Anxiety, OCD, Trauma, and Stress Disorders Flashcards

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1
Q

Anxiety is a…

A

Normal, universal emotion and not a bad thing in and of itself. It involves anticipation accompanied by nervousness or worry about “what’s going to happen

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2
Q

Fear is…

A

Slightly different than anxiety; An immediate/alarming, and usually more intense, reaction to a perceived threat or danger

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3
Q

An anxiety disorder is diagnosed when an individual:

A

Experiences abnormally high anxiety/fear that becomes clinically significant and experiences recurrent anxiety/fear when no danger is present

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4
Q

Anticipation

A

Low lying DREAD

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5
Q

The “Basic/General” Anxiety Disorders

A

Separation Anxiety Disorder and Selective Mutism (Common in childhood), Social Anxiety Disorder (Social Phobia), Specific Phobias, Agoraphobia, Panic Disorder, Generalized Anxiety Disorder

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6
Q

Separation Anxiety Disorder and Selective Mutism

A

90% of cases in children, diagnosable in adults but not as often

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7
Q

Separation Anxiety Disorder

A

Not wanting to be separated from care giver/ important person

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8
Q

Selective Mutism

A

Prolonged periods of refusal to speak

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9
Q

Social Anxiety Disorder

A

An intense worry or fear of being scrutinized or being embarrassed/ humiliated in the presence of others (worry about what people think about you becomes clinically significant); AVOIDANCE

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10
Q

Social Anxiety Disorder involves…

A

Hypersensivity to social cues, as well as significant attempts to avoid drawing attention to oneself, or social avoidance all together (related to Looks or Behaviors)

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11
Q

Types of Social Anxiety Disorder

A

Generalized or Performance Type

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12
Q

Generalized Social Anxiety Disorder

A

Social anxiety occurs in every situation with anyone

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13
Q

Performance Social Anxiety Disorder

A

Specific situations trigger social acuity (Bathroom in public, Meeting new people, Public speaking, Eating around others)

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14
Q

Social Anxiety Disorder is comorbid with…

A

Other anxiety conditions and other types of disorders (Panic Disorder/Substance Abuse)

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15
Q

Specific Phobias

A

Extreme and irrational fear of a specific object or situation that produces significant distress or panic (A fear is not the same thing as a phobia!); Person goes to great lengths to avoid the object or situation, or endures it with extreme distress (effects everyday life); Most can recognize that the fear and avoidance are unreasonable, but “can’t help it”; Must markedly interfere with one’s ability to function

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16
Q

Specific Phobias are often comorbid with…

A

Panic Attacks

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17
Q

Animal SP Subtype

A

All types, including insects (Most common: Snakes, Bats, Bees)

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18
Q

Natural/Environmental SP Subtype

A

Things found in “nature”/ outdoors (e.g., heights, storms, water)

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19
Q

Blood-injection-injury SP Subtype

A

Covers most medical situations (Doctor/Dentist/ Equipment); unusual vasovagal response involved (Fainting, sudden heart rate and blood pressure drop)

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20
Q

Situational SP Subtype

A

Certain occurrences only, might not be situations that happen often but when it does you’re screwed! (Planes, the dark, enclosed spaces, bridges)

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21
Q

“Other” SP Subtype

A

Anything not reflected above (Costumes, Clowns)

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22
Q

Agoraphobia

A

Involves fear and avoidance of situations where escaping or getting help easily is unlikely in the event that something incapacitating or embarrassing happens (Open or public places)

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23
Q

Most commonly, with Agoraphobia the person fears…

A

Having a panic attack in these situations and thus avoids them markedly; DSM provides a list of possible “situations” and at least 2 of those are required (Many due to past occurrences)

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24
Q

Some with agoraphobia may even become

A

“housebound” (Avoid public transportation, restaurants, etc.)

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25
Q

Agoraphobia is commonly comorbid with…

A

Panic disorder

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26
Q

Etiology of Phobias (where does it come from?)

