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Behavioral Health--> Module One > Anxiety Disorders, OCD and Related Disorders, Trauma and Stressor Related Disorders > Flashcards

Anxiety Disorders, OCD and Related Disorders, Trauma and Stressor Related Disorders Flashcards

1
Q

What are the different anxiety disorders?

A 
Panic Disorder 
Agoraphobia 
Social Anxiety Disorder 
Specific Phobia 
Generalized Anxiety Disorder 
Separation Anxiety Disorder 
Selective Mutism
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2
Q

What theme do all the anxiety disorders share?

A

inappropriate anxiety

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3
Q

Anxiety is abnormal when it is?

A
  1. Elicited by inappropriate cues
  2. Excessive intensity
  3. Excessive duration
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4
Q

What is the cause of anxiety?

A

caused by overstimulation of the HPA (hypothalamic-pituitary-adrenal) axis resulting from activation by the amygdala
HPA activation releases cortisol and catecholamines, which are responsible for many physiological and psychological changes

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5
Q

What are the general treatments for anxiety?

A
  1. Cognitive-Behavioral Therapy (CBT) –> modifying ones thoughts to change emotion; using exposure techniques to extinguish the emotion
  2. Anxiolytic Medications —> Benzodiazepines (Short term)
    and Antidepressants (SSRIs)
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6
Q

What is the general diagnostic criteria for panic disorder?

A

Diagnosis requires panic attack followed by 1 month of one or more of the following:

  1. Fear of future panic attacks or
  2. A significant change in behavior related to the attacks
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7
Q

what is a panic attack?

A

intense fear with somatic or cognitive symptoms

abrupt onset with episodic peak within minutes

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8
Q

What is the diagnostic criteria for agoraphobia?

A

a person excessively and persistently fears >2 of the following:
* Using public transportation
* Being in open Spaces
* Being in enclosed spaces
* Standing in line or being in a crowd
* Being outside of the home alone
The person fears/avoids these situations because escape may be difficult in the event that embarrassing symptoms develop.

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9
Q

Agoraphobic often develops in what kind of patients?

A

panic disorder patients

diagnosed as a separate illness

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10
Q

What is the diagnostic criteria for specific phobia?

A

Phobia –> excessive, persistent and disproportional fear of an object or situation
The fear response invariably occurs when exposed to the stimulus, or the person avoids the phobic situation
The fear causes marked distress/impairment and isnt accounted for by a different disorder

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11
Q

What is the etiology of specific phobia?

A

classically-conditioned response (the feared situation/object was once associated with a fear producing stimulus/object)

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12
Q

What is the diagnostic criteria for social anxiety disorder?

A

Excessive, persistent and unrealistic fear of social situations involving possible scrutiny by others due to fear of negative evaluation

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13
Q

What is the diagnostic criteria for generalized anxiety disorder (GAD)

A

Persistent uncontrolled anxiety about multiple events

Trigger of Anxiety–> EVERYTHING

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14
Q

What symptoms are associated with GAD?

A 
Restless, on edge 
decreased concentration 
muscle tension 
fatigued 
irritability 
insomnia
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15
Q

When in a persons life do symptoms of GAD start?

A

young age

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16
Q

What other medical conditions should be ruled out before diagnosis of anxiety is made?

A

Anxiety Disorders due to Another Medical Condition (hyperthyroidism)
Substance-Induced Anxiety Disorders (caffeine, sedative withdrawal)

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17
Q

What is the diagnostic criteria for obsessive-compulsive disorder? (OCD)

A
  1. Recurrent obsessions or compulsions
  2. Obsessions/compulsions are time consuming or distressful/disruptive
  3. Symptoms are not explained by another disorder
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18
Q

Define obsession

A

Intrusive recurrent thoughts, urges , or images that increase distress

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19
Q

Define Compulsions

A

Repetitive behaviors/mental acts that are performed to decrease distress

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20
Q

what is meant when individuals have the diagnosis of OCD with absent insight (delusional beliefs)

A

the person is completely convinced that OCD beliefs are true

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21
Q

What is the cause or etiology of OCD?

A
  1. Prefrontal-Striatal Overactivity

2. Serotonin Deficiency

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22
Q

In rare cases OCD begins after what type of infection?

A

Streptococcal Infection knows as PANDAS

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23
Q

What are some treatments of OCD?

A
  1. Cognitive Behavioral Therapy and/or SSRIs
  2. Psychosurgery –> lesioning of the anterior cingulate gyrus or anterior limb of the internal capsule (GLEN from the video)
  3. Deep Brain Stimulation –> electrical impulses are delivered by an indwelling brain electrode attached to an implanted thoracic pacemaker.
24
Q

What are the OCD related disorders?

A

Hoarding Disorder
Body Dysmorphic Disorder
Excoriation Disorder
Trichotillomania

25
Q

What is the diagnostic criteria for Hoarding Disorder (HD)?

A

Difficulty parting with possessions due to perceived need to save items or distress about discarding them
Accumulation of possessions clutters living areas and substantially compromises their intended use.

26
Q

Specifying if HD is with absent insight (delusional beliefs) means what?

A

person is certain that HD beliefs/behaviors are not problematic despite contrary evidence

27
Q

What is the diagnostic criteria for body dysmorphic disorder (BDD)?

A

Preoccupation with a perceived flaw in physical appearance
Repetitive behaviors or mental acts are performed in response to appearance concerns
BDD must cause functional impairment

28
Q

If the dx is BDD with muscle dysphoria, what does this mean?

A

preoccupation with belief that one’s body is too small or insufficiently muscular

29
Q

If the dx is BDD with absent insight (delusional beliefs), what does this mean?

