Chapter 5 - Anxiety Disorders and OCD Flashcards

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1
Q

How do you define anxiety?

A
  • A general emotional reaction that is out of proportion with the current threats (if any) in the environment. Usually a feeling of short duration (10-20 min) but a recurrent feeling.
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2
Q

What’s a good way to describe a panic attack?

A
  • A fear response at the wrong time.
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3
Q

Obsessions vs. compulsions?

A
  • Obsessions - repeated, unwanted and intrusive thoughts. Occur suddenly and lead to increased anxiety
  • Compulsions - Repetitive behaviours/mental acts done to reduce anxiety caused by obsessions
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4
Q

What’s excessive worry?

A
  • Relatively uncontrollable sequence of negative thoughts. Mainly self-talk, imagining unpleasant scenarios that may never happen
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5
Q

What’s panic disorder?

A
  • Recurrent and unexpected panic attacks
  • One attack followed by at least one month or more of worry and avoidance
  • Can be with or without agoraphobia
  • Cannot be due to a medical condition or drug use/medication
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6
Q

What’s agoraphobia?

A
  • Avoidance of a cluster of situations where fear or panic may have occurred; marked apprehension that another panic attack will occur.
  • Intense fear of public spaces
  • Doesn’t necessarily have to be open or large
  • 95% of the time it occurs with panic disorder
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7
Q

How many symptoms are required for a panic disorder diagnosis?

A
  • 4
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8
Q

What are the different symptoms of panic disorder?

A
  • Palpitations
  • Sweating
  • Trembling/shaking
  • Dyspnea (shortness of breath)
  • Paresthesias (numbness/tingling)
  • Dizziness or faintness
    -Derealization/depersonalization
  • Fear of losing control
  • Fear of dying/heart attack (!)
  • Choking sensations
  • Chest pain/discomfort
  • Nausea
  • Chills/hot flashes
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9
Q

Are nocturnal panic attacks real?

A
  • Yes
  • Between 44-71% with panic disorder experience nocturnal attacks
  • May be because the brain is unable to anticipate attacks
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10
Q

When is panic disorder commonly diagnosed?

A
  • Usually late teens/early adult, but some don’t get diagnosed till early thirties (try to manage symptoms on their own before then)
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11
Q

What are the different types of phobias?

A
  • Animal type
  • Natural environment type
  • Blood, injection (needles, injury type)
  • Situational type (ex. claustrophobia
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12
Q

What’s Social Anxiety Disorder?

A
  • Also known as social phobia
  • The individual fears that they will act in a way or show anxiety symptoms that will be evaluated negatively
  • Can involve a fear of public speaking, eating, or writing in public
  • Have a general fear/concern of making mistakes, especially in front of others
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13
Q

What is required to be diagnosed with Generalized Anxiety Disorder?

A
  • Excessive anxiety/worry about a number of distinct situations/events more days than not over a period of at least 6 months
  • A general fear of uncertainty
  • Most common type of anxiety disorder
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14
Q

What are the three major features of GAD?

A

1) Uncontrollability of worry
2) Intolerance of uncertainty (does not cope well with situations that have no immediate outcome)
3) Ineffective problem-solving skills (worry is often characterized by your self-talk)

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15
Q

What are some common characteristics of those diagnosed with OCD?

A
  • Obsessions and compulsions must be intrusive, unwanted, and unreasonable, but the patient’s insight may vary (i.e., may think they’re necessary or ruining their life)
  • Compulsions must be driven by rigid rules or obsessions, and aimed at reducing anxiety (very procedural)
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16
Q

What are some common obsessions/compulsions?

A
  • Contamination
  • Pathological doubt
  • Mental comparisons
  • Need for symmetry
  • Somatic obsessions (ex. how long you chew)
  • Sexual/aggressive obsessions
  • Scrupulosity (often tied to religion/perfectionism)
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17
Q

How does the neurobiological model describe OCD?

A
  • The interactions between the frontal lobes and the basal ganglia (there’s dysregulation)
  • Depleted memory problems and memory confidence, explaining repeated checking
  • The serotonin hypothesis (not that great for OCD)
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18
Q

How does the cognitive-behavioural model describe OCD?

A
  • Problematic obsessions are caused by people’s catastrophic reactions to intrusive thoughts
  • Treatment involves trying to help them understand these thoughts are excessive and their reactions catastrophic
  • There are also excessive beliefs about personal responsibility and feelings of guilt
  • These obsessions persist because of people’s maladaptive attempts to cope with them
19
Q

What is body dysmorphic disorder?

