptoms and emotional distress to avoid going to school, often due to fear of separation from caregivers (James, Nelson, & Ashwill, 2013).

Question 12

Q: What is the recommended treatment for Separation Anxiety Disorder?

Answer 12

A: Cognitive-behavioral therapy (CBT) is highly effective, incorporating techniques like psychoeducation, gradual exposure, relaxation training, and cognitive restructuring to alleviate symptoms (Eisen, Raleigh, & Neuhoff, 2008).

Question 13

Q: How can treatment outcomes for Separation Anxiety Disorder be improved in children?

Answer 13

A: Combining CBT with parent training is beneficial, as it helps parents support the child’s gradual exposure and coping strategies, enhancing overall treatment effectiveness (Eisen, Raleigh, & Neuhoff, 2008).

Question 14

Q: What is Specific Phobia according to DSM-5?

Answer 14

A: Specific phobia involves intense fear or anxiety about a specific object or situation, leading to avoidance or endurance with distress. The fear must be out of proportion to the actual danger and persist for at least six months (APA, DSM-5).

Question 15

Q: What are the types of specific phobia as per DSM-5 specifiers?

Answer 15

A: Types include animal, natural environment, blood-injection-injury, situational, or other specific fears. These categories specify the particular objects or situations that trigger phobic reactions (APA, DSM-5).

Question 16

Q: What is Mowrer’s two-factor theory explaining the development of specific phobias?

Answer 16

A: It combines classical conditioning (pairing a neutral stimulus with an anxiety-provoking one) and operant conditioning (avoidance behavior negatively reinforced by anxiety reduction), perpetuating the phobic response (Mowrer, 1947).

Question 17

Q: What is the recommended treatment for specific phobia?

Answer 17

A: Exposure therapy, including flooding (immediate exposure to feared stimuli) and graded exposure (gradual exposure to hierarchy of feared stimuli), is effective. Both in vivo (real-life) and virtual reality exposure are utilized, often combined with response prevention (Antony, Craske, & Barlow, 2006).

Question 18

Q: How does applied tension enhance exposure therapy for blood-injection-injury phobia?

Answer 18

A: Applied tension involves tensing muscles to increase blood pressure, preventing fainting during exposure to feared stimuli, which is particularly effective for this subtype of specific phobia (APA, DSM-5).

Question 19

Q: What characterizes Social Anxiety Disorder according to DSM-5?

Answer 19

A: Social Anxiety Disorder is characterized by a fear or anxiety reaction to at least one social situation where the person may be exposed to scrutiny by others. The person fears that they will exhibit symptoms that will be negatively evaluated, leading to avoidance or enduring the situation with intense fear or anxiety (APA, DSM-5).

Question 20

Q: What are the diagnostic criteria and typical treatment for Social Anxiety Disorder?

Answer 20

A: The fear or anxiety must be excessive for the actual threat, persistent (lasting at least six months), and cause significant distress or impaired functioning. Treatment usually involves cognitive behavior therapy with exposure and response prevention, potentially combined with an SSRI, SNRI, or beta-blocker (APA, DSM-5).

Question 21

Q: What are the key diagnostic criteria for Panic Disorder according to DSM-5?

Answer 21

A: Panic Disorder involves recurrent unexpected panic attacks with at least one attack followed by one month or more of persistent concern about additional attacks or their consequences and/or significant undesirable behavior changes related to the attack. A panic attack is defined as an abrupt surge of intense fear or discomfort reaching a peak within minutes, involving at least four of 13 symptoms (e.g., heart palpitations, sweating, fear of losing control or dying) (APA, DSM-5).

Question 22

Q: What are common treatment approaches for Panic Disorder?

Answer 22

A: Treatment often includes cognitive-behavioral interventions such as panic control treatment, which combines interoceptive exposure with relaxation and other symptom control techniques. Interoceptive exposure involves deliberately exposing the person to physical symptoms associated with panic attacks (e.g., running in place). Some antidepressants (e.g., imipramine) and benzodiazepines are also used but are associated with a high relapse rate when used alone (Barlow et al., 1989).

Question 23

Q: What are the key diagnostic criteria for Agoraphobia according to DSM-5?

Answer 23

A: Agoraphobia involves marked fear or anxiety in at least two of five situations: using public transportation, being in open spaces, being in enclosed spaces, standing in line or being in a crowd, and being outside the home alone. The fear or avoidance is due to concern that escape will be difficult or help unavailable if panic symptoms or other incapacitating or embarrassing symptoms occur. The fear, anxiety, or avoidance must be excessive for the actual threat, persistent (lasting at least six months), and cause significant distress or impaired functioning.

Question 24

Q: What is the first-line treatment for Agoraphobia, and what has research indicated about its effectiveness?

