exam 3 - other anxiety disorders

Question 1

hoarding disorder

Answer 1

Difficulty parting or discarding possessions (regardless of value)
Perceived need to save items
Inability to discard items leads to an overwhelming pile up of items
EX// house piled with empty boxes, old clothes, broken tools, etc…

Question 2

body dysmorphic disorder

Answer 2

Preoccupation with perceived flaws and bodily deficits that are not actually present to others
Individual engaged in repetitive behaviors (mirror checking, excessive grooming, etc…) OR mental acts (comparing appearance to someone else’s)

Question 3

OCD

Answer 3

recurrent, time consuming and disturbing obsessions and compulsions

Question 4

obsessions definition

Answer 4

intrusive thoughts that are distressing
Cause extreme anxiety

Question 5

compulsions definition

Answer 5

behaviors that alleviate stresses brought on by obsessions

Question 6

resistant to change

Answer 6

they may be able to rationalize something will probably not happen but anxiety behind intrusive thought is so overwhelming they have to behave in a way to relieve it
EX// “I know I wouldn’t grab that gun, but what if I did?” To relieve this concern, the person may engage in a compulsive behavior

Question 7

OCD treatment

Answer 7

exposure and response prevention
support from family

Question 8

exposure and response prevention

Answer 8

Follow fear hierarchy to slowly expose individuals to different rates of anxiety inducing stimuli without allowing them to engage in disruptive behaviors (compulsions)

Question 9

support from family

Answer 9

better outcomes
Does not mean giving into the extremes of obsessions (acknowledge the unhelpfulness)
EX// do not buy all new countertops (case study from class)

Question 10

panic attack

Answer 10

short period of intense fear accompanied by symptoms characteristic of the fight/flight response
Incredibly intense and unexpected
Thoughts of “I am going crazy” or “I am going to die”
Fixating on intense physical feelings (racing heart, hyperventilating) spirals panic attack

Question 11

anxiety regarding somatic symptoms
(panic disorder)

Answer 11

Irregular heart-beat, chest pain, dizziness, upset stomach, headaches, etc…
Noticing these feelings → is there something wrong with me? → increased symptoms → am I dying? → panic attack

Question 12

_____ month(s) of persistent concern or worry of having another panic attack

Answer 12

1+ month

Question 13

agoraphobia

Answer 13

fear of not being able to escape certain situations. Specific situation can bring on a panic attack that is ultimately unavoidable
Multiple panic attacks may lead to a false association that a place or event may be contributing to the onset of the attack creating a desire to avoid this specific place or situation as a method to avoid panic attacks
EX// elevator may not give an opportunity for escape and will ultimately lead to a panic attack which cannot be avoided

Question 14

panic disorder treatment

Answer 14

CBT and exposure therapy

Question 15

school refusal behavior

Answer 15

often tied to problems in home e.g., abuse/ neglect

Question 16

school refusal behavior symptoms

Answer 16

refusal to attend classes or remain in school
Can be a fear of school (social anxiety disorder) or a fear of leaving parents (separation anxiety disorder)
EX// kicking and screaming when being dropped off at school

Question 17

selective mutism

Answer 17

Not speaking in certain situations
Sometimes related to trauma
Individual will speak in other social situations
Developmental variant of social anxiety disorder
Behavior: can make it through situations (no avoidance) just don’t talk while a part of them
EX// May not speak to teacher, will speak to friends

Question 18

separation anxiety disorder

Answer 18

Age inappropriate, excessive, and disabling anxiety about being away from parents/care-giver or home
Characteristics: withdrawn, apathetic, and depressed
EX// child refuses to spend the night at a friends house because of their anxiety surrounding sleeping away from their parents and own bed

Question 19

separation anxiety treatment

Answer 19

CBT: focuses on challenging distortions, devising ways to get through fits of anxiety, and behavioral changes that better support mood stability

Question 20

coping CAT/ KOALA (SAD)

Answer 20

recognizing cognitive and physical reactions to anxiety, clarifying thoughts and feelings around anxiety, develop plans for effective coping, and evaluate performance
Decrease negative thinking
Increase active problem solving
Creating functional coping outlook

Question 21

FEAR plan (SAD)

Answer 21

F: frightened? (recognize physical symptoms of anxiety)
E: Expect bad outcomes? (recognize anxious cognitions)
A: Attitudes that help (self-talk for when anxiety comes up)
R: results and rewards (self-administered praise)

