Anxiety Related Disorders Flashcards

1
Q

Define anxiety

A

Preoccupied and avoidance, excessive worry

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2
Q

Is anxiety higher among men or women?

A

Women and decreases with age

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3
Q

What are the most common anxiety disorders?

A

PTSD and Social Phobia Disorder

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4
Q

List 4 key features of anxiety

A
  1. Psyhsiological symptoms
  2. Avoidance symptoms
  3. Disturbances in attention - intrusive thoughts, attention biases, re experiencing symptoms
  4. Subjective feeling of anxiety
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5
Q

What is Specific Phobia?

A

Fear or anxiety about a specific object or situation eg animal, blood, dentist

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6
Q

What is Dentophonbia?

A

Fear of the dentist

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7
Q

What is Social Anxiety Disorder?

A

Fear about one or more social or performance situation in which the person is exposed to possible scrutiny by others.

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8
Q

What are the clinical features of Social Anxiety Disorder?

A
  • Hypersentive to criticism
  • Non-assertive
  • Low self-esteem
  • Comorbid anxiety is common
  • Safety behaviours including avoiding eye contact, covering face with hair
    Takes observer perspective for social memories
  • Information processing biases eg negative interpretation of social events, does not detect positive responses of others, focus on the negatives in post event processing.
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9
Q

What is Panic Disorder?

A

Recurrent and unexpected panic attacks. At least one attack followed by one month of:

  1. persistent concern about another attack
  2. significant maladaptive change in behaviour
  3. Rule out specific phobia, other conditions and substance abuse
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10
Q

What are 4 or more symptoms must occur for a panic attack?

A
  • Palpitations/pounding heart
  • Trembling/Shaking
  • Feeling of choking
  • Nausea/abdominal pain
  • Chills/hot flushes
  • Derealisation (unreality)/Depersonalisation (detach)
  • Fear of losing control/going crazy
  • Sweating
  • Shortness of breath
  • Chest pains/discomfort
  • Dizziness/light headness
  • Paresthesias (numbness/tingling)
  • Fear of dying
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11
Q

What is agoraphobia?

A

Anxiety about being in a place where escape might be difficult or embarrassing if a panic attack occurs.

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12
Q

List the fears that at least must be present for a diagnosis of Agoraphobia.

A
  • Using public transport
  • being in open spaces
  • being in enclosed spaces
  • standing in line or being in a crowd
  • being outside of the home alone
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13
Q

List 6 other anxiety disorders

A
  1. Separation Anxiety Disorder
  2. Selective mutisim
  3. Substance/Medication induced anxiety disorder
  4. Anxiety disorder due to medical condition
  5. Other specified anxiety disorder
  6. Unspecified anxiety disorder
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14
Q

What is Generalised Anxiety Disorder?

A

Excessive worry about numerous events/activities with difficulty in controlling the worry

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15
Q

What 3 symptoms must you experience to be diagnosed with Generalised Anxiety Disorder?

A
  • Restlessness/on edge
  • Easily fatigued
  • Difficulty concentrating/mind blank
  • Irritability
  • Muscle tension
  • Sleep disturbance
  • worry and anxiety must cause significant interference
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16
Q

What 3 traits are present in individuals with Generalisd Anxiety Disorder?

A
  1. Less tolerance for uncertainty
  2. Underestimate coping ability
  3. Overestimate the likely event of negative consequences
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17
Q

What is Body Dysmorphic Disorder?

A

Fixation on one part of the body

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18
Q

What is Hoarding Disorder?

A

Inability to let go of objects

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19
Q

What is Trichotillomania?

A

Hair pulling disorder

20
Q

What is Excoriation?

A

Skin picking disorder

21
Q

What is Obsessive Compulsive Disorder?

A

Obsessive thoughts and compulsive behaviours to stop the thoughts

22
Q

What are the DSM-V criteria for OCD?

A
  • Obsessions, compulsions or both
  • Cause distress and time consuming (>1hr/day) or cause significant interference
  • Not restricted to another axis disorder (eg food obsession in eating disorder)
  • Not due to substance abuse or medical condition
  • Pecify if with good or fair insight, with poor insight, with absent insight/delusional beliefs.
23
Q

Is OCD high in males or females?

A

Females

24
Q

What is age of onset for OCD?

A

childhood/teenage. Rare after 35yo.

25
Q

What forms do obsessions take in OCD?

A
  • Thoughts
  • Images
  • Impulses
26
Q

What are common compulsions in OCD?

A
  • Checking
  • Washing
  • Counting
  • Confessing
  • Hoarding
27
Q

What is the context of obsessions in OCD?

