SM_115b: Anxiety Disorders Flashcards

1
Q

Anxiety disorders are ____

A

Anxiety disorders are excessive, persistent, and unfounded feelings of nervousness interfering with normal daily activities and creating distress

(cognitive and somatic symptoms)

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2
Q

Pyschoanalytic theory of anxiety ____, ____, and ____

A

Pyschoanalytic theory of anxiety

  • Anxirty is a signal of danger / conflict in unconscious
  • Incomplete repression
  • Does not differentiate between normal and pathological
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3
Q

Behavioral perspectives of anxiety indicate ____

A

Behavioral perspectives of anxiety indicate anxiety results from negative reinforcement (operant conditioning)

(also classical conditioning)

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4
Q

Cognitive theory of anxiety states anxiety results from ____, including ____ and ____

A

Cognitive theory of anxiety states anxiety results from inaccurate thinking, including overestimation of threat and underestimation of control

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5
Q

Physiological explanation of anxiety is that anxiety is ____

A

Physiological explanation of anxiety is that anxiety is a response to a peripheral phenomenon

  • Physiologic signs associated with release of epinephrine
  • Increased sympathetic tone, adapt more slowly to repeated stimuli, respond excessively to moderate stimuli
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6
Q

Anxiety response arises from the same nervous circuit as the fear response, in which the ____

A

Anxiety response arises from the same nervous circuit as the fear response, in which the amygdala plays a large role

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7
Q

In anxiety, GABA may be ____

A

In anxiety, GABA may be lacking

(GABA is inhibitory)

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8
Q

Describe neurotransmitters involved in anxiety

A

Neurotransmitters involved in anxiety

  • GABA: high concentrations in CNS, major inhibitory
  • Serotonin: cell bodies in raphe nuclei, may attenuate activity of the locus coeruleus
  • NE: poorly regulated system with bursts of activity, majority of noradrenergic neurons in the CNS
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9
Q

Anxiety disorders include ____, ____, ____, ____, ____, and ____

A

Anxiety disorders include

  • Panic
  • Agoraphobia
  • Social phobia
  • Specific phobia
  • OCD
  • GAD
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10
Q

Obsessions are ____

A

Obsessions are recurrent, persistent thoughts, images, or impulses experienced as intrusive and unwanted, usually causing marked distress

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11
Q

Compulsions are ____

A

Compulsions are repetitive behaviors or mental acts which a person feels driven to perform in response to obsession or rigid rules to reduce their anxiety

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12
Q

Describe DSM-5 criteria for OCD

A

OCD DSM-5 criteria

  • Presence of obsessions, compulsions, or both
  • At some point in the illness, individual has relealized obsessions or compulsions are excessive / unreasonable
  • Symptoms are time-consuming (> 1 hr/day) or cause significant distress or impairment
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13
Q

Half of people with OCD have ____ obsessions

A

Half of people with OCD have uncleanliness obsessions

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14
Q

OCD has onset in ____ and recurs in ____

A

OCD has onset in adolescence and recurs in early adulthood

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15
Q

OCD has a ____ etiological component

A

OCD has a genetic etiological component

(linked to Tourette Syndrome, occurrence in Syndenham’s chorea and PANDAS)

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16
Q

In OCD, there is increased activity in the ____, ____, and ____

A

In OCD, there is increased activity in the cingulate cortex, caudate nucleus, and prefrontal cortex

17
Q

Panic disorder diagnosis requires ____, with ____ and ____

A

Panic disorder diagnosis requires a discrete period of intense fear / discomfort, with at least 4 of the following developing abruptly and peaking within 10 minutes

18
Q

Describe DSM-5 criteria for panic disorder

A

Panic disorder DSM-5 criteria

  • Recurrent, unexpected panic attacks
  • ≥ 1 of the attacks has been followed by ≥ 1 month of either: persistent concern about additional attacks or their consequences (heart attack, going crazy), maladaptive change in behavior related to attacks (avoidance)
19
Q

Panic disorder onset is typically ____ and is often comorbid with ____

A

Panic disorder onset is typically in adolescence to 30s and is often comorbid with major depression / other anxiety disorderr / somatization disorder / psychoactive substance use disorders

20
Q

Panic disorder exhibits ____

A

Panic disorder exhibits familial aggregation (massively elevated risk by genetics)

21
Q

Describe DSM-5 criteria for agoraphobia

A

Agoraphobia DSM-5 criteria

  • Marked fear / anxiety about ≥ 2: using public transportation, being in open spaces, being in enclosed spaces, standing in line or being in a crowd, being outside of the home alone
  • Situations are feared / avoided because escape is difficult, help is not available if panic symptoms develop, ir fear of other incapacitating / embarrasing symptoms
  • Situation almost always provokes fear / anxiety
  • Fear / anxiety out of proportion
  • Fear / anxiety is persistent (≥ 6 months)
22
Q

Describe DSM-5 criteria for specific phobia

A

Specific phobia DSM-5 criteria

  • Marked fear / anxiety about a specific object / situation
  • Object / situation almost always provokes immediate fear / anxiety
  • Object / situation is actively avoided or endured with intense fear or anxiety
  • Fear / anxiety is persistent (typically > 6 months)
  • Fear, anxiety, or avoidance cause distress or impairment
23
Q

Specific phobia has ____ onset and is more common in ____

A

Specific phobia has bimodal onset and is more common in women

24
Q

Describe DSM-5 criteria for social anxiety disorder

A

Social anxiety disorder DSM-5

  • Makred fear / anxiety about one or more social situations in which individual is exposed to possible scrutiny of others
  • Individual fears he/she will show anxiety symptoms and be negativwly evaluated
  • Social situations almost always provoke anxiety
  • Social situations are avoided or endured with intense fear / anxiety
  • Fear / anxiety is out of proportion
  • Fear / anxiety / avoidance is persistent (> 6 months)
  • Fear / anxiety / avoidance causes clinically significant distress or impairment
25
Q

Describe DSM-5 criteria for generalized anxiety disorder

A

Generalized anxiety disorder DSM-5 criteria

  • Excessive anxiety and worry, more days than not, for ≥ 6 months, ahout several events / activities
  • Difficult to control worry
  • ≥ 3 symptoms: restlessness / feeling on edge, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance
  • Symptoms cause clinically significant distress or impairment
  • Not due to substance / general medical condition
26
Q

Onset of generalized anxiety disorder is typically ____ with ____

A

Onset of generalized anxiety disorder is typically early with fluctuating course

(genetic factors overlap substantially with those influencing liability for major depression)

27
Q

Primary treatment for anxiety disorders is ____

A

Primary treatment for anxiety disorders is psychotherapy

(antidepressants, other medications, neurosurgery, and TMS may also be used)

28
Q

___ is used to treat anxiety-related insomnia

A

CBT is used to treat anxiety-related insomnia

29
Q

____ is used to treat specific phobia

A

Desensitization is used to treat specific phobia

30
Q

____ is used to treat OCD

A

Response prevention / flooding is used to treat OCD

31
Q

____ can block panic attacks in anxiety and treat comorbid depression, of which ____ are first line

A

Antidepressants can block panic attacks in anxiety and treat comorbid depression, of which SSRIs are first line

32
Q

OCD has a more ____ than dimensional nature and is rare

A

OCD has a more categorical than dimensional nature and is rare