Anxiety/Tics/OCD/Trauma

Question 1

IVIG and penicillin are treatment for which anxiety related disorder?

Answer 1

PANDAS (related to group A beta-hemolytic strep infections)

Question 2

What is the approximate ratio of boys to girls for pediatric OCD?

Answer 2

2:1

Question 3

What percent of children exposed to a traumatic event will develop PTSD?

Answer 3

15%

Question 4

What type of therapy are these the 5 core components of:
psycho-education, somatic mgmt skills training, cognitive restructuring, exposure methods, relapse prevention

Answer 4

CBT for anxiety disorders

gold standard: COPING CAT

Question 5

What is the approximate ratio of boys to girls for pediatric GAD?

Answer 5

1 boy: 2 girls

Question 6

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.

Answer 6

A. First Episode Mood and Anxiety Program (FEMAP)
B. Coping cat
C. PreVenture program
D. EMOTION program
E. C.A.T. program

Question 7

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

Answer 7

A. arbitrary interference

B. Overgeneralization

C. Absolutism

D. Selective abstraction

E. Catastrophizing

F. Personalization

Question 8

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

Answer 8

A. Separation anxiety disorder
B. Selective mutism and separation anxiety disorder
C. DMDD
D. Depression
E. Depression
F. Panic disorder with agoraphobia

Question 9

What NT is the MAIN inhibitory neurotransmitter associated with anxiety disorders?

Answer 9

GABA

Question 10

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?

Answer 10

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

Question 11

What is the approximate ratio of boys to girls for Social Anxiety disorder?

Answer 11

1:1

Question 12

What 3 meds are shown to be efficacious for Social anxiety disorder along with CBT?

Answer 12

Prozac
Fluvoxamine
Paroxetine

Question 13

What is the average age of onset of Tourette’s disorder?

Answer 13

6-8y/o

Question 14

What is the percentage of tic remission seen in adults?
A) 0-25%
B) 25-50%
C) 50-75%
D) 75-90%

Answer 14

B) 25-50%

Question 15

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

Answer 15

SMALLER caudate volumes
DECREASED inhibitory output from basal ganglia may lead to excessive activity in frontal lobes

Question 16

What dx should you think of in someone with tics, parkinsonism, psychosis, cirrhosis and Kaiser-Fleischer rings around the iris?

What is cause?

Answer 16

Wilson’s disease (hepatolenticular degeneration)

• low copper excretion, low serum ceruloplasmin

Question 17

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?

Answer 17

SSPE: subacute sclerosing pan encephalitis

Question 18

What is the therapeutic tx with most evidence for tx of Tourette’s, trichotillomania, nail biting, thumb sucking, skin picking and stereotypic mvmts?

Answer 18

Habit reversal training
——CBIT

Question 19

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?

Answer 19

1. Haloperidol
2. Abilify

Pimozide as second line

Question 20

What is the worrisome AE of Pimozide outside of dystonic reactions and TD?

Answer 20

prolonged QT interval

Question 21

Alpha-2 agonists (ie clonidine/guanfacine) work better or worse for tx of tics when a person has ADHD as well?

Answer 21

work better

Question 22

What are the 5 broad criteria lasting longer than a month are needed to dx PTSD in someone >6y/o?

Answer 22

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)

Question 23

______ is a repetitive motor act that is apparently purposeless.

Answer 23

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.

Question 24

New Beginnings Program (NBP) is a 10-session, group-based program that helps parents guide their children after what event has occurred?

Answer 24

Divorce

Question 25

What is the best initial response performed after a disaster to mentally stabilize the survivors?

Answer 25

Psychological first aid

Question 26

T/F: Individuals with depersonalization/derealization disorder have a harm-avoidant temperament with immature defenses which include disconnection schemata.

Answer 26

True

Question 27

Social inhibition is a risk factor for which 2 anxiety disorders?

Answer 27

1. Selective mutism
2. Social anxiety disorder