Anxiety, Weiss Flashcards
Anxiety
excessive worry has phsyical Sx avoidant behavior sense of dread heightened apprehension
most common class of mental disorders in general population
anxiety disorders
causes of anxiety
psychological
psychoanalytic
behavioral
biological
pyschoanalytical theory of anxiety
signal to ego that unacceptable drive is pressing for conscious representation
behavioral therapy of anxiety
conditioned response to specific environmental stimuli
biological theory of anxiety
NT: NE serotonin, GABA
sub types of anxiety disorders
panic, agorophobia, generalized, specific phobias, social, separation, etc…
panic disorder
recurrent panic attacks followed by at least 1 mo of persistent concern, worry of implications, significant change in behavior related to attacks
what is a panic attack
discrete period of intense fear or discomfort assoc with multiple physical manifestations developing abrubtly and reaching peak in 10 min
Sx panic attack
palpitations sweathing tremor SOB chest pain and discomfort nausea, dizziness fear of losing control fear of dying
agoraphobiea
anxiety about being in places or situations from which escape is difficult or embarrassing if have panic attack there
demographics panic disorder
1:2 M:F
2% population
onset early adulthood
risk of panic disorder
higher rate of suicide
what medical disorders present like panic disorder
CV disease pulm disease neuro disease endo disease drug intoxication drug withdrawal
mental disorders that present like panic
malingering
hypochondriasis
phobias
PTSD
pharmacotherapy for panic disorder
TCA
SSRI!!
benzos– until on SSRI (used short term)
CBT for panic disorder
cognitive behavioral therapy
address patients false beliefs about attacks
gain sense of control
what is phobia
irrational fear resulting in conscious avoidance of feared object, activity or situation
increased risk for what with phobias
depression and substance abuse
common phobias
animals, insect, injury or procedures, heights, darkness
social phobia
fear of humiliation or embarrassment in either general or specific social situations
public speaking, urinating in public restrooms, stage fright
social phobia
fear of humiliation or embarrassment in either general or specific social situations
public speaking, urinating in public restrooms, stage fright
patients with performance phobias release more what
NE than Epi
genetics in social phbia
first degree relatives 3x more likely to be affected
Tx specific phobias
exposure therapy
insight oriented psychotherapy
pharmacotherapy
Tx social phobias
psychotherapy
pharmacotherapy (beta blockers, SSRIs, benzos or buspirone
demogrpahic OCD
male= female
4th most common psych disorder
mean onset 20 y.o
etiology OCD
biological factors: NT dystregulation, genetics
pyschological factors
learned theroty
what is learned theory in OCD
person discovers that certain action reduces anxiety
personality traits
brain imaging in OCD
increased frontal lobe, basal ganglia and cingulum activity
Tx reverses this
dec size caudates b/l
obsession
recurrent and intrusive thought, feeling, idea or sensation
compulsion
a conscious, standardized, recurrent thought or behavior, such as coutning, checking or avoiding
obsession and compulsion affects on anxiety
obsession inc
compulsion dec
most common pattern compulsion
obsession of contamination, compulsion washing and avoidign
2nd pattern compulsion
doubt then checking
pharmacotherapy Tx of OCD
clomipramine
SSRI
lithium
benzos
psychotherapy for OCD
behavioral and family
PTSD
emotional stress in life threatening magnitude
reexperience trauma in dreams and waking thoughts
avoid reminders
numb responsiveness
persisten hyperarousal
epidemiology PTSD
combat related in men
women from assualt
predisposing vulnerability to PTSD
presence of chilhood trauma, personality disorders, poor social support, genetic vulnerability to psych illness, recent stressful life change, recent excessive alcohol use
good prognostic factors for PTSD
rapid onset Sx, short duration, good premorbid functioning, strong support, absence other disorders
pharmacotherapy for PTSD
SSRI mood stabilizer hypnotic anxiolytics antipsychotics
pyschotherapy for PTSD
supportive
cognitive
gorup
family
generalized anxiety disorder
excessive and pervasive worry accompanied by variety of somatic Sc that cause significant impairment in social or occupational funcitoning or marked distress
demographics generalized anxiety disorder
co exists with another psych disorder
W:M 3:2
first seek Tx in 20s
clinical features of generalized anxiety disorder
anxiety, motor tension, autonomic hyperactivity shakiness, restlessness SOB, sweating, palpitations, GI easy startle, irritability chronic condition
pharmacotherapy for generalized anxiety disorder
benzo busprione mood stabilizer antipsychotic SSRI
psychotherapy for generalized anxiety disorder
cognitive behavioral
insight oriented
supportive
