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BMB Test 4 > B7.076 Anxiety Disorders in Psychiatry > Flashcards

B7.076 Anxiety Disorders in Psychiatry Flashcards

1
Q

what

A

me worry?

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2
Q

adaptive features of normal anxiety

A

inborn, unlearned response to threat or the absence of people or objects that signify safety
can result in:
-thought processes like worry
-psychical changes like racing heart, sweating, shaking, freezing

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3
Q

how are physical changes stimulated in anxiety

A

linked to limbic system function (amygdala)

amygdala receives direct input from areas of the sensory cortex

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4
Q

describe general adaptation syndrome

A

immune system’s adaptive response to stress over time

  1. stressor onset
  2. onset shock
  3. compensation phase
  4. resistance phase
  5. decompensation phase
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5
Q

major anxiety disorders

A 
PTSD
OCD
panic disorder
generalized anxiety disorder
specific phobia
social anxiety disorder
anxiety due to a medical condition
substance-induced anxiety disorder
anxiety disorder NOS
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6
Q

PTSD

A 
exposure to a traumatic event
traumatic event is re-experienced
avoidance of related stimuli
emotional numbness
persistent arousal
duration is longer than 1 month
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7
Q

acute stress disorder

A

duration is less than 1 month

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8
Q

obsessions

A

recurrent thoughts, impulses, and images

  • not excessive worries
  • attempts at ignoring/reducing/ distracting
  • recognized as mental processes (not psychosis)
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9
Q

compulsions

A

repetitive behaviors

  • feels driven to perform
  • attempts at reducing distress
  • not rationally connected or are excessive
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10
Q

OCD

A

obsessions recognized as irrational/ excessive/ unreasonable
compulsions
produces dysfunction (personal, social, occupational)

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11
Q

panic disorder

A 
recurrent (non-triggered) panic attacks
rapid experience of sudden anxiety (peak < 10 min)
frequently with multiple features (4 needed for diagnosis):
-chest pain/discomfort
-chills or hot flushes
-derealization or depersonalization
-fear of losing control
-feeling dizzy, unsteady, lightheaded, faint
-feeling of choking
-nausea or abdominal distress
-palpitations or tachy
-paresthesia
-sensations of shortness of breath or smothering
-sense of impending doom
-sweating
-trembling or shaking
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12
Q

agoraphobia

A

fear of being places where escape may be difficult or a companion is required

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13
Q

generalized anxiety disorder

A

excessive worry about multiple events or activities
subjective difficulty redirecting worry
> 6 month duration
associated features (3 of 6):
-restlessness or feeling keyed up or on edge
-being easily fatigued
-difficulty concentrating or mind going blank
-irritability
-muscle tension
-sleep disturbance

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14
Q

specific phobia

A

cued of anticipated fear that is excessive or unreasonable
exposure (cue, situation) provokes immediate anxiety
recognized as unreasonable
prominent avoidance of cue/trigger
associated distress interferes with person’s functional status

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15
Q

social anxiety disorder

A 
fear of one or more social/performance situation
perception of scrutiny by others
exposure provokes immediate anxiety
situations endured with distress
recognized as excessive or unreasonable
avoidance of social situations can occur
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16
Q

anxiety disorder due to a general medical condition

A

anxiety is physiologically related to a known medical condition

17
Q

substance abuse anxiety disorder

A

anxiety is physiologically related to the effects/withdrawal of a substance or medication

18
Q

lifetime prevalence of anxiety disorders

A 
anxiety disorders are common and frequently co-morbid with mood disorders
phobias 25%
social anxiety 13%
PTSD 7.8%
GAD 5%
panic disorder 3.5%
OCD 2.5%
19
Q

other epidemiological characteristics of anxiety disorders

A

onset frequently in late adolescence and early adulthood
2:1 F:M
variable course over lifetime
some have evidence of genetic/familial basis
can be more prominent/common in some personality disorders

20
Q

psychiatric interview for anxiety disorders

A

ask and observe
be aware of comorbidities
patients will typically be cognizant of symptoms and problems (OCD, phobias, panic disorder, GAD)
some patients more avoidant or reluctant to discuss (PTSD)

21
Q

why use screening questions for psych interviews

A

anxiety can be difficult and embarrassing to acknowledge

22
Q

examples of screening questions

A

have you every experienced and anxiety attack or felt out of control all of a sudden?
do you consider yourself a worrier?
have you ever had anything happen that still haunts you? do you have a lot of bad dreams?
do you get thoughts stuck in your head that really bother you or need to do things over and over like washing your hands, checking things or count?
when you are in a situation where people can observe you do you feel nervous and worry that they will judge you?

23
Q

criterion referenced psychodiagnostic testing

A

comparison of participant to particular criteria- assume skewed distribution
goal: determine if a person meets criteria for a psychiatric diagnosis

24
Q

objective testing for psych diagnosis

A

restricted response range (yes or no)

25
Q

projective testing for psych diagnosis

A

open response range

26
Q

examples of objective tests

A

structured clinical interview DSM-IV axis I
Minnesota multiphasic personality inventory
millon clinical multiaxial inventory
beck anxiety inventory

27
Q

examples of projective tests

A 
Rorschach
Holtzman inkblot technique
thematic apperception test
sentence completion
draw a person
play/toy techniques
28
Q

characteristics of treatments for anxiety

A 
generally effecting (40-60% of patients can improve markedly)
treatments are safe
29
Q

“safe” treatment strategies for anxiety

A

SSRIs - also treat co-morbid depressive features
counseling and behavioral interventions are effective
patients typically have good insight and can engage in active coping strategies

30
Q

pharmacological augmentation strategies for anxiety

A

anxiolytics
antipsychotics
mood stabilizers
needs closer monitoring than SSRIs, have abuse/dependence potential

31
Q

types of exposure therapy

A

graded exposure- systematic exposure/dose of related but incrementally threatening triggers/situations
flooding- direct exposure to an intense/threatening stimulus without option of avoidance; thought to produce desensitization

BMB Test 4 (14 decks)

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