L6 - Anxiety part 2 Flashcards
What is separation anxiety disorder/
- Developmentally INAPPROPRIATE and EXCESSIVE FEAR or anxiety concerning separation from attachment figure
- 3 of:
- reluctance/refusal to go out, away from home because of separation fear.
- reluctance about being alone without attachment figure
- refusal to sleep away from home
- repeated night mares
- repeated complaints about physical symptoms
Separation anxiety onset?
can be either acute or insidious - often develops following a life stressor
Separation anxiety and comorbidities?
as high as 73% in young people with panic attacks
Separation anxiety and gender differences?
More common in girls.
Possibly symptoms don’t manifest in the same way in boys, so we don’t recognise it - maybe they receive more encouragement to be independent.
consequences of separation anxiety?
- limited independent activites away from home
- miss out on school camps/sleep overs with friends
- difficulty with appropriate separation as they mature.
Link between childhood SA and panic attacks?
- Strong genetic link between childhood SAD and childhood onset PA.
- Both disorders are associated with heightened sensitivity to inhaled CO2 - and can be influenced by childhood parental loss (early traumatic event)
what is panic?
An abrupt experience of intense fear or acute discomfort accompanied by physical symptoms that include…
- palpitations
- chest pain
- shortness of breath
- dizziness/feeling faint
DSM Panic disorder symptoms?
Somatic:
- increased HR
- shortness of breath
- chest pain
- choking sensation
- nausea
- dizziness
- sweating
- trembling
- numbness/tingling
- hot flashes/chills
- depersonalisation
Cognitive:
- fear of dying
- fear of losing control
1 Attack followed by 1 month of persistent change of behaviour to avoid another panic attack
What are the consequences of suffering a panic attack?
- worry about having another panic attack
- avoiding situations where they have experienced an attack (Safety behaviours), leading to avoidance of leaving home (agoraphobia).
Describe the biology of panic.
Fear leads to adrenaline release and activation of sympathetic NS.
This increases HR, hyperventilation, muscle tension.
Creates light headedness due to less CO2 in lungs, tingling, numbness… leading to MORE PANIC
leading to MORE fear..
Risk Factors for panic?
- Genetics
- Abnormally sensitive fear network
- major life stressors
- a history of sexual or physical abuse in childhood
Some things that may contribute to panic?
- CNS stimulants: caffeine, amphetamines, cocaine
- withdrawal from CNS depressants: alchohol
- medical conditions: hyperthyroidism, arrhythmias
Describe the cognitive model for panic.
- Panic attacks come from CATASTROPHIC MISINTERPRETATION of bodily or mental events.
- Vicious cycle of events is triggered - associated with rising levels of anxiety/panic
internal/external trigger –> perceived threat –> Anxiety –> physical/cognitive symptoms –> avoidance/safety behaviours –> symptoms misperceived as physical illness –> anxiety…-> more cog/physical symptoms
Subtypes of panic attacks?
- Situationally-bound/cued
- Unexpected/uncued - can happen even in sleep.
- Situationally predisposed.
Peak age onset for panic disorder?
15-25 years
- age of gaining independence/finding yourself