Anxiety/Trauma Lecture

Question 1

Separation anxiety
Selective mutism
Specific phobia
Social anxiety disorder
Panic disorder
Generalized anxiety disorder

Answer 1

All fall under anxiety disorders

Question 2

OCD
Body dysmorphic disorder
Hoarding
Trichotillomania
Excoriation disorder

Answer 2

Obsessive compulsive and related disoders

Question 3

Reactive attachment disorder
Disinhibited social engagement disorder
PTSD
Acute stress disorder
Adjustment disorder

Answer 3

Trauma and stress related disorders

Question 4

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

Answer 4

Separation anxiety

Question 5

Tx=
systematic desensitization (feared stimuli paired with relaxation training)
OR
floording (massive exposure to a feared stimulus until anxiety subsides)

Answer 5

Specific phobia

Question 6

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

Answer 6

Social anxiety

Question 7

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)

Answer 7

Panic disorder

Question 8

In order to make a generalized anxiety disorder (GAD) diagnosis, how long must the pt experience symptoms?

Answer 8

longer than 6 months

Question 9

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

Answer 9

Generalized anxiety disorder

Question 10

Tx:

Anti-depressants
Anxiolytics
Behavioral therapy (relaxation training, biofeedback)

Answer 10

Generalized anxiety disorder

Question 11

has a strong genetic component

Pathophys: serotonin-mediated in orbitofrontal cortex, anterior cingulate cortex and striatum

Answer 11

OCD

Question 12

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)

Answer 12

OCD

Question 13

What is the psych terrible triad?

Answer 13

OCD
ADHD
Tourrette disorder

Question 14

Tx=
serotinergic anti-depressants at max dose
clomipiramine

behavioral therapies:
relaxation training, guided imagery, response prevention, thought stopping, modeling)

Answer 14

OCD

Question 15

May have co-morbid delusional DO

Tx- serotinergic drugs at max dose
CBT to help pt develop more accurate sense of self

Answer 15

Body dysmorphic

Question 16

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

Answer 16

Reactive attachment disorder

Question 17

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

Answer 17

Reactive attachment disorder
OR
Disinhibited social engagement disorder

Question 18

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

Answer 18

Disinhibited social engagement disorder

Question 19

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

Answer 19

PTSD

Question 20

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

Answer 20

PTSD

Question 21

Essentially acute or early PTSD

3 days to 1 month= timeline for this dx

Answer 21

Acute stress disorder

>1 month= PTSD!

Question 22

“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

Answer 22

Adjustment disorder

Question 23

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)

Answer 23

Adjustment Disorder