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PSYC 412 > Day 11-13 - Substance Use and Anxiety Disorders > Flashcards

Day 11-13 - Substance Use and Anxiety Disorders Flashcards

1
Q

Substance Use disorders are defined as a ______ of substance use leading to clinically significant impairment or distress as manifested by at least ___ symptoms occurring within a ___-month period

A

problematic pattern; at least 2 symptoms in 12mo

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2
Q

What are the severity specifiers for substance use disorders?

A
  • mild: 2-3 symptoms
  • moderate: 4-5 symptoms
  • severe: 6+ symptoms
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3
Q

Define early remission and sustained remission in the context of substance use disorders

A
  • early: <2 symptoms for 3-12mo (excluding cravings)
  • sustained: same but for 12+mo
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4
Q

(T/F) to be considered in remission for a substance use disorder, you have to be sober

A

FALSE

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5
Q

What are the 4 categories of symptoms for substance use disorders?

A
  • physical dependence
  • risky use
  • social problems
  • impaired control
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6
Q

____% of kids who start drinking by 14 develop alcohol use disorder, compared to __% of those who start @ 21+

A

15%; 2%

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7
Q

Early onset of drinking is a risk (marker/factor) for alcohol use disorder

A

Unclear as of yet (maker=associated; factor=causal)

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8
Q

Substance use in teens is ass w 3 leading causes of death for teens: ___, ___, and ___

A

accidents/injuries, suicide/self-harm, and interpersonal violence

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9
Q

In US, ___ of students in gr 12 and ___ of students in gr 10 report drinking in past year

A

2/3 gr12; 1/2 gr10

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10
Q

What is the lifetime prevalence of any substance use disorder for:
- teens 13-18
- 13-14y
- 15-16y
- 17-18y

A
  • teens 13-18: 11%
  • 13-14y: 4%
  • 15-16y: 12%
  • 17-18y: 22%
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11
Q

Substance use in teens (increased/decreased) during the pandemic

A

DECREASED

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12
Q

What is an example of an early, brief intervention for SUD?

A
  • norm-based intervention for college students
  • ppl overestimate how much their peers drink, so show them the reality to set more healthy norms
  • changes in perceived norms can mediate tx effects
  • these programs work well!!
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13
Q

What is multidimensional family therapy for SUD?

A
  • similar to MST used for conduct disorders
  • involve parents to help with monitoring
  • works well, often better than group therapy or CBT
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14
Q

What is Alcoholics Anonymous for SUD?

A
  • most popular treatment
  • peer support
  • recommends abstinence
  • very easily accessible
  • ass w less alcohol consumption and fewer substance related problems
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15
Q

What are the 3 hypotheses for the link between AA and lower alcohol consumption and related problems? Which is/are supported by research?

A
  • attendance itself leads to using less
  • lower alc use ass w going to more meetings, these ppl are more likely to get better anyways
  • ppl w good prognosis (motivated + less comorbidities) use less and are more likely to go to meetings (so have less risk and more protective factors
  • evidence for #1 only (attendance leads to lower use)
  • study of veterans found AA involvement @1y post-tx predicted less use @2y post-tx (no evidence for other hypotheses)
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16
Q

What does research say about the efficacy of inpatient tx for SUD?

A
  • not enough research to say
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17
Q

There is (high/low) service utilization for kids w anxiety disorders

A

LOW

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18
Q

What groups are most likely to receive MH services for anxiety disorders?

A

girls and older kids/teens

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19
Q

About ___ of kids 6-12 have 7 or more fears

A

half

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20
Q

How does anxiety differ from fear?

A
  • anxiety is future-oriented (anxious apprehension)
  • fear is present-oriented
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21
Q

(T/F) anxiety disorders and OCD now fall under the same DSM category

A

FALSE, used to but now separate (some related features)

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22
Q

When is the typical onset of specific phobia?

A

middle childhood (7-9y)

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23
Q

What are the 5 diagnostic specifiers for specific phobias?

A
  • animal
  • natural environment (heights, storms, water)
  • blood, injection, injury
  • situational (e.g. planes, elevators, small spaces)
  • other (choking/vomiting, sounds, costumed characters)
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24
Q

Separation anxiety occurs in ___% of children and is more prevalent in (boys/girls)

