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Abbey MSII Unit 3 > Behav. Sci. Anxiety > Flashcards

Behav. Sci. Anxiety Flashcards

1
Q

what are physical manifestations of anxiety?

A

sympathetic NS: diaphoresis, mydriasis, tachycardia, tremor, GI/GU symptoms (diarrhea, increased urinary frequency), hyperventilation, dizziness, syncope, parasthesia, numbness and tingling in the extremities and around the mouth

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2
Q

what are the psychological manifestations of anxiety?

A

restlessness, irritability, trouble concentrating, worry

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3
Q

what are the 5 main classifications of anxiety disorder?

A

generalized anxiety disorder, panic disorder (w and w/o agoraphobia), specific phobia/social anxiety disorder, OCD, ASD/PTSD

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4
Q

DD for anxiety: medical causes

A

medical causes (caffeine, substance abuse, withdrawal, hyperthyroid, arrhythmia, vit B12 deficiency, hypoglycemia, pheochromocytoma

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5
Q

what are often seen in ED setting presenting as anxiety?

A

acute MI, pulmonary embolism, COPD, asthma exacerbation

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6
Q

which psychiatric disorders are associated with anxiety?

A

depression, schizophrenia, eating disorders, personality disorders, substance dependence

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7
Q

diagnosing anxiety

A

symptoms must:

  1. be persistent (>6 months) - shorter for children
  2. interfere with normal functioning
  3. cause significant distress
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8
Q

etiology psychosocial factors for anxiety

A
  • traumatic events or extreme stressors (PTSD, panic attack) may help create the anxiety disorder
  • maladaptive coping skills/personality traits make people vulnerable
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9
Q

etiology biologic factors for anxiety

A
  • greater prevalence in populations of family members with anxiety orders (genetics may play role, environment you grew up in)
  • gender bias towards women (except OCD)
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10
Q

neurobiological factors for anxiety

A
  • lowered serotonin and GABA activity

- increased NE and glutamate activity

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11
Q

diagnostic criteria for general anxiety disorder

A

excessive anxiety/worry occurring more days than not for more than 6 months about more than 1 event/activity - difficult to control this worry

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12
Q

what are the symptoms associated with general anxiety disorder? how many symptoms are needed to diagnose?

A

more than 3 symptoms

  1. restlessness
  2. easily fatigued
  3. difficulty concentrating
  4. irritability
  5. muscle tension
  6. sleep disturbance
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13
Q

prognosis for general anxiety disorder

A

without treatment tends to worsen esp during stressful times

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14
Q

treatment for general anxiety disorder

A

best/most studied: cognitive behavioral therapy

  • psychodynamic (childhood trauma, unconscious thoughts)
  • antidepressents: SSRIs frontline
  • buspirone
  • benzodiazepines
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15
Q

what is the mechanism to giving SSRIs in general anxiety disorder

A

increases SR or NE or both by downregulating or desensitizing receptors (needs to be done slowly)

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16
Q

buspirone in general anxiety disorder mechanism

A

initially lowers SR activity as autoreceptors are stimulated, but eventually renders them inactive allowing increases in SR output (has less sexual and weight gain side effects)

17
Q

what is second line pharmacologic treatment for general anxiety disorder? why second line?

A

benzodiazepines - highly addictive, falls, apnea

18
Q

when are beta blockers used?

A

symptomatic relief of PERFORMANCE ANXIETY ONLY

19
Q

panic disorder

A

an abrupt surge of intense fear or discomfort, peaks within minutes and is UNEXPECTED - recurrent - more than one attack followed by more than one month of concern about additional panic attacks or consequences and/or significant maladaptive change in behavior related to attacks

20
Q

what symptoms are associated with panic disorder? how many required to diagnose?

A

need more than 4

  • palpitations
  • sweating
  • shaking
  • sensation of SOB
  • choking feeling
  • chest pain/discomfort
  • nausea
  • dizziness, lightheadedness, fainting
  • chills/heat
  • paresthesias
  • derealization
  • fear of losing of control
  • fear of dying
21
Q

agoraphobia

A

fear/anxiety about more than 2 of the following for more than 6 months

  • using public transportation
  • being in open spaces
  • being in enclosed spaces
  • standing in line or in a crowd
  • being outside the home alone
  • fear of not being able to escape situation
22
Q

treatment for panic disorder

A

cognitive behavioral therapy (esp systemic desensitization or flooding), benzodiazepine, SSRI, benzos

23
Q

what is the emergency treatment for panic disorder? long term 1st line?

A

emergency benzodiazepine

first line long term SSRI

24
Q

specific phobia diagnostic criteria

A
  • more than 6 months
  • causes significant impairment
  • marked by fear/anxiety about specific object/situation
  • object/situation almost always provokes fear/anxiety
  • actively avoids object/situation
  • fear/anxiety out of proportion to actual danger
25
Q

social anxiety disorder diagnostic criteria

A
  • more than 6 months
  • significant impairment
  • marked fear/anxiety when exposed to social situation with possible scrutiny by others
  • fear of acting in ways that will be negatively scrutinized
  • social situation provokes fear
  • avoids social situations
  • fear/anxiety out of proportion to actual threat

-can have PERFORMANCE ONLY - public speaking/performing

26
Q

treatment for specific phobia

A

1st line: flooding, systemic desensitization

medications: maybe sedatives?

27
Q

treatment for social anxiety disorder

A

CBT, assertiveness training, group therapy

-meds: SSR 1st line, MAOI, beta blocker for performance only**

Abbey MSII Unit 3 (36 decks)

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