Anxiety Disorders in Young People Flashcards
Know the main types of anxiety disorders Know the aetiology of the varied anxiety disorders including developmental considerations Know the main principles of treatment for anxiety disorders
State at least 4 types of anxiety disorder in young people
Separation anxiety disorder, generalised anxiety disorder, social anxiety disorder, agoraphobia, specific phobias, panic disorder,
Define social anxiety disorder
The fear of being perceived as foolish or stupid, resulting in avoidance of being the focus of attention (e.g. avoiding eating or talking in public)
Define agoraphobia
Extreme fear and avoidance of crowds, public places, and independent travel
Define panic disorder
Repeated experience of unprovoked panic attacks with intense fear and physical symptoms
Why was obsessive compulsive disorder separated from anxiety disorders in DSM-V?
Its compulsive element
Other than obsessive compulsive disorder, which other disorders are classed as compulsive?
Body dysmorphic disorder, hoarding disorder, trichotillomania, excoriation (skin-picking disorder)
What is the core feature of all anxiety disorders?
Withdrawal
State some typical features of anxiety disorders
Hesitancy, withdrawal, ritualised actions, fearfulness, distrust, shyness, expectation of threat, rumination, negative thoughts
State some physical symptoms of anxiety disorders
Difficulty sleeping, tension headache, dizziness, hyperventilation, ‘lump in the throat’ causing difficulty swallowing, shortness of breath, chest pain, abdominal pain, bowel urgency, bladder urgency
How many people diagnosed with an anxiety disorder have more than one?
75%
How many people diagnosed with an anxiety disorder have a comorbid mental health disorder?
80-90%
Name the three most common comorbid mental health disorders with child or adolescent anxiety disorders
Depression, conduct disorder, ADHD
What percentage of treatment-seeking children with anxiety meet the criteria for an additional mood disorder?
10-15%
What percentage of treatment-seeking adolescents with anxiety meet the criteria for an additional mood disorder?
30%
State the three components of an anxiety disorder assessment in young people
Questionnaire, diagnostic interview, behavioural observation
State a difficulty in assessing a young person for an anxiety disorder
The young person may ‘fake being good’ and provide answers they believe to be socially acceptable rather than the truth
State a difficulty in interviewing a young person’s parent about their child’s anxiety
Anxious parents may exaggerate their child’s symptoms
Over what age should children with a suspected anxiety disorder be interviewed separately from their parents?
8
How is the primary disorder identified?
It is the one which produces the greatest impact on and interference with the young person’s life
What is the prevalence of child and adolescent anxiety disorders in Western populations?
5%
What is the most common anxiety disorder in childhood and adolescence?
Specific phobia
What is the second most common anxiety disorder in childhood and adolescence?
Separation anxiety
What is the male to female ratio of anxiety disorder prevalence?
1:1.5-2
What is the male to female ratio of individuals with anxiety disorder seeking treatment?
1:1
Describe the relationship between development of fears and anxiety disorders
The development of normal fears and anxiety disorders coincide - for example, specific animal phobias tend to have an onset before 5, whereas social phobia tends to start at puberty
What is the average age of onset for generalised anxiety disorder? (de Lijster et al, 2017)
10-12 years
What is the average age of onset for social anxiety disorder? (de Lijster et al, 2017)
11-13 years
What is the average age of onset for panic disorder? (de Lijster et al, 2017)
22-24 years
What is the average age of onset for obsessive-compulsive disorder? (de Lijster et al, 2017)
13-15 years
Describe the association between anxiety disorders and parental marital status
There isn’t one
How can parenting characteristics affect the risk of developing an anxiety disorder?
Overprotection, intrusiveness, and negativity are associated with anxiety disorders - although the extent to which these cause anxiety vs develop due to the child exhibiting anxiety is debated
State at least 3 risk factors for developing an anxiety disorder
Family history, general neuroticism and inhibition, exposure to violence, overprotective and intrusive parenting
How much of the risk of developing an anxiety disorder is attributed to genetics? (Gregory & Eley, 2007)
40%
Give 3 maintaining factors of anxiety disorders
Bullying peer rejection or neglect, cognitive biases (heightened threat beliefs and expectations)
Describe the relationship between anxiety disorder and major depression
Childhood anxiety may be followed by major depression later in life
Name the 3 main neurotransmitters involved in anxiety disorders
Gamma-hydroxybutyric acid (GABA), serotonin, noradrenaline
Describe the changes seen on fMRI in the brains of young people with anxiety disorders
Increased response by the amygdala, prefrontal cortex, and striatum to anxiety-inducing stimuli
What is the first-line treatment for anxiety disorders in young people?
Cognitive behavioural therapy (CBT)
State an alternative treatment to CBT for anxiety disorders in young people
Skills-based psychological treatment (e.g. psychoeducation, relaxation training, exposure, cognitive restructuring)
Name the 2 most commonly prescribed SSRIs in young people
Sertraline and fluoxetine
How long should SSRIs for anxiety disorders in young people be prescribed for?
10-15 weeks
