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psych anxiety Flashcards

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1
Q

neurotransmitters in anxiety

A

increased norepi, and decreased GABA and serotonin

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2
Q

anxiety develops more freq in higher socioeconomic groups

A

right

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3
Q

panic attacks

A

peak within 10 minutes and usually last less than 25 min; four of the listed criteria

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4
Q

criteria for panic attacks

A

palpitations, sweating, shaking, shortness of breath, choking sensation, chest pain, nausea or abdominal distress, lightheadedness, depersonalization, or derealization, etc.

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5
Q

panic disorder

A

spontaneos recurrent panic attacks with no obv precipitant; on avg two times per week; can be as infreq as a few times per year

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6
Q

dsm IV criteria for panic disorder- at least one of the attacks must be followed by a min of 1 month of the following

A

persistent concern about another attack, worry about implications of attack, change in behavior related to attacks

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7
Q

panic disorder you must specify

A

whether the attack is with or without agoraphobia

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8
Q

panic attacks may be induced by

A

nicotine, caffeine, hyperventilation

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9
Q

genetics/gender of panic disorder

A

more common in females; very strong genetic component

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10
Q

onset of panic disorder

A

late teens to early thirties, but may occur at any age

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11
Q

prognosis of panic disorder

A

often chronic; relapses common; ten to twenty percent of patients continue to have signif sx that interfere with daily functioning; fifty percent have mild sx; the rest are free of sx after treatment

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12
Q

treatment for panic disorder

A

SSRI (esp paroxetine and sertraline)

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13
Q

how long does tx take to see results?

A

2-4 weeks

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14
Q

dose of SSRI in panic disorders

A

requires higher doses than those needed for depression

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15
Q

length of treatment for panic disorder

A

8-12 mos as relapse is common after discontinuation of therapy

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16
Q

agoraphobia

A

the fear of being alone in public places; can be diagnosed alone or as panid disorder with agoraphobia

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17
Q

when agoraphobia is not assoc with a panic disorder

A

it is usually chronic and debilitating

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18
Q

phobia

A

patient recognizes that the fear is excessive

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19
Q

length of phobia

A

if person is under 18, duration must be at least 6 mos

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20
Q

average age of onset for social phobias

A

mid teens

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21
Q

phobias genders

A

women are twic as likely to have specific phobia as men, but social phobia occurs equally in men and womne

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22
Q

treatment for specific phobia

A

meds are not effective; behavioral therapy (systemic desens) is most effective; a short course of benzos may be used during desensitization

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23
Q

treatment for social phobia

A

Paroxetine (paxol), an SSRI is used for social anxiety disorder; beta blockers are freq used to control sx of performance anxiety

24
Q

def of obsession

A

recurrent and intrusive thought, feeling or idea that is egodystonic

25
Q

def of compulsion

A

conscious repetitive behavior linked to an obsession that, when performed, functions to relieve anxiety caused by depression

26
Q

egodystonic

A

patients wish they could get rid of these symptoms because they cause signif stress in their lives

27
Q

obsessions

A

person attempts to suppress the thoughts; person realizes thoughts are a product of his or her own mind

28
Q

diagnosis of OCD

A

either obsessions or compulsions; person is aware that they are unrealistic and excessive; obsessions cause marked distres, are time consuming or signif interfere with daily functioning

29
Q

onset of OCD

A

early adulthood, and men and women are equally affected

30
Q

OCD is assoc with what other disorders

A

MDD, eating disorders, other anxiety disorders, and OC personality disorder

31
Q

the rate of OCD is hgiehr in patients with first deg relatives who have tourettes syndrome

A

right

32
Q

mechanism

A

assoc with abnormal regulation of serotonin

33
Q

prognosis of OCD

A

usually chronic; about 30% of patients show signif improvement with tx

34
Q

treatment of OCD

A

SSRIs (higher than normal doses may be required to be effective); TCAs are also effective; behavioral tx is as effective as pharmacotherapy but even better in combo

35
Q

behav treatment for OCD

A

exposure and response prevention (ERP); involves prolonged exposure to the ritual-eliciting stumulus and prevention of relieving compulsion

36
Q

last resort for OCF

A

ECT or surgery (cingulotomy)

37
Q

PTSD def

A

response to a catastrophic (life-threatening) experience in which the patient reexperiences the trauma, avoids reminders of the event, and experiences emotional numbing or hyperarousal

38
Q

PTSD length

A

symptoms must be present for at least one month

39
Q

prognosis for ptsd

A

half of patients are sx free after 3 mos of treatment

40
Q

treatment for PTSD

A

SSRIs, TCAs, MAOIs; anticonvulsants for nightmares and flashbacks

41
Q

eye movement desens and reprocessing

A

a non-pharm treatment that can be used for PTSD

42
Q

difference between PTSD and acute stress disorder

A

PTSD- the event could have happened any time in the past and the sx last over a monht; for ASD, the event occurred less than 1 mo ago and sx last less than 1 mo

43
Q

acute stress disorder

A

patient experiences major traumatic event but has anxiety sx for less than 1 mo; sx are similar to PTSD; treatement is same as for PTSD

44
Q

Generalized anxiety disorder DSM 4 criteria

A

excessive worry about daily events and activities (that is difficult to control) for at least 6 mos; must be assoc with at least 3 of the listed criteria

45
Q

criteria for GAD, at least three of

A

restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance

46
Q

GAD epi

A

45% lifetime prevalence; women twice as likely as men; onset before age 20; most have coexisting mental disorder like MD, phobia, or panic disorder

47
Q

prognosis for GAD

A

chronic, with lifelong fluctuating sx in 50% of patientsl the other half will fully recover within a few years of therapy

48
Q

treatment of GAD

A

combo of CBT and pharmacotherapy (SSRIs, buspirone, venlafaxine); if benzos are used, they hsould be tapered off

49
Q

panic attacks are assoc with what med conditions

A

mitral valve prolapse, asthma, pulm embolus, angina, and anaphylaxis

50
Q

characteristic situations avoided in agoraphobia include

A

bridges, crowds, buses, trains,or any open areas outside the home

51
Q

performance anxiety treatment

A

beta blockers

52
Q

systemic desensitization

A

gradual exposure of a patient to the feared object or situation while teaching relax techniques; the opposite, flooding, would be directly confronting the patient with their fear

53
Q

seventy five percent of OCSF patients have both obsessions and compulsion

A

right

54
Q

difference between OCD and OCPD

A

in OCPD, patient is excessively preoccupied with details, lists, and organization and OCPD patients don’t perceive a problem with their sx

55
Q

why should benzos be avoided in the treatment of PTSD

A

high rate of substance abuse

56
Q

in GAD, the anxiety is free floating

A

as opposed to being fixed on a particular person, event, or activity

Psych (23 decks)

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