SM_105b: Anxiety and Mood Disorders in Children Flashcards
Specific phobia is ___
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)
Separation anxiety disorder is ____ that can be diagnosed over age ____ and lasts at least ____
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
Generalized anxiety disorder involves ____, ____, and ____
Generalized anxiety disorder involves excessive worry and apprehensiveness, unable to control worry, and impairment or distress
Social anxiety disorder is ____ and can be ____ or ____
Social anxiety disorder is fear of social or performance situations and can be specific or generalized
Selective mutism occurs in ____ with ____ who ____
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)
Panic disorder involves ____, ____, ____, and ____
Panic disorder involves attacks of anxiety, worrying about the next anxiety attack, avoidance behavior related to attacks, and agoraphobia
Agoraphobia involves ____
Agoraphobia involves avoiding people or places that may cause panic
(panic disorder)
Obsessive compulsive disorder involves ____ that are ____
Obsessive compulsive disorder involves prominent obsessions or compulsions that are impairing / time consuming
- Dirt, germs, other contamination
- Ordering and arranging
- Checking
- Repetitive acts
All anxiety disorders involve ____, ____, ____, ____, ____, and ____
All anxiety disorders involve
- Hypervigilance
- Reactivity to novel situations
- Biased interpretation of experiences as threatening
- Avoidance coping
- Catastrophic reactions
- Parental accomodation
- Midline physical symptoms
Anxiety presents at age ___
Anxiety presents at age 6-12 years
Panic disorder presents at age ____
Panic disorder presents at age 16-25 years
Describe course of anxiety
Anxiety course
- Onset in childhood: prepubertal affective illness
- Adolescence: symptoms + accumulated disability
- Young adulthood: symptoms + failure in major roles
Some anxiety may morph into ____ in adolescence
Some anxiety may morph into depression in adolescence
Treatment targets for anxiety are ____, ____, and ____
Treatment targets for anxiety are anxiety symptoms, accumulated disability (poor adaptation / coping), and maladaptive behaviors (suicidal and self injurious behavior and substance misuse)
Anxiety symptoms are treated with ___
Anxiety symptoms are treated with CBT and medication
(anxiety, distress tolerance)
Accumulated disability in anxiety (poor adaptation and coping) is treated with ____
Accumulated disability in anxiety (poor adaptation and coping) is treated with life skills training
Maladaptive behaviors in anxiety (suicidal and self-injurious behavior and substance misuse) are treated with ____
Maladaptive behaviors in anxiety (suicidal and self-injurious behavior and substance misuse) are treated with behavioral treatments
Describe role of environment and genetics in anxiety
Role of environment and genetics in anxiety
- Genetic vulnerability
- Anxiety is self-perpetuating
- Anxiety can propagate from person to person
____ is most effective for pediatric anxiety
Combination treatment is most effective for pediatric anxiety
____ is the only medication with FDA indication for non-OCD anxiety disorders
Duloxetine is the only medication with FDA indication for non-OCD anxiety disorders (SSNRI)
Anxiety triad consists of ____, ____, and ____
Anxiety triad consists of anxious thoughts, anxiety feelings, and anxiety behaviors
(CBT seeks to intervene)
Normal human sadness is ____, ____, ____, and ____
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)
Demoralization is ____, ____, ____, and ____
Demoralization is chronic unhappiness due to adverse circumstances, depressive symptoms but not anhedonia, can be severe, and is treated with a change in circumstances
Sadness without a cause is ____, ____, ____, ____, and ____
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
Depression is ____ with changes in ____
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
Symptoms of depression are ____, ____, ____, ____, and ____
Symptoms of depression are endogenous, anxiety, conduct, negative cognitions, and appetite weight
Describe endogenous symptoms of depression
Endogenous symptoms of depression
- Anhedonia
- Fatigue
- Psychomotor retardation
- Social withdrawal
- Depressed mood
- Anorexia
- Decreased weight
- Diurnal mood change
- Hypersomnia
Major depressive episode lasts ____
Major depressive episode lasts 7-9 months
Minor depressive episode lasts ____
Minor depressive episode lasts > 3 years
Most children with depression have ____
Most children with depression have another depressive episode before age 18
(some develop manic depressive illness or other disorders)
Majority of depressed teenagers benefit from ____ in 6-9 months
Majority of depressed teenagers benefit from treatment in 6-9 months
Teen depression is most effectively treated with _____
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
____ response is better for treating depression
Earlier response is better for treating depression
Antidepressants may cause ____ earlier in treatment course or ____ later in treatment course
Antidepressants may cause activation earlier in treatment course or mania later in treatment course
