Anxiety Disorders-Heh Flashcards

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1
Q

What are clinical features of Panic Disorder?

A
  • 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
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2
Q

What are some features of agoraphobia?

A
  • 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
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3
Q

How can Panic Disorder course clinically (changes that take place with each additional panic attack)?

A

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

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4
Q

What is the DSM IV criteria for Generalized Anxiety Disorder?

A

-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
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5
Q

What is a phobia? What are the 3 DSM categories of phobia?

A

-Irrational fear (and disproportionate to any danger) of specific objects, places, situations or activities

  • agoraphobia
  • social phobia
  • specific phobia
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6
Q

What is Social Phobia/Social Anxiety Disorder?

How do children and adults with this diagnosis differ?

A
  • 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

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7
Q

What is the difference between obsessions and compulsions?

A
  • 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)
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8
Q

What are the criteria for a PTSD diagnosis (DSM IV)?

A

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)
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9
Q

What is the difference between acute, chronic and delayed PTSD?

A
  • acute: 1 month-3 month duration
  • chronic: > 3months
  • delayed: symptoms began after > 6 months
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10
Q

What is the diagnosis for a pt with PTSD symptoms but less than 1 month?

A

Acute Stress Disorder:

  • Maximum of 1 month duration
  • greater # dissociative symptoms
  • likely to develop PTSD
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11
Q

What neuropathological changes are seen in PTSD?

A
  • smaller hippocampal area (antidepressants will make this bigger)
  • fewer serotonin 1B receptors in their brain stress circuits
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