Answer 24

A: The first-line treatment for agoraphobia is in vivo exposure and response prevention. Graded exposure is most commonly used, but intense (non-graded) exposure is also effective and may have better long-term effects. Research indicates that combining in vivo exposure with applied relaxation, breathing retraining, or cognitive techniques does not significantly improve outcomes, and the key contributor to effectiveness is learning to tolerate high levels of fear and anxiety (Barlow, Conklin, & Bentley, 2015).

Question 25

Q: What are the key diagnostic criteria for Generalized Anxiety Disorder (GAD) according to DSM-5?

Answer 25

A: Generalized Anxiety Disorder involves excessive anxiety and worry about multiple events or activities occurring on most days for at least six months. The person must find it difficult to control the worry, which must cause significant distress or impaired functioning. Symptoms must include at least three (or one for children) of the following: restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbance.

Question 26

Q: What are the risk factors and effective treatments for Generalized Anxiety Disorder (GAD)?

Answer 26

A: Risk factors for GAD include a family history of anxiety disorders, the temperament dimensions of behavioral inhibition, neuroticism, harm avoidance, and exposure to childhood trauma or chronic stress. Effective treatments for GAD include cognitive-behavioral therapy (CBT) and pharmacotherapy. First-line drugs for GAD are SSRIs and SNRIs, while individuals whose symptoms do not respond to antidepressants may benefit from the anxiolytic buspirone (Buspar) or a benzodiazepine.

Question 27

Q: What disorders are included in the DSM-5 category of Obsessive-Compulsive and Related Disorders?

Answer 27

A: The DSM-5 category of Obsessive-Compulsive and Related Disorders includes Obsessive-Compulsive Disorder (OCD), Body Dysmorphic Disorder, and other related disorders that share several diagnostic validators such as symptoms, comorbidity, and treatment response.

Question 28

Q: What common features do the disorders in the Obsessive-Compulsive and Related Disorders category share?

Answer 28

A: Disorders in the Obsessive-Compulsive and Related Disorders category share common diagnostic validators including similar symptoms, comorbidity with other disorders, and similar responses to treatment.

Question 29

Q: What characterizes Obsessive-Compulsive Disorder (OCD) according to the DSM-5?

Answer 29

A: OCD is characterized by recurrent obsessions and/or compulsions that are time-consuming (more than one hour each day) and/or cause significant distress or impaired functioning. Obsessions are intrusive, unwanted thoughts, urges, or images causing marked anxiety or distress, while compulsions are repetitive behaviors or mental acts performed to reduce anxiety or prevent an undesirable situation.

Question 30

Q: What are obsessions and compulsions in the context of OCD?

Answer 30

A: Obsessions are recurrent and persistent thoughts, urges, or images that cause marked anxiety or distress. Compulsions are repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession or according to rigidly applied rules, aiming to reduce anxiety or distress or prevent an undesirable event.

Question 31

Q: How do the prevalence rates and comorbidities of OCD differ between males and females?

Answer 31

A: Males have an earlier onset and a slightly higher prevalence rate in childhood, while females have a slightly higher prevalence rate in adulthood. Males are more likely than females to have a comorbid tic disorder.

Question 32

Q: What specifiers are used for OCD in the DSM-5?

Answer 32

A: Specifiers for OCD indicate the person’s level of insight into the veracity of their beliefs and the presence of tics.

Question 33

Q: What neurological abnormalities and neurotransmitter levels are associated with OCD?

Answer 33

A: OCD is linked to lower-than-normal levels of serotonin and elevated activity in the caudate nucleus, orbitofrontal cortex, cingulate gyrus, and thalamus.

Question 34

Q: What are the first-line treatments for OCD and how effective are they?

Answer 34

A: Exposure and response prevention (ERP) is a first-line, evidence-based treatment for OCD. Combining ERP with an SSRI or clomipramine may be most effective in some cases, such as when either treatment alone is ineffective, when symptoms are severe, or when there are comorbid symptoms responsive to antidepressants. Cognitive-behavior therapy and acceptance and commitment therapy are also effective.

Question 35

Q: What is Body Dysmorphic Disorder (BDD) according to the DSM-5?

Answer 35

A: BDD involves a preoccupation with a perceived defect or flaw in physical appearance that is not observable or appears minor to others. This preoccupation must cause significant distress or impaired functioning.

Question 36

Q: What behaviors or mental acts are associated with Body Dysmorphic Disorder?

Answer 36

A: People with BDD perform repetitive behaviors or mental acts in response to their perceived defect or flaw, such as mirror checking or skin picking.

Question 37

Q: How do individuals with Body Dysmorphic Disorder often seek to address their concerns?

Answer 37

A: Individuals with BDD often seek medical treatment to correct their perceived defects or flaws.