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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
Q

In children diagnosed w separation anxiety, ____ have another anxiety disorder and ___ have a depressive disorder

A

2/3 anxiety; 1/2 depressive

26
Q

What are the key features of GAD?

A
  • excessive, uncontrollable anxiety or worry
  • somatic (physical symptoms as well!)
27
Q

When is the typical onset of GAD? What is the gender ratio?

A
  • onset in adolescence and beyond (older kids have more symptoms)
  • similar levels in boys and girls
28
Q

A panic attack is a period of intense ____ that develops abruptly and is accompanied by at least ___ symptoms

A

intense fear or discomfort; at least 4 symptoms

29
Q

DSM5 criteria for panic disorder:
- recurrent, ____ panic attacks
- at least one attack followed by ___mo+ of one of: _____, _____, _____

A
  • 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
Q

(T/F) you can have panic attacks without having panic disorder

A

TRUE

31
Q

What are obsessions?(4 points)

A
  • 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
Q

What are compulsions?

A
  • 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
Q

What is the lifetime prevalence in kids/teens for:
- any anxiety disorder
- specific phobia
- separation anxiety
- social phobia
- GAD
- panic disorder
- OCD
- selective mutism

A
  • 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
Q

What is the girl:boy ratio for anxiety and OCD?

A
  • anxiety 2:1
  • OCD 1:2
35
Q

(T/F) lower SES and single parent household are linked to greater likelihood of anxiety disorder

A

TRUE

36
Q

Anxiety disorders are more common in (Black/white) youth, and (Black/white) youth receive more services for anxiety

A

Black; white

37
Q

(T/F) anxiety disorders are often comorbid w other anxiety disorders

A

TRUE

38
Q

Diagnostic comorbidity btw anxiety and depression can be as high as ____%

A

75-80%

39
Q

Often, (anxiety/depression) preceeds (anxiety/depression)

A

anxiety preceeds depression

40
Q

What 5 symptoms overlap between GAD and MDD?

A
  • fatigue
  • sleep disturbance
  • irritability
  • concentration difficulties
  • negative affectivity
41
Q

What is the typical age of onset for:
- separation anxiety
- OCD
- GAD
- social phobia
- panic disorder

A
  • separation anxiety: 7-8y
  • OCD: 9-12y
  • GAD: 10-14y
  • social phobia: teens
  • panic disorder: teens
42
Q

Long term outcomes of anxiety disorders are (homotypic/heterotypic)

A

not sure yet (homotypic = disorder predicting itself over time, heterotypic = predicting other, related disorder)

43
Q

Children of parents w anxiety disorder are __x more likely to have an anxiety disorder

A

5x

44
Q

__% of variability in anxiety is heritable

A

33%

45
Q

What is the 2-stage model of fear acquisition

A
  • stage 1: fear develops through classical conditioning
  • stage 2: avoidance behavior maintained through operant conditioning
46
Q

(T/F) compulsions can be cognitive, not just physical

A

TRUE (eg counting)

47
Q

What are the 5 steps of social information processing?

A
  • encoding (what you pay attention to)
  • interpretation
  • response search
  • response decision
  • enactment
48
Q

How does anxiety impact social information processing?

A
  • encoding: attention to threat
  • interpretation: negative bias, catastrophizing
49
Q

What are 4 environmental (family) factors in pediatric anxiety

A
  • 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
Q

(T/F) research has found that parents of anxious kids tend to talk them into engaging in avoidant responses

A

TRUE

51
Q

SSRIs can be used to treat what 4 anxiety/related disorders?

A
  • OCD
  • GAD
  • SAD
  • social anxiety disorder
52
Q

What is the effectiveness of SSRIs for youth w anxiety disorders?

A
  • not much research
  • some evidence, but not large effect
53
Q

What are the 3 core components of effective anxiety interventions?

A
  • reduce cognitive biases
  • reduce bodily tension
  • exposure and habituation
54
Q

What are 2 ways to reduce cognitive biases in anxiety?

A
  • coping self-talk (identify and challenge negative thoughts)
  • retraining attention to threat bias
55
Q

How is attention re-training done for threat bias?

A
  • dot-probe task
  • trained to look away from angry face
  • found decrease in threat bias! (AND number and severity of symptoms)
56
Q

What is flooding?

A
  • exposure technique involving intense exposure to highest level of fear (can lead to quick improvement but can also be traumatic)
57
Q

What were the main findings of the CAMS (child/adolescent anxiety multimodal study)?

A
  • 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
Q

What were the main findings of the POTS (pediatric OCD treatment study)?

A
  • combined was best
  • CBT and SSRI equal ish and both better than placebo
  • BUT effect of CBT and SSRI varied across tx sites
59
Q
A

PSYC 412 (9 decks)

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