Intro to Psychiatry - Anxiety and Anxiety-Related Disorders Flashcards
When is fear pathologic?
- When its out of proportion to risk/severity of threat
- Response lasts beyond threat duration
- Response becomes generalized to other situations
- Social/occupational functioning impairment
“True” Anxiety disorders
- Panic Disorder
- Agoraphobia
- Specific phobia
- Generalized Anxiety Disorder
“Anxiety-like” disorders
- OCD
- PTSD
Type of anxiety disorder characterized by recurrent panic attacks?
Panic disorder
Criteria for panic disorder diagnosis?
- need to have periods in between attacks where patient fears another attack OR does maladaptive things to avoid another one
- Panic can’t be due to a phobia or other disorder
- Must have at least 4 panic symptoms not due to an underlying medical disorder
Generalized worry that occurs more days than not that is disproportionate to the severity of the event that is feared
Generalized Anxiety Disorder
Diagnostic criteria for GAD?
- Excessive anxiety more days than not for 6 months
- Difficulty controlling the anxiety
- Accompanied by at least 3 of the diagnostic symptoms
Unreasonable fear of being out-of-doors, being in a crowd, being in a place where they can’t escape, or may suffer from embarassement?
Agoraphobia
How long does the fear or anxiety need to be present for agoraphobia to be diagnosed?
6 months
Fears of specific objects or situations that go beyond the true threat of the stimulus and cause avoidance and functional impairment?
Specific phobias
Diagnostic criteria for specific phobias? (6)
- exposure to phobia results in immediate fear/anxiety
- phobia actively avoided
- fear is out of proportion
- person recognizes it as excessive
- significantly impacts daily functioning
- Must be present for > 6 months
Persistent (> 6mo.) fear of social or performance situations?
Social anxiety
When does PTSD happen?
- Exposure to actual death, threatened by death, physical or sexual violence, serious injury
- Frequently associated with combat in men
- Frequently associated with abuse in women
Intrusion symptoms of PTSD?
Intrusive, distressing memories, flashbacks, dreams
Avoidance behaviour of PTSD?
- Avoiding situations or events that are associated with the trauma
- Can also involve avoiding people, places, or conversations
Cognitive and mood symptoms of PTSD?
- memory deficits, negative emotions, guilt, shame
- detachment from others, loss of interest in people or activities
Arousal and reactivity symptoms of PTSD?
- Difficulty sleeping, exaggerated startle response
- Anger, irritability, increased risk-seeking behaviour
Definition of an obsession?
intrusive and unwanted repetitive thoughts, urges, or impulses that lead to a marked increase in anxiety or distress
Definition of a compulsion?
repeated behaviours or mental acts that are done in response to obsessions, or in rigid-rule bound ways
Obsessions and compulsions in OCD must take up ________/day or cause what?
1 hour/day; cause significant distress or impairment in social, occupational, or other areas of function
What is it called when patients are aware that their obsessions and compulsions are illogical and not based on fact?
Insight
Other disorders that share a similar neurobiology to OCD?
- hoarding disorder
- skin-picking disorder or trichitomania
- Body dysmorphic disorder
Fear response initial steps?
Activation of locus coeruleus (LC) that releases norepinephrine (NE)
Result of LC activation and increase release of NE?
- Activation of amygdala = emotional fear response
- Activation of hypothalamus = SNS and cortisol release
- Activation of reticular activating system = increased arousal
