Exam 2

Question 1

symptoms of panic attack

Answer 1

1. Palpitations, pounding heart, or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or smothering
5. Feeling of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, lightheaded, or faint
9. Derealization (feelings of unreality) or depersonalization (being detached from oneself)
10. Fear of losing control or going crazy
11. Fear of dying
12. Paresthesias (numbness or tingling sensations)
13. Chills or hot flushes

Question 2

panic disorder

Answer 2

recurrent, unexpected panic attacks (false alarms) lasting one month or longer

Question 3

amount of adult population who’s experienced a panic attack

Answer 3

30%

Question 4

lifetime prevalence of panic disorder

Gender ratio (F:M)

Answer 4

5%

2:1

Question 5

role of blood pH in panic

Answer 5

respiratory control center (brain stem) may register that you’re suffocating if your pH level is high; higher amounts of acidity in our blood for any reason can lead us to feel more anxious

Question 6

sodium lactate infusion challenge

Answer 6

if you hook up a person with panic or an immediate relative without the disorder to an IV and fuse sodium lactate, it will likely induce a panic attack

Question 7

revised lactate infusion challenge

Answer 7

Barlow told one group that the IV was safe, the other group he told nothing; those who were told it was safe were less likely to panic (cognition matters)

Question 8

Barlow’s CBT model of panic

Answer 8

1. patients misinterpret interoceptive cues
2. catastrophic thoughts lead to panic
3. modify thoughts –> reduce panic
4. Exposure to interoceptive cues (extinction of conditioned alarms)

Question 9

efficacy of benzos for panic disorder

Answer 9

over 80% accute

Question 10

efficacy of SSRI/SNRI/impiramine for panic disorder

Answer 10

60% accute

Question 11

efficacy of CBT for panic disorder

Answer 11

60-75% accute

Question 12

short term vs. long term efficacy of benzos

Answer 12

high efficacy in the short term; brain neutralizes effects of the drug in the long term

Question 13

GABA receptors

Answer 13

1/3 of brain cells use this neurotransmitter; benzos slow down the firing of these signals and impairs mental functions including memory

Question 14

1 best selling psych drug

Answer 14

Xanax

Question 15

Benzos

Answer 15

Ativan, Klonopin, Valium, Versed, Rohypnol, Xanax

Question 16

side effects of benzos

Answer 16

loss of restorative phase of sleep, can trigger depression, impaired memory/concentration, sedation, impaired reasoning, reduced insight/awareness, loss of inhibition, emotional numbing, increased dementia risk

Question 17

symptoms of agoraphobia

Answer 17

person begins to fear and avoid places associated with occurrence of panic attacks (open spaces, cars, malls); generalize one panic attack to all locations similar to where it occurred; person may be homebound

Question 18

how many patients with panic disorder have agoraphobia?

Answer 18

half

Question 19

symptoms of GAD

Answer 19

high anxiety and excessive worry > 6 months, restlessness, fatigue, insomnia, irritability, concentration difficulties, muscle tension

Question 20

uncertainty intolerance

Answer 20

Michael Dugas: people with GAD suffer from feeling of not knowing outcomes (worse than the negative outcome itself)

Question 21

error detection

Answer 21

anterior cingulate cortex (behind frontal cortex) gives us sensation that something’s wrong and motivates us to fix it; for GAD patients these circuits don’t calm down

Question 22

______________ meditation added to CBT leads to 75% success response for GAD patients

Answer 22

mindfulness

Question 23

GAD treatments

Answer 23

magnesium supplement, mindfulness meditation, exercise (aerobic), probiotics

Question 24

subtypes of social anxiety disorder

Answer 24

performance-linked (public speaking), generalized (pervasive social anxiety)

Question 25

beta blocker

Answer 25

very effective for treating performance-linked subtype

Question 26

Nardil

Answer 26

MAO inhibitor; highest efficacy of any treatment of social anxiety disorder (80%); blood pressure/hypertensive crisis risk from aged foods (cheese, sausage, wine)

Question 27

lifetime prevalence of social anxiety disorder

Answer 27

12%

Question 28

activation syndrome

Answer 28

agitation & possible suicidality/aggression during first few weeks of taking drug or during withdrawal (2-5% of ppl)

Question 29

Rohypnol

Answer 29

type of benzo; also a date rape drug

Question 30

Versed

Answer 30

type of benzo; also used during surgeries to erase memories - reduces likelihood that they’ll be sued if you wake up (you won’t remember it)

Question 31

Cymbalta Case

Answer 31

1 out of 200 participants would make a suicide attempt on an antidepressant

Question 32

Dissociation

Answer 32

• derealization: things feel dreamlike

- depersonalization: out of body experience; watching it happen to someone else

Question 33

SSRIs:

Answer 33

Prozac, Paxil, Zoloft, Celexa, Lexapro

Question 34

SNRIs:

Answer 34

Effexor, Pristiq, Cymbalta

Question 35

What do antidepressants do with serotonin?

Answer 35

These drugs do not increase brain’s “serotonin levels” (they block serotonin synaptic re-uptake)

Question 36

Xanax also known as

Answer 36

alprazolam

Question 37

Obsession

Answer 37

recurrent intrusive thought, impulse, or image that causes anxiety and cannot be dismissed or put out of one’s mind

Question 38

Compulsion

Answer 38

repetitive action (ritual) person feels compelled to do

Question 39

Subtype of social anxiety disorder

Answer 39

performance-based anxiety (treated with beta blockers)