A
  • Violent
  • Sex
  • Blasphemy and sacrilege
28
Q

What are not obsessions?

A
  • Worries about real life eg work
  • Depressive remunerations (thinking/mulling)
  • Recurrent sexual fantasies
  • Jealousy
  • Preoccupations eg car or boyfriend
  • Cravings to gamble, drink, etc
29
Q

What is Post Traumatic Street Disorder?

A

Exposure to actual or threatened death or serious injury or sexual assault via:

  1. directly
  2. witnessing
  3. learning about it happening to someone close to us
  4. experiencing repeated/extreme exposure to aversive details
30
Q

How long must symptoms be present for a diagnosis of PTSD?

A

1 month

31
Q

What must be present for a diagnosis of PTSD?

A
  • Involuntary and intrusive distressing memories
  • Distressing dreams
  • Dissociative reaction eg flashbacks
  • Distress or reactivity to cues that resemble event
  • Avoidance of stimuli associated with event
  • Negative alterations to cognitions and mood eg inability to remember important aspects of trauma, persistent negative state (fear, anger), avolition, detached feelings
32
Q

What is Acute Stress Disorder?

A

Must have 9 or more of PTSD symptoms present for 3 days to 1 month and cause significant distress and impairment

33
Q

What is Adjustment Disorder?

A
  • Distress is out of proportion to stressor eg death of a loved one or starting uni and occurs within 3 months of stressor
  • Significant impairment to functioning
  • Symptoms do not persist past 6 months
34
Q

What are the physiological arousal symptoms of trauma and stress related disorders?

A
  • Irritability or angry outbursts
  • Reckless or self destructive behaviour
  • Hypervigilence
  • Exaggerated startle response
  • Difficulty concentrating
  • Sleep disturbance
35
Q

What is the Psychodynamic aetiology for Anxiety?

A

Conflict between unconscious sexual or aggressive wishes (ID) and threats to SuperEgo. When impulse is too high anxiety occurs.

36
Q

What is the Evolutionary aetiology for Anxiety?

A

Anxiety is part of protective adaptive system (flight or fight)

37
Q

What is the Biological aetiology for Anxiety?

A
  • Genetic Predisposition: High concordance in MZ than DZ
  • Neuroanatamy/Biology - 2 pathways (subcortical for fight or flight or cortex for slower analysis) so pathways may fire incorrectly.
38
Q

What happens to anxiety when serotonin and GABA increase?

A

Anxiety descreases

39
Q

What part of the brain are affected by anxiety?

A

Cortical-striatal thalmac circuit (Prefrontal cortex, thalamas, basal ganglia)

40
Q

What is the Psychosocial aetiology for Anxiety?

A
  • Stressful life events
  • Childhood adversity
  • Overprotective/controlling parents
  • Child temperament/behaviour
  • Insecure attachment
41
Q

What is the Behavioural aetiology for Anxiety?

A
  • Classic conditioning (little albert)
  • Operant conditioning - avoidant behaviours negatively reinforce
  • Vicarious/observational learning
42
Q

What is the Cognitive aetiology for Anxiety?

A
  • Misinterpret ambiguous situations as danger
  • Maladaptive thoughts/beliefs
  • Catastrophic misinterpretation
  • Attentional bias to threat
  • Thought suppression
  • Fear of fear model
  • Thought fusion leads to psychological rigidity based on acceptance and commitment therapy
43
Q

What are the Biological treatments for Anxiety?

A

Anxiety is due to decreased serotonin:

  • Benzodiazepines (GABA transmission), valium
  • Tricyclics
  • Antidepressants eg SSRI’s ;ike zoloft, prozac, luvox
44
Q

What are the side effects of Benzodiapines?

A
  • Sedation
  • Impaired psychomotor skills
  • Decreased attention and memory
  • Highly addictive
45
Q

What are the side effects of Tricyclics?

A
  • Weight gain
  • Dry mouth
  • Nervous
  • Sleeping problems
46
Q

What are the Psychodynamic treatments for Anxiety?

A
  • Free association
  • Dream interpretation
  • Interpersonal Psychotherapy
47
Q

What are the Cognitive and Behavioural treatments for Anxiety?

A
  • Psychoeducation - anxiety is normal and it will pass
  • Relaxtion
  • Identify anxiety provoking cognitions and restructure them
  • Exposure therapy - gradual and repeated exposure to fear based on hierarchical model
  • Acceptance and Commitment Therapy - increases patients willingness to take part in exposure therapy