Chapter 5 Pt 2 Flashcards
what is agoraphobia
intense fear of being in public places where escape or obtaining help may be difficult
often develops with panic disorder
avoidance behaviors may become as extreme as complete confinement to the home
what is the criteria for agoraphobia
intense fear/anxiety about >2 situations due to concern of DIFFICULTY ESCAPING or OBTAINING HELP in the case of PANIC or other HUMILIATING symptoms:
- outside of home alone
- open spaces
- enclosed places
- public transport
- crowds/lines
SYMPTOMS LAST 6 MONTHS
triggering situations cause fear/anxiety out of proportion to the potential danger posed, leading to endurance of intense anxiety, avoidance, or requiring a companion (includes people with IBS)
significant social or occupational dysfunction
what is the etiology of agoraphobia
strong genetic factor: heritability about 60%
onset frequently follow traumatic event
over 50% of patients experience what before developing agoraphobia
panic attack
what are the common domains of social anxiety disorder (social phobia)
speaking in public
eating in public
using public restrooms
what is treatment for agoraphobia
CBT and SSRI
what is a phobia
irrational fear that leads to endurance of anxiety and/or avoidance of the feared object or situation
what is a specific phobia
an intense fera of a specific object or situation
what is social anxiety disorder (social phobia)
fear of SCRUTINY by other or fear of acting in a HUMILIATING or EMBARRASSING way
what are some common specific phobias
animal- spiders, insects, dogs, snakes, mice
natural environment- heights, storms, water
situational- elevators, airplanes, enclosed spaces, buses
blood-injection injury- needles, injections, blood, invasive medical procedures, injury
what is the criteria for specific phobia
persistent, eccessive fear elicited by a specific situation or object which is out of proportion to any actual danger/threat
exposure to situation triggers an immediate fear response
SYMPTOMS LAST 6 MONTHS
situation or object avoided when possible or tolerated with intense anxiety
what frequently co-occurs with phobias
substance use and major depression
what are the most common psychiatric disorder in women and second most common in men (substance related is first)
PHOBIAS
what is mean age of onset for specific phobia and social anxiety
specific phobia: 10
social anxiety: 13
what is treatment of choice for specific phobia
CBT
what is treatment of choice for social anxiety
CBT
if needed: 1st line pharmacotherapy is SSRI
what is selective mutism
rare condition characterized bt failure to speak in specific situation for AT LEAST 1 MONTH, despite the intact ability to comprehend and use language
usually starts in childhood
lots of social anxiety
what is criteria for selective mutism
consistent failure to speak in a select social situations (i.e. school) despite speech ability in other scenarios
mutism is not due to a language difficulty or a communication disorder
cause significant impairment in academic, occupational, or social functioning
symptoms LAST > 1 MONTH (extending beyond first month of school)
what is treatment for selective mutism
CBT and family therapy
SSRIs can be used for anxiety
stranger anxiety begins when and peaks when
starts around 6 MONTHS
peaks around 9 MONTHS
separation anxiety usually starts when and peaks when
emerges by 1 YEAR old
peaks by 18 MONTHS
what is criteria for separation anxiety disorder
excessive and DEVELOPMENTALLY INAPPROPRIATE FEAR/ANXIETY regarding SEPARATION from ATTACHMENT FIGURES, with at least 3 of the following:
- separation leads to extreme distress
- excessive worry about loss of or harm to attachment figures
- excessive worry about experiencing an event that leads to separation from attachment figures
- reluctance to leave home, or attend school or work
- reluctance to be alone
- reluctance to sleep alone or away from home
- complaints of physical symptoms when separated from a major attachment figure
- nightmares of separation
LASTS MORE THAN 4 WEEKS in children/adolescents and 6 MONTHS for adults
what is tx for separation anxiety
CBT and family therapy
