Exam 2 DSM V Criteria Flashcards
A. Six months with prominent tension, worry & apprehension
B. Difficulty controlling symptoms
C. At least three symptoms from list of six
- Restlessness
- Easy fatigability
- Poor concentration
- Irritability
- Muscle tension
- Sleep disturbance
GAD
A. Marked/persistent fear of one or more social/performance
situations, with possible scrutiny by others
B. Fear of showing anxiety symptoms that will be negatively evaluated
C. Social situation always provokes fear or anxiety
D. Situations are avoided or enduring with intense fear
E. Fear is out of proportion to event
F. Persistent: 6 months or more
SAD
Mild GAD tx
10-15 60 min CBT sessions
Moderate/Severe GAD Tx
1st: SSRI/SNRI + CBT
2nd: Buspirone/hydroxyzine or BZs + CBT
3rd: Quentiapine
last: TCAs
1st line SAD tx…
CBT +/- SSRI/SNRI
Performance anxiety tx
propranolol/atenolol
short-term BZ
A. Discrete period of intense fear or discomfort, in which four (or more) of the
following symptoms developed abruptly and reached a peak within 10 minutes
(i.e. Panic Attack):
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
Panic d/o
at least 1 month of one (or more) of the following:
- Persistent concern about having additional attacks or worry
about the implications of the attack or their consequences (e.g.,
losing control, having a heart attack, “going crazy”) - Significant maladaptive change in behavior related to attacks
Panic d/o
Panic d/o tx
CBT + SSRI/SNRI +/- Clonazepam PRN
A. Marked/persistent excessive/unreasonable fear of
presence or anticipation of specific object/situation
B. Exposure almost invariably provokes immediate
anxiety response, may be panic attack
C. Avoided or endured with intense anxiety/distress
D. Fear/anxiety is out of proportion to stimulus
E. 6 months or longer
Specific Phobias
Phobia tx
short term CBT
Pharm: SSRI/SNRI, short term BZs PRN
A. Either obsessions or compulsions or both
Obsessions defined by (1) and (2):
¨ 1. Recurrent & persistent thoughts, impulses, or images experienced as
intrusive & inappropriate, and cause marked anxiety or distress
¨ 2. Attempts to ignore or suppress the thoughts, or to neutralize them with
other thought/action (by performing compulsion)
Compulsions defined by (1) and (2):
¨ 1. Repetitive behaviors or mental acts, driven to perform in response to obsession or according to rigid rules
¨
2. Aimed at preventing/reducing distress, preventing dreaded event;
however not connected in realistic way or are clearly excessive
B. O/C are time consuming (>1 hr/day) or cause impairment
OCD
Possessions: persistent difficulty discarding regardless
of value
B. Perception is to need to save items and distress would
occur with discarding them
C. Results in accumulation until they congest and clutter
active living areas, and compromise their intended use
hoarding d/o
Tx for OBDs
CBT, exposure and response prevention (ERP)
SSRI/SNRI
clomipramine (TCA)
Psychological response to an identifiable stressor(s) resulting in clinically significant emotional or behavioral symptoms
A. Symptoms develop w/in 3 months of stressor
B. Distress out of proportion to event and significant impairment
in social/occupational functioning
C. Not due to another mental disorder
D. Rule out Bereavement
E. Must resolve w/in 6 months following stressor
Adjustment d/o