A

Biological dimension, Psychological Dimension, Social Dimension, Sociocultural Dimension

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27
Q

Biological Dimension (etigology of phobias)

A

Genetics, exaggerated anxiety/fear response in brain (Higher risk for those who have a disorder in family)

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28
Q

Psychological Dimension (etigology of phobias)

A

Classical conditioning, “negative information” received, catastrophic thoughts (associate situations)

29
Q

Social Dimension (etigology of phobias)

A

High stress or negative emotions within family system

30
Q

Sociocultural Dimension (etigology of phobias)

A

Women more likely, certain culture-bound fears

31
Q

Panic Disorder

A

Recurrent, unexpected panic attacks (frightening attacks of fear and bodily symptoms); Also apprehension about future panic attacks, or significant changes in behavior to avoid attacks (Must be present for a month or longer) Many avoid situations to avoid attacks and working out bc it feels like an attack

32
Q

Generalized Anxiety Disorder

A

Excessive and uncontrollable apprehension and worry about virtually everything; The anxiety is present on the majority of days for at least 6 months; Also accompanied by certain physical symptoms (e.g., restlessness or muscle tension); Most frequently diagnosed anxiety disorder (Disruptive to everyday life)

33
Q

Treatment of Anxiety Disorders

A

Some medications are effective; benzodiazepines and SSRI’s are most common but Cognitive-behavioral therapy has strong research support in terms of efficacy

34
Q

Benzodiazepines (treatment of anxiety disorders)

A

Significant caution applied to prescribing these (RISKY), Easily form dependence; Combining then with other GABA stimulators (alcohol) can cause problems such as death (ex. Xanax) (GABA’s are calming, used to unwind)

35
Q

SSRI’s (treatment of anxiety disorders)

A

Can’t have too much but can have too little with risks emotional stability (Cannot get addicted to these!)

36
Q

Cognitive-Behavioral Therapy (treatment of anxiety disorders)

A

Cognitive = restructuring thoughts to be more rational and healthy/calm; Behavioral = modifying behavior (most commonly with EXPOSURE and relaxation for anxiety disorders)

37
Q

The cognitive element involves…

A

Recognizing and changing catastrophic thoughts (e.g., “this is just a panic attack; it’s uncomfortable, but it will pass. I’m in control, and I’m not dying.”

38
Q

Behavioral exposure happens many ways…

A

Phobias, Panic d/o, GAD

39
Q

Phobias (behavioral exposure)

A

Systematic desensitization or flooding

40
Q

Panic D/O (behavioral exposure)

A

Exposure to and coping with panic symptoms

41
Q

GAD (behavioral exposure)

A

Exposure to worrisome thoughts while restructuring and relaxing

42
Q

3 Steps of Systematic Desensitization

A

1) Teach relaxation to client, 2)Develop fear hierarchy, 3) Expose and pair with relaxation as needed

43
Q

Example of progression/ hierarchy (Claustrophobia)

A

1) Small Room, Pitch Black> Progressively gets Bigger and Lighter> 20) Big room, Very Bright

44
Q

Obsessive-Compulsive and Related Disorders

A

A new category in DSM-5, as we have significant evidence that all these disorders share common tendencies; Obsessive-compulsive disorder, Body dysmorphic disorder, Hair-pulling and skin-picking disorders, Hoarding disorder (Anxiety plays a role in these)

45
Q

Obsessive-Compulsive Disorder (OCD)

A

Vicious cycle of Obsessions and Compulsions

46
Q

Most common themes of OCD

A

Contamination (germs, bacteria, viruses), Errors/Uncertainty, Unwanted Impulses, and Orderliness

47
Q

OCD is an interesting spectrum with lots of…

A

“Gray Area”, Many people report some form of obsessive thinking or compulsive behavior that’s “subclinical”…

48
Q

OCD Thoughts

A

“Need to do this”; Thoughts of hurting someone (Urges/Images)

