Anxiety, Phobias, OCD Flashcards
Phobia anxiety disorders (PAD) can present in a similar way to generalised anxiety disorder (GAD). But which of the following is key to distinguishing between GAD and PAD?
1 - anxiety occurs to a very specific stimulus
2 - avoidance of the specific stimulus causing anxiety
3 - anticipatory anxiety to stimulus
4 - all of the above
4 - all of the above
What is a phobia?
1 - fear specific to childhood
2 - fear of a traumatic event
3 - overwhelming and debilitating fear of a specific object/ situation etc…
3 - overwhelming and debilitating fear of a specific object/ situation etc…
- more pronounced than fears
There are 3 categories of Phobia anxiety disorders (PAD). Which of the following is NOT one of these categories?
1 - specific phobia
2 - diurnal phobia
3 - agoraphobia
4 - social phobia
2 - diurnal phobia
In specific phobias patients are inappropriately anxious to a specific object or situation. Patients will go out of their way to avoid this object or situation. When do specific phobias generally occur when?
1 - from birth
2 - childhood
3 - puberty
4 - adulthood
2 - childhood
- then continue into adulthood
In patients with phobia, they have an unrealistic response to a specific stimulus, which can be anything, including specific locations or venues. Why is this important clinically?
- can significantly impair patients life and ADL
- for example if hospitals are the patients phobia, how will they get treated?
- patients anticipate the phobia and experience huge anxiety
What is anticipatory anxiety?
1 - patient expresses anxiety if someone mentions phobia
2 - patient anticipates phobia and becomes severely anxious
3 - patient becomes anxious seeing phobia
2 - patient anticipates phobia and becomes severely anxious
Which 2 of the following are the main features of a specific phobia in line with the ICD-11?
1 - reduced physical symptoms
2 - excessive fear/anxiety associated with specific phobia all the time
3 - phobic object is avoided at all costs for fear of excessive anxiety
4 - fear of obscure objects
2 - excessive fear/anxiety associated with specific phobia all the time
3 - phobic object is avoided at all costs for fear of excessive anxiety
In order to be diagnosed with a specific phobia, the phobia must have a significant impact on the patients employment and life in general and last how long?
1 - 1 week
2 - 3 weeks
3 - 2-3 months
4 - >6 months
3 - 2-3 months
- several months
What % of patients with a specific phobia will meet the criteria for another psychiatric condition?
1 - 8%
2 - 28%
3 - 48%
4 - 83%
4 - 83%
Do patients with specific phobias always present immediately?
- no
- often manage it
- BUT if they have to face their phobia for some reason, they may come for help
Blood injury phobias are a serious problem. There is said to be a biphasic (means 2 responses) anxiety reaction in patients, what is this?
1 - 2 consecutive stimulations of the sympathetic system
2 - 2 consecutive stimulations of the para-sympathetic system
3 - stimulation of the sympathetic and then para-sympathetic system
4 - stimulation of the para-sympathetic and then sympathetic system
3 - stimulation of the sympathetic and then para-sympathetic system
- initial reaction = sympathetic arousal (tachycardia)
- second reaction = parasympathetic arousal (fainting)
How is classical conditioning associated with developing phobias?
- experience an encounter with a specific event or object
- patient attends hospital and has bad reaction to medication. This enforces a learned behaviour with a negative experience
- patient will then associate coming into hospital with similar responses
- leads to avoidance, making it difficult to eliminate the phobia
How does the “Biological preparedness” hypothesis contribute to phobias?
1 - following an initial fear of something that persists and develops into a phobia
2 - developing a phobia from birth
3 - developing a phobia based on survival and what we should be scared of
3 - developing a phobia based on survival and what we should be scared of
- we know we should run from bears and lions
Which of the following are suitable psychological treatment approaches in a patient with a specific phobia?
1 - self help books
2 - group computerised CBT
3 - individual CBT
4 - all of the above
4 - all of the above
- this is generally sufficient for most patients and no medications are required
What group of medications are the 1st line treatment for patients with specific phobias?
1 - antipsychotics
2 - antiepileptics
3 - anti-depressants
4 - benzodiazepines
3 - anti-depressants
- SSRIs = Citalopram, Fluoxetine, Sertraline are 1st choice
- can try tricyclics = Amitriptyline
Anti-depressants are the 1st line drug for patients with specific phobias, either SSRIs or tricyclic anti-depressants. If these are successful, how long following recovery should they be provided for?
1 - stop when patient feels better
2 - 2 weeks
3 - 2 months
4 - 6 months
4 - 6 months
Anti-depressants are the 1st line drug for patients with specific phobias, either SSRIs or tricyclic anti-depressants. If at least 2 of these have been tried, but have been unsuccessful, which 2 classes of medication can be prescribed?
1 - anti-epileptics
2 - benzodiazepines
3 - non-benzodiazepines
4 - anti-psychotics
2 - benzodiazepines
- Diazepam, Lorazepam, Chlordiazepoxide
3 - non-benzodiazepines
- must use with caution due to high risk of dependence
Social anxiety disorder, also known as social phobia relates to an acute attack of anxiety in a public space, subsequently anxiety occurs in similar places. Which of the following are principle features of social anxiety?
1 - specific concerns about being observed critically
2 - situations, such as public speaking or eating
3 - anticipatory anxiety
4 - avoidance of social interactions causing anxiety
5 - symptoms of general anxiety
6 - drugs and alcohol used to relieve anxiety
7 - low self esteem and perfectionism
8 - all of the above
8 - all of the above