Anxiety Disorders and Panic Flashcards
Difference between Abnormal vs Normal Anxiety
FUN JEWS DO ICE
F: Functioning?
J: Justification of anxiety (is it normal)
D: Duration
I: Intensity
What are the 3 elements of Anxiety?
Name the 7 most prevalent anxiety disorders
- GAD
- Specific Phobias
- OCD
- PTSD
- Social Anxiety
- Panic
- Separation Anxiety
What is the core symptom of anxiety?
A future orientated state of worry
Explain the future state of worry in the following anxiety disorders
What is the most prevalent disorder in children?
Anxiety Disorders
What is the diagnostic criteria for GAD?
Why is GAD the least validated of all anxiety disorders?
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
Social Phobia
Compare Social Phobia Generalized vs. social phobia specific type
What are the diagnostic criteria for Social Phobia
- Extreme or persistent fear of social or performance situations.
- Exposure to situation produces extreme anxiety resulting in panic attack, dizziness, sweating etc.
- Knowledge that fear is irrational (but not in children)
- Social/Performance situations are avoided at all costs or endured with extreme duress
- Significantly interferes with person’s normal routine, job functioning, school functioning or social activities
What is the best treatment for Social Phobia?
Cognitive Behavioral Treatment
Cognitive: “Just because they are looking at me, it’s ok”
Behavorial: Exposure
Systematic Desensitization
Process of daily exposure in a gradual step by step manner using a “hierarchy
Specific Phobia
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
Specific Phobia Diagnostic Criteria
- Fear that is excessive
- Exposure to stimulus causes immediate fear
- Fear is irrational
- Person aviods fear at all cost
What are the four types of specific phobia?
- Animal Type
- Natural Environment
- Situational Type
- Blood/Injury injection
Which of the specific phobias has a strong familiar link?
Bloody/Injury Type
What are the three learning perspectives for specfic phobias?
- Classical Conditioning (aka direct conditioning)
- Vicarious Conditioning
- Information Transfer
* Learning perspective is the strongest for origin of phobias
Classical Conditioning
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
Vicarious Conditioning
You become conditioned by watching or seeing somebody become conditioned. You don’t have direct access.
Information Transfer
When somebody instructs you to be afraid
“Don’t go near that outlet!”
Treatments for Phobias
Learning perspective: EXPOSURE
Cognitive Perspective: Challenge your thoughts with statistics (75 years, elevator has not stopped!)
Physiological: Medication (Benzos) Ex. Xanax and Valum
What are two disorders that Benzos aren’t great for?
Panic and OCD
SAD Overview
- Severe and unreasonable fear from separation from parent?
- Not categorized under Anxiety
- Falls under disorders of childhood
- Kids over 4, normal for a 2 year old
- 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).
What happens when SAD goes away in kids?
Kids are often left with GAD, predisposition to anxiety
PTSD-Overview
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
PTSD Diagnostic Criteria
- Experience or witness trauma and response is fear or extreme helplessness
- Tramautic event is relived through dreams, flashbacks or thoughts
- Feels emotionally numb
- High biological arrousal (can’t sleep, hypervigilant), jumpy
- MIMINUM OF ONE MONTH
Protective factors against PTSD?
Methods of coping (active coping)
Strong Support (family and therapy)
Treatment: CBT (but more caring)
Panic Disorder vs. Panic Attack
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
Panic Disorder Diagnostic Criteria
- Person has panic attacks that are out of the blue
- 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.
Agoraphobia
Anxiety of being in places where escape would be difficult or embarrassing should the person have a panic attack
Panic with Agoraphobia
- You have panic attack
- You worry after
- Afraid of going outside and have another one
vs. Panic without agoraphobia: You have panic attack. but you go out anyway
What are coping mechanisms against Panic
- Safety behaviors
- 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.
What’s the 3rd most common psychiatric disorder in US?
