Anxiety/Tics/OCD/Trauma Flashcards
IVIG and penicillin are treatment for which anxiety related disorder?
PANDAS (related to group A beta-hemolytic strep infections)
What is the approximate ratio of boys to girls for pediatric OCD?
2:1
What percent of children exposed to a traumatic event will develop PTSD?
15%
What type of therapy are these the 5 core components of:
psycho-education, somatic mgmt skills training, cognitive restructuring, exposure methods, relapse prevention
CBT for anxiety disorders
gold standard: COPING CAT
What is the approximate ratio of boys to girls for pediatric GAD?
1 boy: 2 girls
Match the therapy with the description:
-Coping Cat
-C.A.T.
-EMOTION program
-PreVenture
-First Episode Mood and Anxiety Program (FEMAP)
A. early interventional program aimed at managing emotional concerns based on symptoms of anxiety and mood in people aged 16-25 year
B. CBT program for children aged 7-13 years of age for the treatment of various anxiety-related disorders
C. evidence-based prevention program with targeted interventions to promote mental health and delay substance use
D. prevention program that targets both anxiety and depression by involving children along with their parents.
E. interventional program for dealing with anxiety issues in adolescence.
A. First Episode Mood and Anxiety Program (FEMAP)
B. Coping cat
C. PreVenture program
D. EMOTION program
E. C.A.T. program
Identify the cognitive errors:
-Overgeneralization
-Catastrophizing
- Arbitrary interference
- Absolutism/”black and white thinking”
- Selective abstraction
- Personalization
A. a cognitive distortion that leads a person to draw conclusions based on false assumptions, without sufficient evidence, or evidence at all.
B. a belief that one specific outcome can be generalized to all other circumstances even though there is no sound basis for that generalization. For example, a person who fails at one test starts believing they are going to fail every test in their life.
C. the belief that all events are either totally good or totally bad and that no other outcome is possible; or what is true in one example must be applied to all examples. Individuals with this distortion find it hard to accept outcomes that are less than ideal and often use words such as “never” and “always.” For example, a person who gets one question wrong on a test believes they are a failure and that they will never succeed in life.
D. in this cognitive distortion, people view things out of context while focusing on only the negatives of a situation.
E. Individuals with this cognitive distortion expect the most terrible outcomes on the basis of a single negative event. For example, a person might think they will never be able to get a job after they do badly in one interview.
F. a cognitive error where a person takes responsibility for undesirable or unhealthy external events that are out of their control
A. arbitrary interference
B. Overgeneralization
C. Absolutism
D. Selective abstraction
E. Catastrophizing
F. Personalization
Match pathogenesis with the disorder.
A. Lower levels of oxytocin
B. Polymorphism in contactin-associated protein-like 2-gene (CNTNAP2)
C. Disturbed amygdala-prefrontal cortex circuitry function during face-emotion processing
D. Decreased function in noradrenergic locus coeruleus, serotoninergic dorsal raphe and median raphe, and dopaminergic ventral tegmental area.
E. Decreased expression of brain-derived neurotrophic factor (BDNF)
F. Long alleles of the MAOA-uVNTR promoter polymorphism
A. Separation anxiety disorder
B. Selective mutism and separation anxiety disorder
C. DMDD
D. Depression
E. Depression
F. Panic disorder with agoraphobia
What NT is the MAIN inhibitory neurotransmitter associated with anxiety disorders?
GABA
MDD can have anxious distress specifier.
There are 5 criteria for an anxious distress specifier: 1) feeling keyed up or tense, 2) feeling unusually restless, 3) difficulty concentrating because of worry, 4) fear that something awful may happen, 5) feeling that the individual might lose control of himself or herself.
How many symptoms do you need for mild vs. mod vs mod-severe vs severe symptoms?
Mild specifier requires 2 of these 5 symptoms,
Moderate specifier needs 3 symptoms,
Moderate-severe requires 4-5 symptoms
Severe requires 4-5 symptoms with motor agitation
What is the approximate ratio of boys to girls for Social Anxiety disorder?
1:1
What 3 meds are shown to be efficacious for Social anxiety disorder along with CBT?
Prozac
Fluvoxamine
Paroxetine
What is the average age of onset of Tourette’s disorder?
6-8y/o
What is the percentage of tic remission seen in adults?
A) 0-25%
B) 25-50%
C) 50-75%
D) 75-90%
B) 25-50%
What is the neurobiology seen in Tourette’s disorder?
____ caudate volumes
____ inhibitory output from basal ganglia may lead to excessive activity in frontal lobes
Dopamine hypersensitivity
SMALLER caudate volumes
DECREASED inhibitory output from basal ganglia may lead to excessive activity in frontal lobes
What dx should you think of in someone with tics, parkinsonism, psychosis, cirrhosis and Kaiser-Fleischer rings around the iris?
What is cause?
Wilson’s disease (hepatolenticular degeneration)
- low copper excretion, low serum ceruloplasmin
What dx should you think of in someone with tics, personality changes, ataxia and photosentivity who had a hx of measles before 2 y/o?
SSPE: subacute sclerosing pan encephalitis
What is the therapeutic tx with most evidence for tx of Tourette’s, trichotillomania, nail biting, thumb sucking, skin picking and stereotypic mvmts?
Habit reversal training
——CBIT
What are the 2 FDA approved medications for 1st line tx of Tourette’s that are dopamine antagonists?
What is the FDA approved medication for 2nd line tx of Tourette’s?
- Haloperidol
- Abilify
Pimozide as second line
What is the worrisome AE of Pimozide outside of dystonic reactions and TD?
prolonged QT interval
Alpha-2 agonists (ie clonidine/guanfacine) work better or worse for tx of tics when a person has ADHD as well?
work better
What are the 5 broad criteria lasting longer than a month are needed to dx PTSD in someone >6y/o?
1) exposure to actual or threatened death serious injury or sexual violence.
2) intrusion symptoms (dreams, dissociative rxns, distress at cues, etc)
3) avoidance
4) negative alterations in cognition and mood (inability to remember, cant experience positive emotions, etc)
5) marked alterations in arousal and reactivity (hypervigilance, sleep issues, startle response)
______ is a repetitive motor act that is apparently purposeless.
stereotypy
stereotypic movement disorder. Stereotypic movement disorder requires repetitive, seemingly driven, and nonfunctional motor behavior that either markedly interferes with normal activities or results in a self-inflicted bodily injury requiring medical treatment.
New Beginnings Program (NBP) is a 10-session, group-based program that helps parents guide their children after what event has occurred?
Divorce
What is the best initial response performed after a disaster to mentally stabilize the survivors?
Psychological first aid
T/F: Individuals with depersonalization/derealization disorder have a harm-avoidant temperament with immature defenses which include disconnection schemata.
True
Social inhibition is a risk factor for which 2 anxiety disorders?
- Selective mutism
- Social anxiety disorder
