Week 4 - Anxiety Flashcards
What are the shared features among those with anxiety disorders?
Preoccupation with, or persistent avoidance of, thoughts or situations that provoke fear/anxiety
What are the considerations for a diagnosis of anxiety-related disorders? (x5)
Pattern of symptoms: Nature Frequency Severity Duration
What are the differences between anxiety and fear? (x3)
Anxiety is anticipation of future problems - fear is reaction to immediate danger
Anxiety is general/diffuse emotional reaction - fear quickly builds intensity
Anxiety is disproportionate - fear helps behaviour response to threat
When does anxiety become unhelpful (rather than warning us of threats/prompting adaptive behaviour)? (x3)
When person allows it to limit living, by avoiding things that elicit anxiety
Usually occurs when anxiety is very intense
Resulting dysfunction may warrant an anxiety-related disorder diagnosis
What is the prevalence of anxiety disorders? (x4)
One of most common in Oz - more than double mood disorders
Women 50% more likely than men
Across all ages, but decrease with age
PTSD and social phobia most common
What are 3 categories of anxiety-related disorders in the DSM?
Anxiety Disorders
Obsessive-compulsive & Related Disorders
Trauma- & Stressor-related Disorders
What are the features of anxiety-related disorders? (x7)
Physiological symptoms Avoidance symptoms Disturbances in attention Intrusive thoughts Attentional biases Re-experiencing symptoms
Subjective feeling of Anxiety
What are 5 anxiety disorders listed in the DSM?
Specific Phobia Social Anxiety Disorder (Social Phobia )Panic Disorder Agoraphobia Generalised Anxiety Disorder
What are the essential features of specific phobias? (x4)
Marked fear/anxiety about /specific object/situation
Exposure to phobic stimuli invariably provokes immediate fear/anxiety
Phobic stimuli actively avoided/endured with intense fear/anxiety
Fear/anxiety is out of proportion to actual danger
What is the prevalence of specific phobias? (x3)
7-9% prevalence rate
Females more affected 2:1
Rates/gender balance vary across stimuli
What are 5 specific phobia specifiers?
Animal Natural environment Blood/Injection injury Situational - bridges, enclosed space Other - choking, costumes
Describe the case study of 12yo boy who developed dentophobia (x5)
Reported traumatic experience
Anxiety grew and generalized
‘Fear of catastrophe’ - of panic attacks
Anticipatory anxiety
Overwhelmed by his dental problems
Specific stimuli perceived as real threat to personal safety
Describe the fear hierarchy developed to treat 12yo boy who developed dentophobia (x5)
Drill, Panic attacks, Sound, Atmosphere, Chair, Embarrassment, Fear of treatment, Fear of no treatment, Injection, Everybody watching over me
What are the characteristics of social anxiety disorder? (x2)
Marked fear/anxiety about one/more social/performance situations in which person exposed to possible scrutiny
Fears he/she will act/show anxiety that will be negatively evaluated (humiliation, embarrassment, rejection, offend)
What is the prevalence of social anxiety disorder? (x1)
5%
What are the clinical features of social anxiety disorder? (x11)
Belief that others see them as inept, stupid, foolish
Often vicious cycle of anxiety -social deficits - anxiety
Hypersensitive to criticism
Non-assertive
Low self-esteem
Comorbid anxiety common
Safety behaviours common
Avoiding eye contact
Talking to ‘safe’ people
Covering face with hair, hands
Take ‘observer perspective’ vantage point for social memories
What information processing biases are present in clinical social anxiety disorder? (x3)
Interpretations of social events
Detection of positive responses of others
Anticipatory and post-event processing
What are the DSM criteria for panic disorder? (x5)
Recurrent unexpected panic attacks
At least one has been followed by one month or more of the following:
*Persistent concern about additional attacks or their consequences
*Significant maladaptive change in behaviour (avoidance)
Rule out specific phobia/other conditions/attacks that are the direct result of a substance (i.e., drug abuse)
What is the prevalence of panic disorder? (x1)
But…(x2)
2.6 %
3 –5% of population experience panic attacks without meeting criteria
*Panic attacks do not equal panic disorder
Define a panic attack (x14)
Abrupt surge of intense fear/discomfort, in which 4+ of the following develop rapidly - peaks within minutes:
Palpitations/pounding heart Sweating Trembling/shaking Sensation of shortness of breath Feelings of choking Chest pain or discomfort Nausea or abdominal distress Dizziness/lightheadedness Chills/Hot flushes Paresthesias (numbness/tingling) Derealisation (unreality)/Depersonalization (detached) Fear of losing control or going crazy Fear of dying
What are the essential features of agoraphobia? (x7)
Marked fear or anxiety about 2+ of the following:
- Using public transport
- Being in open spaces
- Being in enclosed places
- Standing in line or being in a crowd
- Being outside of the home alone
Anxiety about being in places from which escape might be difficult or embarrassing in the event of having a panic attack
What is the prevalence of agoraphobia? (x1)
3%
What are the DSM criteria for generalised anxiety disorder (GAD)? (x10)
Excessive anxiety and worry about numerous events or activities
Difficulty in controlling worry
Experience 3+ of the following:
*Restlessness/on edge
*Easily fatigued
*Difficulty concentrating / mind blank
*Irritability
*Muscle tension
*Sleep disturbance
Anxiety, worry or physical symptoms cause significant interference
What is the prevalence of GAD? (x1)
3%
What characteristics are displayed by those with GAD? (x3)
Less tolerance for uncertainty than others
Underestimate ability to cope with difficult/ambiguous circumstances
Overestimate likelihood of negative consequences
What life experiences may contribute to development of GAD? (x1)
Early experiences of uncontrollability and unpredictable negative events
Name 6 additional anxiety disorders
Separation anxiety disorder
Selective mutism
Substance / Medication Induced Anxiety Disorder
Anxiety Disorder Due to another medical condition
Other specified anxiety disorder
Unspecified Anxiety Disorder
Name 8 disorders related to OCD
Body dysmorphic disorder - fixation on imperfection
Hoarding disorder
Trichotillomania - hair pulling
Excoriation - skin picking
Substance/medication-induced obsessive-compulsive and related disorder
Obsessive-compulsive and related disorder due to another medical condition
Other specified obsessive-compulsive & related disorder
Unspecified obsessive-compulsive & related disorder
Describe the obsessions in OCD (x5)
Thoughts, images or impulses
Repetitive, intrusive - uncontrollable (rebound effects)
Not just excessive worries about real life problems
Cause anxiety or distress
Compel person to ignore, suppress, neutralise obsessions in some way