A

4-10%; girls

25
In children diagnosed w separation anxiety, ____ have another anxiety disorder and ___ have a depressive disorder
2/3 anxiety; 1/2 depressive
26
What are the key features of GAD?
- excessive, uncontrollable anxiety or worry - somatic (physical symptoms as well!)
27
When is the typical onset of GAD? What is the gender ratio?
- onset in adolescence and beyond (older kids have more symptoms) - similar levels in boys and girls
28
A panic attack is a period of intense ____ that develops abruptly and is accompanied by at least ___ symptoms
intense fear or discomfort; at least 4 symptoms
29
DSM5 criteria for panic disorder: - recurrent, ____ panic attacks - at least one attack followed by ___mo+ of one of: _____, _____, _____
- recurrent, unexpected panic attacks - 1mo+ of one of: persistent concern of having more attacks, worry ab consequences of attack, significant change in behaviour related to attacks
30
(T/F) you can have panic attacks without having panic disorder
TRUE
31
What are obsessions?(4 points)
- obsessions: recurrent/persistent thoughts, impulses, or images that cause anxiety or distress - not just excessive worrying ab real life problems - attempts to ignore/suppress w another thought or action - person recognizes thoughts as product of own mind
32
What are compulsions?
- repetitive behaviours/mental acts that the person feels driven to perform in response to obsession - aimed at preventing distress but not connected in a realistic way to the problem or are clearly excessive
33
What is the lifetime prevalence in kids/teens for: - any anxiety disorder - specific phobia - separation anxiety - social phobia - GAD - panic disorder - OCD - selective mutism
- any anxiety disorder: 32% - specific phobia: 19% - separation anxiety: 8% - social phobia: 9% - GAD: 2% - panic disorder: 2% - OCD: 1-2% - selective mutism: 0.7%
34
What is the girl:boy ratio for anxiety and OCD?
- anxiety 2:1 - OCD 1:2
35
(T/F) lower SES and single parent household are linked to greater likelihood of anxiety disorder
TRUE
36
Anxiety disorders are more common in (Black/white) youth, and (Black/white) youth receive more services for anxiety
Black; white
37
(T/F) anxiety disorders are often comorbid w other anxiety disorders
TRUE
38
Diagnostic comorbidity btw anxiety and depression can be as high as ____%
75-80%
39
Often, (anxiety/depression) preceeds (anxiety/depression)
anxiety preceeds depression
40
What 5 symptoms overlap between GAD and MDD?
- fatigue - sleep disturbance - irritability - concentration difficulties - negative affectivity
41
What is the typical age of onset for: - separation anxiety - OCD - GAD - social phobia - panic disorder
- separation anxiety: 7-8y - OCD: 9-12y - GAD: 10-14y - social phobia: teens - panic disorder: teens
42
Long term outcomes of anxiety disorders are (homotypic/heterotypic)
not sure yet (homotypic = disorder predicting itself over time, heterotypic = predicting other, related disorder)
43
Children of parents w anxiety disorder are __x more likely to have an anxiety disorder
5x
44
__% of variability in anxiety is heritable
33%
45
What is the 2-stage model of fear acquisition
- stage 1: fear develops through classical conditioning - stage 2: avoidance behavior maintained through operant conditioning
46
(T/F) compulsions can be cognitive, not just physical
TRUE (eg counting)
47
What are the 5 steps of social information processing?
- encoding (what you pay attention to) - interpretation - response search - response decision - enactment
48
How does anxiety impact social information processing?
- encoding: attention to threat - interpretation: negative bias, catastrophizing
49
What are 4 environmental (family) factors in pediatric anxiety
- modeling (parents demonstrate anxious response) - information transmission - low expectations (expect child won't be able to cope) - parental reinforcement of problematic behavior (eg avoidance)
50
(T/F) research has found that parents of anxious kids tend to talk them into engaging in avoidant responses
TRUE
51
SSRIs can be used to treat what 4 anxiety/related disorders?
- OCD - GAD - SAD - social anxiety disorder
52
What is the effectiveness of SSRIs for youth w anxiety disorders?
- not much research - some evidence, but not large effect
53
What are the 3 core components of effective anxiety interventions?
- reduce cognitive biases - reduce bodily tension - exposure and habituation
54
What are 2 ways to reduce cognitive biases in anxiety?
- coping self-talk (identify and challenge negative thoughts) - retraining attention to threat bias
55
How is attention re-training done for threat bias?
- dot-probe task - trained to look away from angry face - found decrease in threat bias! (AND number and severity of symptoms)
56
What is flooding?
- exposure technique involving intense exposure to highest level of fear (can lead to quick improvement but can also be traumatic)
57
What were the main findings of the CAMS (child/adolescent anxiety multimodal study)?
- major RCT for youth anxiety treatments - combined SSRI + CBT worked best - CBT and SSRI equal ish and both better than placebo - SSRI better than CBT for social anxiety disorder - CBT better than SSRI for GAD - results maintained at 3mo and 6mo - improvements related to long-term outcomes 3-11y later!
58
What were the main findings of the POTS (pediatric OCD treatment study)?
- combined was best - CBT and SSRI equal ish and both better than placebo - BUT effect of CBT and SSRI varied across tx sites
59

PSYC 412 (9 decks)

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