Kohlenberg: Anxiety Disorders, PTSD

Question 1

Marked fear about a specific object or situation (flying, heights, animals, injections, blood).
Lasting over 6 months
Prevalence: 12 month, US, 7-9%
Etiology: After a trauma, sometimes

Answer 1

Specific phobia

Question 2

How to treat specific phobia?

Answer 2

exposure to the feared stimulus thru in-session exercises or actually encountering the stimulus, which leads to systematic desensitization

Question 3

Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others.
Such as talking, meeting unfamiliar people, being observed, performing.
The social situations are avoided
12 month prevalence, 7%

Answer 3

Social anxiety disorder

**third largest mental health problem in the world today

Question 4

Recurrent, unexpected panic attacks.  Intense fear, reaches a peak within minutes, can experience 4 or more of the following:
Palpitations, accelerated heart rate
Sweating
Trembling, shaking
Chest pain
Nausea
Chills
Paresthesias
Derealization
Fear of losing control or going crazy
Fear of dying
Dizzy

Answer 4

Panic disorder

Question 5

Treatment for panic attacks?

Answer 5

exposure
interoceptive exposure: increasing heart rate, hyperventilation, inducing dizziness
then, teach relaxation skills, breathing, imagining a safe place

Question 6

Marked fear or anxiety about two or more of the following:
Using public transportation
Being in open spaces
Being in enclosed spaces
Standing in line or being in a crowd
Being outside of the home alone
And the individual avoids these situations

Answer 6

agoraphobia

Question 7

Agoraphobia is often preceded by (blank)

Answer 7

panic attacks

Question 8

Treatment for agoraphobia?

Answer 8

exposure

Question 9

Excessive anxiety and worry (apprehensive expectation) about a number of events or activities, occurring more days than not for at least six months.
Difficulty controlling worry
At least 3 specific anxiety symptoms (restlessness, fatigued, difficulty concentrating..)
Not consistent with other anxiety disorder
Anxiety interferes with person’s life
Anxiety is not due to a substance
Causing clinically significant distress

Answer 9

generalized anxiety disorder

Question 10

recurrent and persistent thoughts, urges or images, they are intrusive and unwanted, and cause marked distress.
The individual tries to ignore or suppress them, or to neutralize them by another thought or action.

Answer 10

obsessions

Question 11

Repetitive behaviors or mental acts, that the person feels driven to perform in response to an obsession
This is to prevent or reduce anxiety

Answer 11

compulsions

Question 12

What is the suicide risk for patients with OCD?

Answer 12

50% of these patients have suicidal thoughts; 25% of these patients attempt suicide

Question 13

Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.
Repetitive behaviors (mirror checking, excessive grooming, skin picking…)
Preoccupation causes distress

Answer 13

body dysmorphic disorder

Question 14

Persistent difficulty discarding or parting with possessions, regardless of their actual value.
This is due to a perceived need to save items and to distress associated with discarding them.
Clinically significant distress
More common in older adults
Comorbidity: 75% have a comorbid mood or anxiety disorder (MDD, social phobia, and GAD, OCD)

Answer 14

hoarding disorder

Question 15

How to treat pretty much all of these disorders?

Answer 15

exposure!!!!

Question 16

How can you treat OCD in therapy?

Answer 16

have the person talk about their obsession until they are so sick of talking about it; you could have them write about it for a long time

in time, the anxiety associated with the thought will be decreased