Anxiety Disorders-Heh Flashcards
What are clinical features of Panic Disorder?
- recurrent, unexpected anxiety/panic attacks
- 1 month concern about having another attack, worry about implications of another attack or significant change in behavior related to the attack (avoidance)
- symptoms: palpitations, sweating, trembling, sensations of SOB, choking sensation, CP, nausea, feel dizzy/faint, derealization, fear of losing control and dying, paresthesias, chills or hot flashes
- sudden attacks, 5-30 minutes long with residual symptoms
- bad prognosis: vivid memory of 1st attack, occurs at night, severe symptoms
What are some features of agoraphobia?
- Unfamiliar setting/crowds/wide open spaces
- Inability to escape a place or situation
- Unable to get help in event of panic attack
- Feel trapped
- Need to be accompanied in crowded places
- Social embarrassment
How can Panic Disorder course clinically (changes that take place with each additional panic attack)?
higher baseline develops –> more likely to develop panic attacks more frequently with residual anxiety and longer recovery
self-medication with alcohol or medication often leads to depression
What is the DSM IV criteria for Generalized Anxiety Disorder?
-excessive worry/anxiety about life and things that they should not be worrying about for at least 6 months (affecting different activities)
- 3 or more: WATCHERS
- Worry
- Anxiety
- Tension in mm.
- Concentration difficulties
- Hyperarousal (irritability)
- Energy loss
- Restlessness
- Sleep disturbance
What is a phobia? What are the 3 DSM categories of phobia?
-Irrational fear (and disproportionate to any danger) of specific objects, places, situations or activities
- agoraphobia
- social phobia
- specific phobia
What is Social Phobia/Social Anxiety Disorder?
How do children and adults with this diagnosis differ?
- Fear of humiliation or embarrassment in public places
- Fear of being observed by other people
- Fear public speaking, eating in restaurants, writing in public, using public bathroom, using the telephone
- Children: crying, tantrum, freezing, shrinking away from social situations
- adults: situationally predisposed panic attacks
-children do not realize that their fear is disproportionate to the situations and adults do
What is the difference between obsessions and compulsions?
- Obsessions: Persistent and recurrent thoughts/ideas/impulses or images that experienced as intrusive /inappropriate and cause anxiety/distress. (common are contamination and pathological doubt)
- Compulsions: Repetitive and intentional behaviors(mental acts) or rituals are performed in response to the obsession.
- ->Complusions meant to neutralize or reduce the anxiety/distress. (washing and checking)
What are the criteria for a PTSD diagnosis (DSM IV)?
TRAUMA
- Traumatic event (proximal to pt and with intense fear, helplessness or horror)
- Re-experience
- Avoidance
- Unable to function
- Month or more of symptoms
- Arousal increased (irritable, anger outbursts, difficulty sleeping, exaggerated startle response, difficulty concentrating)
What is the difference between acute, chronic and delayed PTSD?
- acute: 1 month-3 month duration
- chronic: > 3months
- delayed: symptoms began after > 6 months
What is the diagnosis for a pt with PTSD symptoms but less than 1 month?
Acute Stress Disorder:
- Maximum of 1 month duration
- greater # dissociative symptoms
- likely to develop PTSD
What neuropathological changes are seen in PTSD?
- smaller hippocampal area (antidepressants will make this bigger)
- fewer serotonin 1B receptors in their brain stress circuits