Anxiety/Obsessive Disorders/Trauma Flashcards
obsessions definition
Recurrent, persistent, unwanted thoughts, impulses or images
- intrusive; causes distress
compulsions definition
Repetitive behaviors or mental acts
- Provide temporary relief
- Not performing causes marked increase in anxiety
behavioral inhibition
a lab-based temperamental construct !!
- the tendency to be unusually withdrawn or timid and to show fear and withdrawal in novel and/or unfamiliar social and nonsocial situations
THIS IS A RISK FACTOR for the development of anxiety disorders in children
attachment research
insecure attachment
- hyperactivating
- clingy with caregivers
THIS IS A RISK FACTOR for the development of childhood anxiety disorders
differentiating “expected” anxiety from “disorders”
Expected
- anxiety is needed for adaptation and survival
- fears and worries are common in children
Disorder
- Children with anxiety disorders may present with fear or worry but may not recognize their fears as unreasonable
- THERE ARE PHYSICAL SYMPTOMS !!
- headaches
- upset stomach or nausea
- increased heart rate
- sleep disturbance
- tightness in chest
questions to ask when differentiating expected vs disorder anxiety (6 CATEGORIES)
INTENSITY: Is the degree of distress unrealistic given the child’s developmental stage and the object/event?
IMPAIRMENT: Does the distress interfere with the child’s
SOCIAL FUNCTIONING: unable to make friends
ACADEMIC FUNCTIONING: failing classes
FAMILY FUNCTIONING: creating conflicts, limiting family choices
ABILITY TO RECOVER: Is the child able to recover from distress when the event is not present?
- Tend to worry about future occurrences of event/object
- Distress occurs across multiple settings
2 theories on how fears develop
- Psychoanalysis
- Classical Learning Theory
psychoanalysis
- Phobias develop as defense against anxiety which is produced by repressed “id” impulses
- Anxiety is displaced from the “id” impulses to a fear object that is linked symbolically
- By avoiding the phobic object, one avoids dealing with repressed childhood conflicts
classical learning theory
says anxiety can be learned
- john b watson
- “little albert” theory
- Most specific fears (phobias) are related to paired or misplaced internalization of cues with anxiety from previous experience
- During infancy and childhood children mirror their caretakers’ responses when interpreting internal states of pain, arousal, and anxiety
importance of the amygdala
The amygdala serves as an “early warning system”
- response system to fear and anxiety
It perceives danger through the five senses, evaluating the “emotional meaning” of sensory input, then setting in motion hormonal stress releases and somatic reactions that instantaneously active fight/flight/freeze response
importance of the hippocampus
–> the hippocampus is a bridge that connects the amygdala to the prefrontal cortex (rational meaning) which enables us to reassess and decide if we are safe, or propels us to take action to get safer
Involved in the storage of sensory information and is very sensitive to stress
Threat alters the ability of the hippocampus and connected cortical areas to store certain types of cognitive information (verbal)
Many of the cognitive distortions that are associated with anxiety disorders may be related to anxiety related alterations in the tone of the hippocampus
ESSENTIALLY:
when there is threat, alters ability to encode, verbal memory, leads to distorisons
changes in child/adolescent anxiety diagnoses between DSM-IV & DSM-5
Obsessive compulsive disorder and Trichotillomania were moved outside of the anxiety section
Made a separate section for trauma !!
risk factors of anxiety
- Behaviorally inhibited young children
- Offspring of parents with anxiety disorders
- Insecure attachment relationships with caregivers
protective factors of anxiety
- strong support and caring family system
- no family history of anxiety
- not behavioral inhibited children
difference between a panic attack and a panic disorder
panic attack:
- A discrete period of intense fear or comfort, in which 4 or more of the following develop abruptly and reach a peak within 10 minutes:
- sweating, trembling, nausea, chest pain, dizzy, shortness of breath
panic disorder:
- recurrent unexpected panic attacks
- Fear of fear itself, overtime fear that you are going to have more
when do anxiety disorders develop
Anxiety is the most prevalent mental health disorder in children and teens
- Estimated at 6-20%
Commonly diagnosed issue in childhood
- Separation anxiety ! right from the beginning
- Develop phobias - ex: shots
Often in adults we recognize our fears are irrational, kids don’t necessarily think that their fears are irrational
- Makes sense to them
differential diagnosis of GAD
generalized anxiety disorder
Characterized by chronic, excessive worry in a number of areas (e.g., schoolwork, social interactions, family, health/safety, world events, and natural disasters) with at least one associated somatic symptom
Somatic Symptoms ex: stomachaches, headaches, etc
differential diagnosis of SAD
separation anxiety disorder
Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached
–> Excessive worry about:
–> be alone
–> separation from home
–> safety/harm of a caregiver
differential diagnosis of social anxiety disorder
—– child feels scared or uncomfortable in social situations (including classrooms and extracurricular activities)
—— they fear they are being scrutinized constantly or doing something embarrassing
—— LARGE GROUPS
Shown through:
- attending social events
- raising hand and talking in class
differential diagnosis of SM
selective mutism
Consistent failure to speak in specific social situations (in which there is an expectation for speaking, e.g., at school despite speaking in other situations)
–> at least one month
refusing to speak even though they are able to do so
trichotillomania
Recurrent pulling out of hair resulting in noticeable hair loss
Pleasure, gratification, or relief when pulling out the hair
simple tics vs tourettes
Tics:
A “tic” is a sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vulcanization
- common comorbidity to anxiety
- motor tic, twitch in neck, etc
Tourettes:
Involves uncontrollable repetitive movements or unwanted sounds
- starts in childhood
- Over the course of the year
- Lasting a long time
- Complex
- Wax and wane over time
- Worse in times over stress
