Problem 2 Flashcards
1
Q
Shared Features of Anxiety Disorders
A
- chronic worry
- certain response patterns: i.e. escape/avoidance, negative self- appraisals, rapid breathing and tremors
2
Q
Age of onset of anxiety disorders
A
- separation anxiety, selective mutism and specific phobias are the earliest occurring
- onset of GAD is 8-10 years
- Social anxiety disorder and panic disorder generally occur around adolescence
3
Q
Separation Anxiety Disorder (SAD)
A
- excessive worry about separation from significant caregivers of home, lasting at least 4 weeks and causing significant distress and impairment socially and academically
- distress and worry about separation from caregiver or potential harm to caregiver, preoccupation with future adverse events causing separation from caregiver, nightmares, somatic complaints when separation is anticipated
-occurrence before age 6 is early onset, manifestation is usually before age 18 - more common in females
- precursor to increased risk of later depression, anxiety disorders, panic attacks and agoraphobia for females in adulthood
- 80% of children with SAD had mothers with history of anxiety disorders, overprotectiveness and reinforcement of child’s avoidance behaviours
- cognitive behavioural interventions adopted specifically for children with anxiety disorders (coping cat) are effective in reducing anxiety
4
Q
Selective Mutism
A
- reluctance to verbalize when expected in specific situations where speaking is anticipated, for eat least one month
- not the behavioural response of weak language skills or a speech problem as verbalizing is not an issue when in the presence of familiar territory or individuals
- onset is associated with starting school (5 yrs)
- most outgrow it, symptoms can manifest as social anxiety with age
- comorbidity with speech and language disorders
- risk factors include being prone to negative affectivity (neuroticism), behavioural inhibition, parental history of social anxiety or shyness
- limited research due to extremely low prevalence
- behavioural methods have been effective in treatment (shaping, modeling, systematic desensitization)
5
Q
Phobia
A
- persistent, significant fear of an object or place that does not have a reasonable basis and exposure can cause significant somatic responses or emotional responses in children
- older children and adults will be aware that it is unreasonable but younger children will usually not
- immediate fear, anxiety, avoidance, excessive responses out of proportion to the danger assessed, persistence (i.e. persistent worrying)
- 15% of children who are referred for other anxiety disorders have phobias, 15% of adolescents and 5% of young children have phobias
- girls are reportedly more fearful than boys
6
Q
Social Anxiety Disorder Symptoms
A
- pervasive fear of embarrassment or humiliation that often leads to avoidance of social or performance situations that cause significant distress or impairment
- anxiety can be evident in situations where the individual feels like they are being evaluated or scrutinized
- reactions to social anxiety are avoidance and escape behaviours, negative self-appraisals and increased physiological arousal
- social skills are often poor
7
Q
Social Anxiety Disorder Info
A
- prevalence is 3-13%, 1-2% in children, 7% in adolescents
- common comorbid disorders are GAD and separation anxiety disorder
- onset is between 8-15 years
- social anxiety disorder is a predictor of school dropout, decreased quality of life and depression later in adulthood
- BI (behavioural inhibition) temperament, familial history of anxiety, parent communication and attachment and parenting style have been attributed as causes
8
Q
Treatment of Social Anxiety
A
- CBT with an added component of social skills training which focuses on skill awareness, situational awareness, practice and roleplay and eventual in-vivo application using participant modeling techniques
9
Q
Panic Disorder Symptoms
A
- panic attacks result from intense, overwhelming and inescapable fear that affects one’s thoughts, feelings and sensations
- these attacks are sudden, acute and include at least 4 somatic symptoms (sweating, palpitations, etc)
- can be unexpected or triggered by situations, can accompany any anxiety disorder
- 16% of adolescents report experiencing one panic attack with females reporting twice as many as males
- can be defined as the fear of having a panic attack after experiencing repeated panic attacks
- it is considered a disorder if there is persistent fear of having another attack and/or if the attack results in significant behavioural change resulting from attempts to avoid having another panic attack (i.e. avoidance measures)
10
Q
Panic Disorder Info
A
- prevalence rate of 3.5% with onset between late adolescence and early 30s
- if arises in adolescence the course tends to be chronic and associated with comorbid disorders such as depression, anxiety and bipolar disorder
- highly heritable
- irregular activity of norepinephrine has been implicated in the onset of panic attacks
11
Q
Treatment of Panic Disorder
A
- cognitive theorists suggest that panic attacks can result from a misinterpretation of bodily sensations (anxiety sensitivity)
- antidepressant drugs that work to restore norepinephrine levels and CBT focused on coping skills (cognitive appraisals, educational awareness and situational exposure) such as the Panic Control Treatment for Adolescents have been successful in treatment
12
Q
Agoraphobia
A
- extreme or irrational fear of entering public places, leaving one’s home and being in places where escape would be difficult
- these situations provoke persistent and out of proportion fear and anxiety
- 1.7% prevalence rate with females being twice as likely to be diagnosed
- onset is late adolescence or early adulthood
- highly heritable and associated with experiencing negative or stressful life events/situations
- highly comorbid with panic attacks and panic disorder
- family situations are often described as lacking in warmth and high on parental overprotection (authoritarian)
- treatment is similar to other phobias using systematic desensitization, participant modeling and reinforced practice
- it is new and made its debut in the DSM-V
13
Q
GAD symptoms
A
- uncontrollable worries that generalize across concerns about family, friends, school, health and performance issues
- DSM does not distinguish between GAD in adults and children but for children the diagnosis only requires one additional symptom
- GAD is often missed in children because of their overly conforming and hard working nature
14
Q
GAD info
A
- onset is early (8-10 years)
- 70% of young children have comorbid GAD and SAD
- adolescents with GAD often have depression
- quite heritable
- self-blame, negative information appraisal and negative focus are key features
- anxious parents may have modeled anxious behaviours in their children with GAD
- treatment is CBT (coping cat) for both child and parent so parent can model healthier behaviour
15
Q
OCD and Related disorders
A
- OCD involves obsessive thoughts which drive compulsive behaviours which are attempts to neutralize the anxiety caused by the obsessive thoughts
- BDD: obsession with thoughts of one or more flaws in appearance
- Hoarding: need to preserve and not dispose of possessions even if useless
- Trichotillomania (hair picking) and excoriation (skin picking) involve behaviours centered on the body
- disruptive to daily life
16
Q
OCD info
A
- 1% prevalence rate
- more females but males have an earlier onset
- hoarding more common in adults but can appear in early adolescence
- little difference between men and women for BDD
- trichotillomania and excoriation have prevalence rates of 1-2% and symptoms are more common in females
17
Q
Risks of OCD
A
- family history of tourettes
- parental modeling
- low levels of serotonin
18
Q
Treatment of OCD
A
- based on behavioural models
- ERP: one is exposed to anxiety situation while attempting to block the response to develop tolerance and greater ability to cope with other similar circumstances
- family-based CBT approaches like FOCUS ( freedom from obsessions and compulsions using special tools)
