Anxiety Disorders and Panic

Question 1

Difference between Abnormal vs Normal Anxiety

Answer 1

FUN JEWS DO ICE

F: Functioning?

J: Justification of anxiety (is it normal)

D: Duration

I: Intensity

Question 2

What are the 3 elements of Anxiety?

Question 3

Name the 7 most prevalent anxiety disorders

Answer 3

1. GAD
2. Specific Phobias
3. OCD
4. PTSD
5. Social Anxiety
6. Panic
7. Separation Anxiety

Question 4

What is the core symptom of anxiety?

Answer 4

A future orientated state of worry

Question 5

Explain the future state of worry in the following anxiety disorders

Question 6

What is the most prevalent disorder in children?

Answer 6

Anxiety Disorders

Question 7

What is the diagnostic criteria for GAD?

Question 8

Why is GAD the least validated of all anxiety disorders?

Answer 8

People make the most mistakes diagnosing it because it seems like it can be present when it is not; it’s very hard to differentiate it from the others.

However, we don’t see the physiological response in GAD: no sweating, heart racing etc like we see in panic. Rather we see high blood pressure and ulcers

Question 9

Social Phobia

Question 10

Compare Social Phobia Generalized vs. social phobia specific type

Question 11

What are the diagnostic criteria for Social Phobia

Answer 11

1. Extreme or persistent fear of social or performance situations.
2. Exposure to situation produces extreme anxiety resulting in panic attack, dizziness, sweating etc.
3. Knowledge that fear is irrational (but not in children)
4. Social/Performance situations are avoided at all costs or endured with extreme duress
5. Significantly interferes with person’s normal routine, job functioning, school functioning or social activities

Question 12

What is the best treatment for Social Phobia?

Answer 12

Cognitive Behavioral Treatment

Cognitive: “Just because they are looking at me, it’s ok”

Behavorial: Exposure

Question 13

Systematic Desensitization

Answer 13

Process of daily exposure in a gradual step by step manner using a “hierarchy

Question 14

Specific Phobia

Answer 14

Person is afraid of specific object or situation and the fear is extreme or irrational

You need to rule out trauma and PTSD and ask “Why are you afraid of this?” If a person can rationalize it, it could be PTSD (I’m not going in that plane, I was in 9/11)

Irrational

Extreme

Consistent

Impairs functioning

Question 15

Specific Phobia Diagnostic Criteria

Answer 15

1. Fear that is excessive
2. Exposure to stimulus causes immediate fear
3. Fear is irrational
4. Person aviods fear at all cost

Question 16

What are the four types of specific phobia?

Answer 16

1. Animal Type
2. Natural Environment
3. Situational Type
4. Blood/Injury injection

Question 17

Which of the specific phobias has a strong familiar link?

Answer 17

Bloody/Injury Type

Question 18

What are the three learning perspectives for specfic phobias?

Answer 18

1. Classical Conditioning (aka direct conditioning)
2. Vicarious Conditioning
3. Information Transfer

* Learning perspective is the strongest for origin of phobias

Question 19

Classical Conditioning

Answer 19

Whne you have two objects, one that causes the response and one that does not.

Bell: Conditioned

Meat Powder: Unconditioned

Doctor: Conditioned

Shot: Unconditioned

Bunny: Conditioned

Noise: Unconditioned

Physiological Theory states that people are genetically predisposed to classical conditioning, higher levels of neurological arrousal

Question 20

Vicarious Conditioning

Answer 20

You become conditioned by watching or seeing somebody become conditioned. You don’t have direct access.

Question 22

Information Transfer

Answer 22

When somebody instructs you to be afraid
“Don’t go near that outlet!”

Question 23

Treatments for Phobias

Answer 23

Learning perspective: EXPOSURE

Cognitive Perspective: Challenge your thoughts with statistics (75 years, elevator has not stopped!)

Physiological: Medication (Benzos) Ex. Xanax and Valum

Question 24

What are two disorders that Benzos aren’t great for?

Answer 24

Panic and OCD

Question 25

SAD Overview

Answer 25

1. Severe and unreasonable fear from separation from parent? 2. Not categorized under Anxiety 3. Falls under disorders of childhood 4. Kids over 4, normal for a 2 year old 5. Afraid something bad will happen to them or parent They say "They can't go to school, I'm sick) Kids typically have physical complaints (headache, difficulty sleeping, can't sleep in another house).

Question 26

What happens when SAD goes away in kids?

Answer 26

Kids are often left with GAD, predisposition to anxiety

Question 27

PTSD-Overview

Answer 27

Traumatic (war, earthquake, accident) or even watching something bad. Person experience high level of anxiety AND CONSISTENTLY RELIVES IT, through nightmares. BUT CAN't REMEMBER DETAILS Person reports feeling detached, can't be happy, love, feeling they are not connected, numbness, can't enjoy stuff they used to Report heightened arousal Biggest myth: all trauma is PTSD

Question 28

PTSD Diagnostic Criteria

Answer 28

1. Experience or witness trauma and response is fear or extreme helplessness 2. Tramautic event is relived through dreams, flashbacks or thoughts 3. Feels emotionally numb 4. High biological arrousal (can't sleep, hypervigilant), jumpy 5. MIMINUM OF ONE MONTH

Question 29

Protective factors against PTSD?

Answer 29

Methods of coping (active coping) Strong Support (family and therapy) Treatment: CBT (but more caring)

Question 30

Panic Disorder vs. Panic Attack

Answer 30

Panic Attack: when you know where it's coming from, it's in response to something Panic Disorder: It comes out of nowwhere \*Panic attacks can be found in specific phobia, socail phobia, and PTSD

Question 31

Panic Disorder Diagnostic Criteria

Answer 31

1. Person has panic attacks that are out of the blue 2. Develop a consistent worry about having additional attacks Some people can't leave their house, they go to the doctor a lot One panic attack is not enough.

Question 32

Agoraphobia

Answer 32

Anxiety of being in places where escape would be difficult or embarrassing should the person have a panic attack

Question 33

Panic with Agoraphobia

Answer 33

1. You have panic attack 2. You worry after 3. Afraid of going outside and have another one vs. Panic without agoraphobia: You have panic attack. but you go out anyway

Question 34

What are coping mechanisms against Panic

Answer 34

1. Safety behaviors 2. Interoceptive Avoidance : a person aviods stuff that will make their heart beat faster Treatment: SSRIs. Not anti-anxiety CBT is also effective It can happen in dreams. Proves biological reason. Drop in O2.

Question 35

What's the 3rd most common psychiatric disorder in US?