A

person is completely convinced that BDD beliefs are true

30
Q

What is the diagnostic criteria for excoriation disorder?

A

recurrent skin picking resulting in lesions
attempts to stop picking
picking results in significant distress/functional impairment
picking is not explained by another disorder

31
Q

What are some feature of excoriation disorder?

A 
time consuming (usually >1 hr/day)
social avoidance
medical complications
32
Q

What is the diagnostic criteria for trichotillomania?

A

Recurrent pulling out of one’s hair resulting in hair loss
attempts to stop hair pulling
pulling causes significant distress/functional impairment

33
Q

what are features of trichotillomania?

A

any body region can be affected and change over time
pulling usually occurs during sedentary activities
episodes can be frequent but brief or infrequent by sustained

34
Q

What are the trauma and stressor related disorders?

A 
Posttraumatic stress disorder 
Acute stress disorder 
Adjustment Disorder 
Reactive Attachment Disorder 
Disinhibited Social Engagement Disorder
35
Q

What is the etiology of trauma/stressor related disorders?

A

these disorders share in common psychological distress in response to a traumatic/stressful event
psychological distress can manifest in many forms

36
Q

What is a traumatic stressor?

A

Involves actual/threatened death or serious injury

37
Q

What is a non-traumatic stressor?

A

Situations in which a person perceives that environmental demands exceed one’s resources to cope

38
Q

What is the diagnostic criteria for posttraumatic stress disorder (PTSD)?

A

Exposure to a traumatic stressor:

  1. Actual or threatened death or serious injury or sexual violence
  2. Exposure may include direct experience of event, witnessing event or learning about event to close family member/friend
39
Q

What are the four types of symptoms associated with PTSD that may develop at any time? (each card will go through one)

A
  1. Intrusion Symptoms –> dreams, recollections, feeling event reoccur, psychological or physiological distress when encounters symbols
40
Q

2nd type of symptom with PTSD?

A
  1. Avoidance Symptom –> symptoms such as avoidance of thoughts, places, or conversations, that are reminders of events
41
Q

3rd type of symptom with PTSD?

A
  1. Negative Alterations in Cognition and Mood –> persistent –> negative beliefs/expectations, negative emotional states, inability to experience positive emotion, diminished interest/participation in activities, detachment/estrangement from others and dissociative amnesia
42
Q

4th type of symptom with PTSD?

A
  1. Alteration in Arousal and Reactivity –> sleep disturbance, irritable and angry outbursts, reckless or self destructive behavior, concentration problems, hypervigilance, and exaggerated startle response
43
Q

What is the duration and onset of PTSD?

A

Duration –> last greater than 1 month

Onset –> within 3 months of trauma but can begin ANYTIME

44
Q

What is the diagnostic criteria for acute stress disorder (ASD)?

A
  1. Exposure to a traumatic stressor
  2. Numerous PTSD-like symptoms develop from any of the PTSD symptom categories
  3. Duration of the disorder is 3 days to 1 month after trauma exposure
45
Q

What is the key in differentiating PTSD and ASD?

A

Timeline
ASD: symptoms start and resolved within the first 30 days after the trauma
PTSD: symptoms start anytime after the trauma and last more than 30 days

46
Q

What is the diagnostic criteria for adjustment disorder?

A

Development of significant emotional/behavioral symptoms
Due to an identifiable stressor (often an ordinary life experience): Acute Onset and Brief Duration
Symptoms do not meet criteria for another disorder (aka major depression) –> if criteria for another disorder is met, diagnose the other disorder

47
Q

What is treatment of adjustment disorder?

A

Treatment typically involves: learning of coping strategies in therapy sessions or involvement in support groups
Treatment may involve crisis intervention: hospitalization and psychotropic medications

48
Q

What are the dissociative disorders?

A
  1. Dissociative Amnesia
  2. Dissociative Identity Disorder
  3. Depersonalization/Derealization Disorder
49
Q

What is the diagnostic criteria for dissociative amnesia (psychogenic amnesia)?

A

Memory loss for autobiographical information, which doesnt occur due to another disorder

50
Q

What are the different types of memory loss in dissociative amnesia?

A

Localized –> total loss of personal memory during a circumscribed period
Selective –> Some (but limited) recall of personal memories during a circumscribed period
Generalized –> loss of personal memory of entire life up to and including event

51
Q

During a mental status exam (MSE) how does one identify if the memory problem is physiological or psychological?

A

Physiological basis: patient has difficulty learning NEW information in addition to past memory loss
Psychological (dissociative) basis: patient learns new information well; only past memory loss will be present

52
Q

If patient has dissociative amnesia with dissociative fugue, what does fugue mean?

A

purposeful travel or bewildered wandering associated with amnesia for identity or other autobiographical information
(usually brief, rarely recurs and spontaneous termination of amnesia)

53
Q

What is the diagnostic criteria for dissociative identity disorder?

A

1) Disruption of identity characterized by >2 distinct personalities states: the primary and an alter
2) Inability to recall personal information (as evidenced by frequent memory gaps in host while an alter takes control)

54
Q

What is a hint for remembering DID?

A

Amnesia along with mistaken identity experiences and changes in personal possessions

55
Q

What is the diagnostic criteria for depersonalization/derealization disorder?

A

Either (or both)

  1. Depersonalization: Experiences of unreality, detachment or being an outside observer with respect to one’s thoughts, feelings, sensations, body or actions
  2. Derealization: Experiences of unreality or detachment with respect to surrounding (objects seem unreal or dreamlike)
56
Q

What is a common therapy for dissociation disorders?

A

typically involves psychotherapy

hypnosis is often used

Behavioral Health--> Module One (21 decks)

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