Anxiety/Trauma Lecture Flashcards
Separation anxiety
Selective mutism
Specific phobia
Social anxiety disorder
Panic disorder
Generalized anxiety disorder
All fall under anxiety disorders
OCD
Body dysmorphic disorder
Hoarding
Trichotillomania
Excoriation disorder
Obsessive compulsive and related disoders
Reactive attachment disorder
Disinhibited social engagement disorder
PTSD
Acute stress disorder
Adjustment disorder
Trauma and stress related disorders
Leaving of caregivers, fantastic worries, school refusal, academic difficulties, co-morbid depression and familial conflict over separation
Tx= identifying triggers and using therapy to understand and cope with triggers
Possible anxiolytics or antidepressants plus therapy
Separation anxiety
Tx=
systematic desensitization (feared stimuli paired with relaxation training)
OR
floording (massive exposure to a feared stimulus until anxiety subsides)
Specific phobia
Can result from avoidant personality traits and sometimes pt has a co-morbid diagnosis of avoidant personality disorder
Tx= cognitive behavioral therapy (assertiveness training)
pharm tx= SSRIs, Buspirone, Benzos PRN, beta blockers
Social anxiety
Recurrent, unexpected panic attacks of abrupt surges of intense fear and discomfort that peaks at about 1 minute
*must have 4/13 symptoms listed in DSM
(ie..sweating, palpitations, CP, nausea, etc)
Panic disorder
In order to make a generalized anxiety disorder (GAD) diagnosis, how long must the pt experience symptoms?
longer than 6 months
Excessive, poorly controlled anxiety about routine life circumstances that continues for over 6 months, where pt finds it difficult to control the worry and worry impairs function
anxiety associated with 3 symptoms of:
Restlessness
Easily fatigued
Poor concentration
Irritability
Muscle tension
Sleep disturbance
Generalized anxiety disorder
Tx:
Anti-depressants
Anxiolytics
Behavioral therapy (relaxation training, biofeedback)
Generalized anxiety disorder
has a strong genetic component
Pathophys: serotonin-mediated in orbitofrontal cortex, anterior cingulate cortex and striatum
OCD
Recurrent obsessions and/or compulsions that are disruptive to patient’s life and greatly interferes with daily functioning (must be at least 1 hour/day)
OCD
What is the psych terrible triad?
OCD
ADHD
Tourrette disorder
Tx=
serotinergic anti-depressants at max dose
clomipiramine
behavioral therapies:
relaxation training, guided imagery, response prevention, thought stopping, modeling)
OCD
May have co-morbid delusional DO
Tx- serotinergic drugs at max dose
CBT to help pt develop more accurate sense of self
Body dysmorphic
A disorder of childhood
A consistent pattern on inhibited and emotionally withdrawn behavior toward adult caregivers
child seeks minimal comfort when distressed
child has..limited affect, minimal social responsiveness to others, unexplained irritability or saddness
Reactive attachment disorder
This disorder is seen when a child has experienced extremes of insufficient care
ie.. social neglect, repeated changes of primary caregiver, rearing in unusual settings
*disturbances occur before age 5 and child has a development age of at least 9 months
Reactive attachment disorder
OR
Disinhibited social engagement disorder
Child approaches and interacts with unfamiliar adults and exhibits at least 2 of the following:
- reduced or absent reticence in approaching adults
- overly familiar verbal or physical behavior
- decreased checking in with primary caregiver
- willingness to go off with strangers
Disinhibited social engagement disorder
Symptoms often begin immediately after stressor
most resolve within 3 months, some can last a lifetime
includes.. 1+ intrusion symptoms, 1+ avoidance symptoms, 2+ negative cognitions, 2+ arousal symptoms
PTSD
Tx:
Group psychotherapy helpful for survivors or similar trauma
Serotonergics and anxiolytics (cation bc increased risk of drug abuse in this pop)
Not debriefinf, but immediately starting therapy may prevent
PTSD
Essentially acute or early PTSD
3 days to 1 month= timeline for this dx
Acute stress disorder
>1 month= PTSD!
“nervous breakdown”
environmental stressors such as
interpersonal issues
occupational issues
medical issues
cause anxiety, depression, or behavioral symptoms that interefere with fxn
most occur within 3 months of stressor
Adjustment disorder
Tx=
Removing stressor if possible
CBT or psychodynamic psychotherapy
focus= improve coping skills, strengthen defense mechanisms, change how a person interacts with a stressful situation
*meds may be used as adjunct therapy to help with specific sxs (ie anxiety, insomnia)
Adjustment Disorder