Question 22

SSRis (SAD)

Answer 22

(selective serotonin reuptake inhibitors) have demonstrated success in symptom reduction

Question 23

social anxiety disorder

Answer 23

Fear of judgment from others
Fear of social interactions or performance which could result in embarrassment or scrutiny
Feelings: highly emotional, socially fearful, sad, and lonely
EX// fear of ordering food in a restaurant, fear of raising hand in class, fear of making new friends…..
Social fears must apply to multiple contexts beyond a singular situation (i.e., public speaking alone). If only 1 situation triggers anxiety this may be a specific phobia

Question 24

social anxiety disorder treatment

Answer 24

CBT: children come to understand how thoughts contribute to anxiety and learn ways to change their maladaptive thinking as a way to decrease their symptoms
Coping CAT and FEAR plan can be applied here.
SSRIs are also effective in symptom reduction
exposure-graded or systematic

Question 25

specific phobia

Answer 25

Irrational or exaggerated fear which leads to a complete avoidance of a feared object/stimuli
Causes impairment in routine
Child goes at great lengths to avoid object
Fears are of things most kids would not find to be risky
EX// fear of dogs
Emotional expressions: crying, tantrums, freezing, or clinging

Question 26

specific phobia treatment

Answer 26

exposure therapy: exposing them to fear inducing situation slowly until the situation no longer affects them

Question 27

accomodation

Answer 27

When family members “give in” to anxious tendencies of a child
Behaviors which maintain or facilitate avoidance of situations which are anxiety inducing to the child
may have good intentions from the parents (believe they are being supportive) in reality, they are reinforcing the negative feelings associated with certain situations
EX// when a family replaces their countertops for their child with OCD (obsession with dirt and cleanliness)

Question 28

exposure

Answer 28

Exposing an individual to a situation that induces fear and/or anxiety while providing coping strategies to work through their emotions

Question 29

graded exposure

Answer 29

child rates various situations on the SUDS (Subjective Units of Distress Scale) to determine the lowest and highest points of fear inducing situations
From there– individual will be exposed from the lowest point of fear and progress up to the highest point of fear
While being exposed to each scenario, the individual will be taught coping strategies

Question 30

flooding

Answer 30

immediately exposes individual to highly distressing situations which is then repeated through multiple sessions
Ratings for how distressing each event is should decrease through repeated exposure
First few sessions may be HIGHLY distressing

Question 31

systematic desensitization

Answer 31

Individual is taught how to relax
Clinician and individual build a fear hierarchy
Anxiety inducing events are presented sequentially while child remains relaxed

Question 32

relaxation

Answer 32

techniques that combat typical somatic symptoms which accompany anxiety (hyperventilating, increased heart rate, dizziness, etc…)
Techniques are aimed to reduce these symptoms in hopes of decreasing feelings of anxiety
I.e. controlled breathing

Question 33

problem solving

Answer 33

a way of developing rational coping skills in response to feelings of anxiety
“My heart is beating so fast I can’t think straight!” → “I feel nervous but this will pass and I will be okay!”

Question 34

addressing family accomadation

Answer 34

psychoeducation for families will help them understand why their forms of accommodation are more harmful than helpful. From there, families can learn techniques to be supportive without further worsening symptoms

Question 35

systematic desensitization versus flooding (differences between)

Answer 35

Flooding: immediate exposure to extremely fear inducing situation
Client expectations: high distress in first few sessions slowly become less distressed with time
Systematic desensitization: slowly working up to extremely fear inducing situation while keeping client in a constant state of relaxation
Client expectations: total relaxation through all sessions, requires a slow build up to most distressing situation

Question 36

tricholillomania

Answer 36

hair-pulling disorder
Excessively pulling one’s own hair
Attempts to stop cause extreme distress

Question 37

tricholillomania treatment

Answer 37

CBT is best
Educate on the dangers of hair pulling
Come up with less damaging tactics which do not trigger distress or anxiety

Question 38

excoriation disorder

Answer 38

skin picking disorder
Recurrent skin picking leading to skin lesions
Attempts to stop cause extreme distress

Question 39

excoriation disorder treatment

Answer 39

CBT is best
Educate on the dangers of skin picking
Come up with less damaging tactics