- Excessive anxiety/worry about various daily events/activities >6 months - Difficulty controlling the worry - Associated >3 sx: restlessness, fatigue, impaired concentration, irritability, muscle tension, insomnia

Psych 2 Flashcards by Giselle McIntyre

DSM criteria of specific phobia/social anxiety disorder

Persistent, excessive fear elicited by a specific situation or object which is out of proportion to actual danger/threat
Exposure to situation triggers an immediate fear response
Situation of object avoided or tolerated with intense anxiety
Sx cause significant social or occupational dysfunction

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Tx of specific phobia

CBT

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Tx of social anxiety disorder

CBT = Tx of choice
SSRI = 1st line medication if needed
Benzos PRN, Beta blocker

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DSM criteria of selective mutism

Consistent failure to speak in select social situations despite speech ability in other scenarios
Mutism not due to language difficulty or communication disorder
Symptoms cause significant impairement

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Time frame for selective mutism diagnosis

> 1 month

THINK: You SELECT a single (1) choice

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Time frame for specific phobia/social anxiety diagnosis

> 6 month

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Tx of selective mutism

CBT, family therapy

SSRI for anxiety

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Time frame of separation anxiety in children/adolescents and in adults

> 4 weeks in children/adolescent

> 6 weeks in adults

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Tx of separation anxiety

CBT, family therapy

SSRI as possible adjunct

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Somatic sx associated with GAD

Fatigue, muscle tension

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Time frame for diagnosis of GAD

> 6 months

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DSM criteria for GAD

Excessive anxiety/worry about various daily events/activities >6 months
Difficulty controlling the worry
Associated >3 sx: restlessness, fatigue, impaired concentration, irritability, muscle tension, insomnia

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Median age of onset of GAD

30 y/o

But sx of worry begin in childhood

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Tx of GAD

Most effective tx is psychotherapy + pharacotherapy

CBT, SSRI/SNRI, short-term benzo, uncommonly TCA or MAOI

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What are obsessions?

Recurrent, intrusive, undesired, anxiety-provoking thoughts, images, or urges that the patient attempts to suppress, ignore or neutralize by some other thought or action

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What are compulsions?

Repetitive behaviors or mental rituals performed in attempt to relieve obsessive anxiety

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Average age of onset of OCD

20 y/o

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Tx of OCD

Psychopharmacology and CBT (exposure and response prevention)

SSRI, Clomipramine (TCA), atypical antipsychotics

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DSM criteria for body dysmorphic disorder

Preoccupation with one or more perceived defects of flaws in physical appearance that are not observable by or appear slight to others
Repetitive behaviors or mental acts are performed in response to appearance concerns
Causes significant distress or impairment in functioning

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Tx of body dysmorphic disorder

SSRI and/or CBT

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Time frame (onset and duration) of PTSD

Can occur immediately after trauma or have delayed expression

Symptoms last > 1 month

Time frame (onset and duration) of Acute Stress Disorder

Trauma occurred < 1 month ago

Symptoms last < 1 month

Symptoms of PTSD

Recurrent intrusions (nightmares, flashbacks), distress at exposure to cues relating to trauma, avoidance of triggers, dissociative amnesia, negative feelings of self/others/world, self-blame, hypervigilance, exaggerated startle response, irritability/angry outburts, impaired concentration, insomnia

Pharmacologic tx of PTSD

SSRI/SRI
Prazosin (a1 antagonist) = nightmares and hypervigilance
Atypical antipsychotics

Psychotherapy tx of PTSD

Specialized CBT, supportive and psychodynamic therapy

Diagnostic criteria of adjustment disorder

- Emotional or behavioral sx within 3 months in response to an identifiable stressful life even - Sx are not of normal bereavement - Sx resolve within 6 months after stressor has terminated

Subtypes of adjustment disorder

Depressed mood, anxiety, mixed anxiety and depression, disturbance of conduct (such as aggression), or mixed disturbance of conduct and emotions

Tx of adjustment disorder

Supportive psychotherapy, group therapy, occasional pharmacotherapy

What do you call irrational beliefs that one is being persecuted

Delusions of persecution/paranoid delusions

What do you call belief that cues in the external environment are uniquely related to the individual (i.e. TV characters talking directly to me)

Ideas of reference

What do you call belief that one's thoughts can be heard by others

Thought broadcasting

What do you call belief that others thoughts are being placed in one's head

Though insertion

What do you call belief that on has special powers beyond those of a normal person

Delusions of grandeur

What do you call belief that one is guilty or responsible for something (e.g. I am responsible for all world wars)

Delusions of guilt

What do you all belief that on is infected with a disease or has a certain illness

Somatic delusions

Ddx of psychosis

- Psychotic disorder due to medical condition - Substance/medication-induced - Delirium/dementia - Bipolar disorder - Major depression with psychotic features - Brief psychotic disorder - Schizophrenia - Schizophreniform disorder - Schizoaffective disorder - Delusional disorder

Describe delusion vs. illusion vs. hallucination

Delusion = false belief Illusion = misinterpretation of an external stimulus Hallucination = perception in the absence of external stimulus

CNS diseases that can cause psychosis

Cerebrovascular disease, multiple sclerosis, neoplasm, Alzheimers, Parkinson's, Huntingtons, tertiary syphilis, epilepsy (temporal lobe), encephalitis, prion disease, AIDS

Endocrinopathies that can cause psychosis

Addison's, Cushings, hyper/hypothyroidism, hyper/hypocalcemia, hypopituitarism

Time frame of schizophrenia-like disorders

Brief psychotic disorder < 1 month Schizophreniform disorder between 1 and 6 months Schizophrenia > 6 months

DSM for schizophrenia

2 or more of the following for at least one month: - 1. Delusions - 2. Hallucinations - 3. Disorganized speech - 4. Grossly disorganized or catatonic behavior - 5. Negative ssx At least one myst be 1, 2, or 3 Duration > 6 months

Positive sx of schizophrenia

Hallucinations, delusions, bizarre behavior, disorganized speech

Negative sx of schizophrenia

Flat or blunted affect, anhedonia, apathy, alogia, and lack of interest in socialization

Cognitive sx of schizophrenia

Impairments in attention, executive function, and working memory

1st phase of schizophrenia

Prodromal = decline in functioning that precedes the first psychotic episode

2nd phase of schizophrenia

Psychotic = perceptual disturbances, delusions, and disordered thought process/content

3rd phase of shizophrenia

Residual = occurs following an episode of active psychosis. Mild hallucinations or delusions, social withdrawal, and negative sx

Age of presentation of schizophrenia

Men = mid-20s Women = late 20s

Neurotransmitter associated with schizophrenia

Increased dopamine activity

Tx of schizophrenia

1st generation (typical) antipsychotics = Haloperidol, Chlorpromazine, Fluphenazine 2nd generation (atypical) antipsychotics = Aripiprazole, Clozapine, Olanzapine, Quetiapine, Risperidone) Behavioral therapy