A
  • Intense dissatisfaction with certain aspects of one’s appearance
  • Only diagnosed if the concern with slight defects is markedly excessive
  • Characterized by intense suffering. BDD patients tend to be more severely disturbed than those with OCD
  • Shares traits with anorexia nervosa
20
Q

What describes the trauma required by those to be diagnosed with PTSD later on?

A
  • The experience of both an event involving actual and/or threatened injury or death, and the response of intense fear, helplessness and/or horror to the event. The traumatic event may include oneself or another person, usually someone close
  • Must experience event in REAL-TIME
21
Q

What are the common symptoms of PTSD?

A
  • Flashbacks of past trauma
  • Avoidance (common in anxiety disorders)
  • Increased autonomic arousal (body stress responses)
  • Symptoms last for more than one month
  • The HPA axis is continually turning
22
Q

What’s Acute Stress Disorder (ASD)?

A
  • Can occur within 4 weeks of trauma exposure
  • Completely made-up disorder by clinicians to identify potential signs of PTSD early on.
  • Other symptoms may include dissociative symptoms such as dissociative amnesia, depersonalization, and derealization
23
Q

What’s the Innate Alarm System (IAS)?

A
  • Loops in the brain characterized by the brainstem, amygdala, and frontal cortex. Provides basic emotional reactions and movements in response to threats
  • May be unconsciously activated in those with PTSD
24
Q

What are the risk factors (pre/post-event) for PTSD?

A
  • Pre-event: Being female, low SES, low education, low tested intelligence, having a previous psychiatric history, ACEs
  • Post-event: Severity of event, lack of support, whether more traumatic events occur after the fact
25
Q

T/F: Interpersonal traumas (ex. sexual abuse) tend to provoke PTSD more often than non-interpersonal traumas (ex. natural disasters).

A
  • TRUE
26
Q

What social factors contribute to anxiety disorders?

A
  • Social factors
  • Childhood adversity
  • Anxious attachment; separation anxiety
27
Q

What two psychological theories may contribute to anxiety disorders?

A
  • Classical conditioning, potentially encouraged by biological preparedness
  • Observational (social) learning
28
Q

What cognitive theories may contribute to anxiety disorders?

A
  • Perception of a lack of control
  • Disgust sensitivities (more for phobias)
  • Catastrophic misinterpretation
  • Thought-action fusion (OCD
  • Intolerance of uncertainty
  • Dual representation theory
29
Q

What’s thought-action fusion?

A
  • Mainly in OCD
  • The belief that the thoughts they have will increase the probability of these bad things actually happening
30
Q

What’s dual representation theory?

A
  • Mainly seen in PTSD
  • Trauma is mainly encoded in the brain as images while regular memories are encoded as words, helping explain why flashbacks occur
  • Why PTSD treatment involves having patients write down what happened to them
31
Q

What is composed of the fear circuitry in the brain?

A
  • The sensory cortex > thalamus > amygdala <> Pre-frontal cortex, and hippocampus
32
Q

What is the major treatment for anxiety disorders?

A
  • EXPOSURE
33
Q

What are the different types of in-vivo desensitization?

A
  • Systematic desensitization - working through a fear hierarchy
  • Flooding - Intense exposure
  • Interoceptive exposure - used for panic disorder, mimic physiological stress responses
  • Exposure + ritual prevention for OCD
34
Q

What are the different types of imagery-based exposure?

A
  • Systematic desensitization (in your head) - an option when real stimuli are unavailable/difficult to manage
  • Worry imagery exposure (GAD)
  • Writing and telling an integrated story of trauma (PTSD)
  • Eye-movement desensitization and reprocessing (EMDR) - Often controversial, used for PTSD
35
Q

T/F: Benzodiazepines can work as an antianxiety medication.

A
  • TRUE
  • Repeated use can lead to addiction, so not highly recommended
  • Antidepressants now more common
36
Q

What are the three distinct components of emotion?

A
  • Physiological, cognitive, and behavioural
37
Q

Between men and women, whose more likely to be diagnosed with panic disorder?

A
  • Women (x2 more likely)
38
Q

What medical conditions can mimic panic disorder?

A
  • Hypoglycemia, hyperthyroidism
39
Q

What’s tachycardia?

A
  • Increased heart rate
40
Q

What are neutralizations?

A
  • Related to OCD
  • Behavioural/mental acts used by people to try to prevent, cancel, or undo the feared consequences and distress caused by an obsession
41
Q

How much time spent on OCD behaviours a day does the DSM-5 merit a diagnosis of OCD?

A
  • Spending more than one hour per day engaged in OCD behaviours
42
Q

T/F: 25% of those diagnosed with body dysmorphia disorder will commit suicide.

A
  • TRUE
43
Q

What’s the most effective treatment for panic disorder?

A
  • CBT