SM_105b: Anxiety and Mood Disorders in Children

Question 1

Specific phobia is ___

Answer 1

Specific phobia is fear of a specific thing

• Animals, insects, etc
• Environmenta: thunder, water, heights
• Blood, injection, or other suspected painful event
• Situational: tunnels, bridges, elevators

(70% have another anxiety disordr)

Question 2

Separation anxiety disorder is ____ that can be diagnosed over age ____ and lasts at least ____

Answer 2

Separation anxiety disorder is excessive concern regarding separation from home or attachment figures that can be diagnosed over age 18 years and lasts at least 6 months

Question 3

Generalized anxiety disorder involves ____, ____, and ____

Answer 3

Generalized anxiety disorder involves excessive worry and apprehensiveness, unable to control worry, and impairment or distress

Question 4

Social anxiety disorder is ____ and can be ____ or ____

Answer 4

Social anxiety disorder is fear of social or performance situations and can be specific or generalized

Question 5

Selective mutism occurs in ____ with ____ who ____

Answer 5

Selective mutism occurs in young children with an ability to speak who do not speak in social situations

Not part of another disorder

(Kids with mild variant - single words, soft spoken) may develop language and social skills delay and then receive autism spectrum disorder diagnosis)

Question 6

Panic disorder involves ____, ____, ____, and ____

Answer 6

Panic disorder involves attacks of anxiety, worrying about the next anxiety attack, avoidance behavior related to attacks, and agoraphobia

Question 7

Agoraphobia involves ____

Answer 7

Agoraphobia involves avoiding people or places that may cause panic

(panic disorder)

Question 8

Obsessive compulsive disorder involves ____ that are ____

Answer 8

Obsessive compulsive disorder involves prominent obsessions or compulsions that are impairing / time consuming

• Dirt, germs, other contamination
• Ordering and arranging
• Checking
• Repetitive acts

Question 9

All anxiety disorders involve ____, ____, ____, ____, ____, and ____

Answer 9

All anxiety disorders involve

• Hypervigilance
• Reactivity to novel situations
• Biased interpretation of experiences as threatening
• Avoidance coping
• Catastrophic reactions
• Parental accomodation
• Midline physical symptoms

Question 10

Anxiety presents at age ___

Answer 10

Anxiety presents at age 6-12 years

Question 11

Panic disorder presents at age ____

Answer 11

Panic disorder presents at age 16-25 years

Question 12

Describe course of anxiety

Answer 12

Anxiety course

• Onset in childhood: prepubertal affective illness
• Adolescence: symptoms + accumulated disability
• Young adulthood: symptoms + failure in major roles

Question 13

Some anxiety may morph into ____ in adolescence

Answer 13

Some anxiety may morph into depression in adolescence

Question 14

Treatment targets for anxiety are ____, ____, and ____

Answer 14

Treatment targets for anxiety are anxiety symptoms, accumulated disability (poor adaptation / coping), and maladaptive behaviors (suicidal and self injurious behavior and substance misuse)

Question 15

Anxiety symptoms are treated with ___

Answer 15

Anxiety symptoms are treated with CBT and medication

(anxiety, distress tolerance)

Question 16

Accumulated disability in anxiety (poor adaptation and coping) is treated with ____

Answer 16

Accumulated disability in anxiety (poor adaptation and coping) is treated with life skills training

Question 17

Maladaptive behaviors in anxiety (suicidal and self-injurious behavior and substance misuse) are treated with ____

Answer 17

Maladaptive behaviors in anxiety (suicidal and self-injurious behavior and substance misuse) are treated with behavioral treatments

Question 18

Describe role of environment and genetics in anxiety

Answer 18

Role of environment and genetics in anxiety

• Genetic vulnerability
• Anxiety is self-perpetuating
• Anxiety can propagate from person to person

Question 19

____ is most effective for pediatric anxiety

Answer 19

Combination treatment is most effective for pediatric anxiety

Question 20

____ is the only medication with FDA indication for non-OCD anxiety disorders

Answer 20

Duloxetine is the only medication with FDA indication for non-OCD anxiety disorders (SSNRI)

Question 21

Anxiety triad consists of ____, ____, and ____

Answer 21

Anxiety triad consists of anxious thoughts, anxiety feelings, and anxiety behaviors

(CBT seeks to intervene)

Question 22

Normal human sadness is ____, ____, ____, and ____

Answer 22

Normal human sadness is common, expectable reaction to certain events, can be severe if event is severe, and is time limited but not episodic

(can progress to autonomous, excessive, and disproportionate sadness)

Question 23

Demoralization is ____, ____, ____, and ____

Answer 23

Demoralization is chronic unhappiness due to adverse circumstances, depressive symptoms but not anhedonia, can be severe, and is treated with a change in circumstances

Question 24

Sadness without a cause is ____, ____, ____, ____, and ____

Answer 24

Sadness without a cause

• Depression with anhedonia
• Many physical manifestations
• Disproportionate and unexpected as to cause
• Mood is distinct form normal sandess
• Autonomous course - unaffected by changes in life circumstances

Question 25

Depression is ____ with changes in ____

Answer 25

Depression is depressed / irritable mood with changes in energy, interest, sleep and appetite, motivation, attention and concentration, morbid thoughts, and decreased self-attitude and vital sense

Question 26

Symptoms of depression are ____, ____, ____, ____, and ____

Answer 26

Symptoms of depression are endogenous, anxiety, conduct, negative cognitions, and appetite weight

Question 27

Describe endogenous symptoms of depression

Answer 27

Endogenous symptoms of depression

• Anhedonia
• Fatigue
• Psychomotor retardation
• Social withdrawal
• Depressed mood
• Anorexia
• Decreased weight
• Diurnal mood change
• Hypersomnia

Question 28

Major depressive episode lasts ____

Answer 28

Major depressive episode lasts 7-9 months

Question 29

Minor depressive episode lasts ____

Answer 29

Minor depressive episode lasts > 3 years

Question 30

Most children with depression have ____

Answer 30

Most children with depression have another depressive episode before age 18

(some develop manic depressive illness or other disorders)

Question 31

Majority of depressed teenagers benefit from ____ in 6-9 months

Answer 31

Majority of depressed teenagers benefit from treatment in 6-9 months

Question 32

Teen depression is most effectively treated with _____

Answer 32

Teen depression is most effectively treated with combination of psychotherapy and medications

• Psychological: CBT, interpersonal therapy
• Medications: SSRIs and atypical antidepressants, TCAs and MAO-i’s

Question 33

____ response is better for treating depression

Answer 33

Earlier response is better for treating depression

Question 34

Antidepressants may cause ____ earlier in treatment course or ____ later in treatment course

Answer 34

Antidepressants may cause activation earlier in treatment course or mania later in treatment course