exam 3 - other anxiety disorders Flashcards
hoarding disorder
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…
body dysmorphic disorder
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)
OCD
recurrent, time consuming and disturbing obsessions and compulsions
obsessions definition
intrusive thoughts that are distressing
Cause extreme anxiety
compulsions definition
behaviors that alleviate stresses brought on by obsessions
resistant to change
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
OCD treatment
exposure and response prevention
support from family
exposure and response prevention
Follow fear hierarchy to slowly expose individuals to different rates of anxiety inducing stimuli without allowing them to engage in disruptive behaviors (compulsions)
support from family
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)
panic attack
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
anxiety regarding somatic symptoms
(panic disorder)
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
_____ month(s) of persistent concern or worry of having another panic attack
1+ month
agoraphobia
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
panic disorder treatment
CBT and exposure therapy
school refusal behavior
often tied to problems in home e.g., abuse/ neglect
school refusal behavior symptoms
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
selective mutism
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
separation anxiety disorder
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
separation anxiety treatment
CBT: focuses on challenging distortions, devising ways to get through fits of anxiety, and behavioral changes that better support mood stability
coping CAT/ KOALA (SAD)
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
FEAR plan (SAD)
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)
SSRis (SAD)
(selective serotonin reuptake inhibitors) have demonstrated success in symptom reduction
social anxiety disorder
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
social anxiety disorder treatment
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
specific phobia
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
specific phobia treatment
exposure therapy: exposing them to fear inducing situation slowly until the situation no longer affects them
accomodation
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)
exposure
Exposing an individual to a situation that induces fear and/or anxiety while providing coping strategies to work through their emotions
graded exposure
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
flooding
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
systematic desensitization
Individual is taught how to relax
Clinician and individual build a fear hierarchy
Anxiety inducing events are presented sequentially while child remains relaxed
relaxation
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
problem solving
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!”
addressing family accomadation
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
systematic desensitization versus flooding (differences between)
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
tricholillomania
hair-pulling disorder
Excessively pulling one’s own hair
Attempts to stop cause extreme distress
tricholillomania treatment
CBT is best
Educate on the dangers of hair pulling
Come up with less damaging tactics which do not trigger distress or anxiety
excoriation disorder
skin picking disorder
Recurrent skin picking leading to skin lesions
Attempts to stop cause extreme distress
excoriation disorder treatment
CBT is best
Educate on the dangers of skin picking
Come up with less damaging tactics