49
Q

OCD Behaviors

A

Repetitive or Ritualistic Behaviors; Doubting Actions (opening/closing doors)

50
Q

Body Dysmorphic Disorder

A

A preoccupation with perceived physical defects in a normal-appearing person, or Excessive (unwarranted) distress over an actual slight bodily defect; “Perceived ugliness”

51
Q

The “compulsive” part of Body Dysmorphic Disorder involves the…

A

Associated repetitive behaviors (e.g., mirror-checking, over-use of make-up)

52
Q

Body Dysmorphic Disorder is often associated with a desire for…

A

Cosmetic surgery

which is UNHELPFUL…because BDD is a problem of the mind and not the body, by definition!

53
Q

Hair-Pulling and Skin-Picking Disorders

A

Trichotillomania and excoriation, respectively; Vicious cycles that involve constant obsessions about the behavior in question, as well as the compulsive act

54
Q

With trichotillomania…

A

Hair loss is visible and significant

More common in women, typically young onset ( < 17)

55
Q

With excoriation…

A

The picking results in visible lesions/scabs/scars (and infection can be a risk)
Also more common in women, onset more variable

56
Q

Hoarding Disorder

A

Now classified as a form of OCD, but this is questioned by some…;Persistent difficulty in parting with possessions, regardless of value, such that living areas are substantially cluttered and dysfunctional as a result; Typically see obsessions over the “need” for items and a compulsion to acquire more and more; Can be quite serious to the point that the person has no insight re: the dirtiness or danger of living that way

57
Q

Treatment of Obsessive-Compulsive Disorders

A

Again, medications can help and SSRI’s are most often recommended; Exposure also plays a central role here

58
Q

Exposure to treat OCD’s

A

“Exposure and response prevention” for OCD involves actual or imagined exposure to the relevant situation, while preventing the compulsive response; Quite effective, but there is a high drop-out rate and many clients have to make several attempts or re-visit therapy

59
Q

Trauma & Stress-Related Disorders

A

Involve exposure to a stressor (usually something quite traumatic) and subsequent anxiety/avoidance that causes significant distress or impairment (Acute Stress Disorder, Post-Traumatic Stress Disorder (PTSD))

60
Q

Acute Stress Disorder and PTSD

A

Both require either witnessing or experiencing a significant stressor/trauma; What “counts” as a trauma = tough question

61
Q

Acute Stress Disorder and PTSD Require 4 categories of “aftermath” symptoms:

A

Persistent intrusion (or “re-experiencing”) symptoms such as memories, nightmares, or flashbacks; Significant avoidance of trauma-related triggers; Problems with cognition and mood; Changes in reactivity/physiological arousal

62
Q

Acute Stress Disorder and PTSD Differences

A

The MAGNITUDE of what’s involved; The DURATION of the response

63
Q

MAGNITUDE difference btw Acute Stress Disorder and PTSD Differences

A

PTSD usually involves worse trauma, requires more symptoms, and symptoms are more severe

64
Q

DURATION difference btw Acute Stress Disorder and PTSD Differences

A

Acute stress disorder is diagnosed when the symptoms persist for at least 3 days, but less than a month
PTSD is diagnosed when symptoms last at least a month

65
Q

Many people experience trauma, so: why do only some of them develop one of these disorders?

A

One factor is the type/severity of trauma and It also has to do with the person’s underlying vulnerability

66
Q

Type/Severity of Trauma Example

A

Injuries involving burns tend to produce a ASD/PTSD response more than other kinds of injuries

67
Q

Vulnerability of Individual who Experiences Trauma Example

A

Some people are “biologically predisposed” to develop a pathological/anxious response to trauma and others are not; Psychological, social, and cultural factors also affect vulnerability

68
Q

Obsessions

A

Intrusive (frequent/intense) cognitions: thoughts, images, or urges that won’t go away

69
Q

Compulsions

A

Behaviors to reduce the anxiety brought on by obsessions