V - Anxiety Disorders (Pt II)

Question 1

Generalized Anxiety Disorder

Answer 1

Chronic, excessive, unreasonable anxiety about many aspects of life. More days than not for 6 months Must be experienced as difficult to control. Worrying cannot be exclusively related to another disorder, such as worry over having a panic attack.

Question 2

GAD Individual/Personality Characteristics

Answer 2

Future-oriented mood state of anxious apprehension, tension, uneasiness. Vigilance for threat, engagement in avoidance activities such as procrastinating and checking, constant worry -> discouragement, difficulties making decisions, rarely experience present moment.

Question 3

GAD co-occurence with other Axis I

Answer 3

Often co-occurs w/ other anxiety disorders, PTSD, Mood Disorders, substance abuse

Question 4

GAD Psychological Factors

Answer 4

Psychoanalytic - conflict between id and ego. Perceptions of uncontrollability. Need mastery - history of control over environment. Worry plays central role and has negative consequences. Cognitive biases for threatening cues.

Question 5

GAD Biological Causal Factors

Answer 5

Modestly heritable. GABA, serotonin, norepinephrine all play role. Corticotropin-releasing hormone system. GAD and MDD link. Neurobiological differences between anxiety and panic.

Question 6

GAD Treatments

Answer 6

Medications include Anxiolytics (benzodiazepines), Antidepressants. Cognitive-behavioral therapy increasingly effective, but one of the hardest anxiety disorders to treat.

Question 7

OCD and Related Disorders (5)

Answer 7

(1) OCD
(2) Hoarding
(3) Excoriation
(4) Body Dysmorphic Disorder
(5) Trichotillomania

Question 8

Obsessive-Compulsive Disorder

Answer 8

Recurring intrusive thoughts, impulses, images - disturbing, inappropriate, uncontrollable. Usually accompanied by compulsive behaviors to neutralize obsessive thoughts or prevent dreaded event/situation

Question 9

OCD - Most common obsessions

Answer 9

Contamination, fear of harming self or others, lack of symmetry, pathological doubt.

Question 10

OCD - Most common compulsions

Answer 10

Cleaning, checking, repeating, ordering/arranging, counting

Question 11

OCD Comorbidity

Answer 11

Frequently comorbid w/ anxiety disorders, mood disorders. Co-occurs with body dysmorphic disorder sometimes.

Question 12

Question - must answer

Answer 12

Is OCD considered an anxiety disorder? DSM IV vs V classification?

Question 13

OCD Psychological causal factors

Answer 13

Learned behavior - Mowrer’s two-process theory of avoidance learning. Classical conditioning, reinforcement. Concerned with preparedness. Cognitive: thought suppression may increase frequency; inflated sense of responsibility; cognitive biases and distortions

Question 14

OCD Biological Causal Factors

Answer 14

Moderately heritable. Abnormalities in function may include cortico-basal-ganglionic thalamic circuit. Serotonin

Question 15

Behavioral/cognitive behavioral treatments for OCD

Answer 15

Exposure and response prevention most effective. Gradually move through hierarchy of stimuli - start small.

Question 16

Medications for OCD

Answer 16

Meds that affect serotonin helpful in some individual, but relapse rates are high when meds are continued

Question 17

Surgery for OCD

Answer 17

Neurosurgical techniques used for intractable OCD

Question 18

Body Dysmorphic Disorder

Answer 18

Previously classified as Somatoform Disorder. Obsessed with imagined or actual flaw in appearance so far to believe they are disfigured. Compulsive checking. Avoidance of behaviors so people will not see defect. Reassurance only provides temporary belief.

Question 19

BDD vs OCD and ED

Answer 19

BDD more convinced that obsessive beliefs are accurate than OCD, but serotonin also involved. BDD look normal but distressed; ED/AN emaciated and satisfied with this aspect of appearance.

Question 20

BDD Biopsychosocial causal factors

Answer 20

Serotonin, PFC deficits. Biased attention and interpretation about body. Family emphasis on attractiveness, teasing.

Question 21

BDD treatment

Answer 21

Antidepressants - SSRIs. CBT - exposure/response prevention - prevent checking. Wear something that highlights defect.

Question 22

Hoarding Disorder

Answer 22

Acquire and fail to discard many possessions of dubious value. Often more disabled in terms of work, social life. Risk for fire, falling, sanitation, health problems. Medications and behavioral therapy less effective than OCD. May be neurologically distinct.

Question 23

Trichotillomania

Answer 23

Urge to pull hair from anywhere on body. Tension followed by temporary relief. Usually when person is alone or with family members.