Week 4: Anxiety-Related Disorders Flashcards
What is the difference between fear and anxiety?
Fear is a stress response to a real, immediate danger, whereas anxiety is a stress response from just thoughts. Fear usually builds quickly in intensity, and helps motivate behavioural responses to real threats. Anxiety is associated with anticipation of future problems, can involve more general or diffuse emotional reactions, and the emotional experience is out of proportion to the threat.
Why does anxiety happen?
Anxiety is a signal that threat is imminent, and both cues us to attend to important stimuli and signals for us to activate protective responses.
True of False: Anxiety can be helpful
True
When is anxiety unhelpful?
When it restricts/impairs living. This usually occurs when anxiety is very intense/long lasting/out of proportion with the threat. This resulting dysfunction may then warrant an anxiety-related disorder diagnosis.
What are some commonalities between anxiety-related disorders?
Features of excessive fear and anxiety; excessive, persistent responses; beyond developmentally appropriate, negative impact on life
What are some features of anxiety-related disorders?
Subjective feeling of anxiety; threat appraisals/expectation of disaster, physiological symptoms; avoidance symptom; differences in thinking/attention
In the DSM-5-TR, what are the most common disorders under the classification of anxiety disorders?
Specific phobia, social anxiety disorder, panic disorder, agoraphobia, generalised anxiety disorder
What are some of the essential features of specific phobia in the DSM-5-TR?
Marked fear of anxiety about a specific object or situation
Exposure to the phobic stimuli almost always provokes immediate fear or anxiety
Phobic stimuli is actively avoided or endured with intense fear or anxiety
Fear or anxiety is out of proportion to the actual danger posed and to the sociocultural context
The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more
Causes clinically significant distress or impairment in social, occupational or other important areas of functioning
What is the prevalence rate for specific phobia?
7-9% - vary across stimuli
What are specific phobia specifiers?
Animal, natural environment, situational, blood-injection injury, or other (e.g. vomiting, choking)
What are essential features of social anxiety disorder?
Marked fear or anxiety about one or more social situations in which the person is exposed to possible scrutiny by others
Fears that they will act in a way or show anxiety that will be negatively evaluated (humiliation, embarrassment, rejection, offend)
Social situations almost always provoke fear or anxiety
What is the prevalence rate of social anxiety?
7%
What are some clinical features that can be linked with anxiety?
Belief that others see them as inept, stupid, foolish; avoidance; safety behaviours; pre- and post- analysis of event; hypersensitive to criticism; focus on internal sensations; non-assertive behaviour; low self esteem
What is the primary criteria for panic disorder?
Recurrent unexpected panic attacks
At least one attack has been followed by one month or more of the following: persistent concern about additional attacks or their consequences; significant maladaptive change in behaviour
Rule out specific phobia/other conditions/attacks that are the direct result of a substance
What is the criteria for panic attacks in the DSM-5-TR?
An abrupt surge of intense fear or discomfort, that reaches peak within minutes during which four (or more) occur:
Palpitations/pounding heart or accelerated heart rate
Sweating
Trembling/shaking
Sensation of shortness of breath or smothering
Feelings of choking
Chest pain or discomfort
Nausea or abdominal distress
Feeling dizzy, unsteady, light-headed or faint
Chills or heat sensations
Paresthesias (numbness/tingling)
Derealisation (unreality)/Depersonalization (detached from one self)
Fear of losing control or “going crazy”
Fear of dying
What are the essential features of agoraphobia?
Marked fear or anxiety about two (or more) 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 because of thoughts that escape might be difficult or help not available in the event of panic-like or other incapacitating or embarrassing symptoms
Almost always provoke anxiety
6 months
Impairing
What is the criteria for Generalised Anxiety Disorder in the DSM-5-TR?
Excessive anxiety & worry more days than not for at least 6 months about a number of events or numerous events or activities
Difficulty in controlling worry
Experience three (or more) 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
In the DSM-5-TR, what are other anxiety disorders included?
Separation anxiety disorder
Selective mutism
Substance / Medication Induced Anxiety
Disorder
Anxiety Disorder Due to another medical condition
Other specified anxiety disorder
Unspecified Anxiety Disorder
What are some common compulsions for those diagnosed with OCD?
Checking, washing, counting, symmetry/precision, ritual behaviours, hoarding
In OCD, what are obsessions?
Recurrent and persistent intrusions. They are thoughts, urges or images that are intrusive and unwanted, and cause anxiety or distress.
What are common obsessions for those diagnosed with OCD?
Contamination, need for symmetry, harm/doubt, forbidden or taboo thoughts (aggressive, sexual, religious)
What are compulsions for those with OCD?
Repetitive behaviours or mental acts that are aimed at preventing or reducing anxiety or distress or preventing some dreaded event or situation. They are not connected in a realistic way with what they are designed to neutralise or prevent, or are clearly excessive.
In the DSM-5-TR what is the criteria for OCD?
Presence of obsessions, compulsions, or both
Obsessions or compulsions are time consuming (>1 hour/day), or clinically significant distress or impairment
Content of obsession or compulsion is not restricted to another Axis I disorder (e.g., food obsession in an eating disorder)
Specify if with good or fair insight, with poor insight, with absent insight/delusional beliefs
Not due to a substance or medical condition
In the DSM-5-TR, what disorders fall under trauma and stress-related disorders?
Posttraumatic Stress Disorder (PTSD), Acute Stress Disorder, Prolonged Grief Disorder, Adjustment Disorder, Other specified trauma and stress-related disorders, Unspecified trauma and stressor-related disorders
When was Prolonged Grief Disorder introduced to the DSM?
In the DSM-5-TR
In the DSM-5-TR, what is the criteria for PTSD?
A. Exposure to actual or threatened death or serious injury, or sexual violence via:
1 Directly
2 Witnessing
3 Learning about it happening to someone close or
4 Experiencing repeated or extreme exposure to aversive details of traumatic events (does not apply to exposure through media unless exposure is work related)
B. Presence of one or more of the following intrusions:
Involuntary and intrusive distressing memories
Distressing dreams related to event
Dissociative reactions e.g. flashbacks
Intense or prolonged psychological distress or reactivity to cues that resemble the traumatic event
Marked physiological reactions to internal or external cues that symbolise/resemble aspect of the traumatic event
C. Avoidance of stimuli associated with the event (one or +)
thoughts feelings or memories
external reminders
D. Negative alterations in cognitions and mood (2 or +):
Inability to remember important aspects of the event
Persistent and exaggerated negative beliefs about oneself, other, the world “I am bad” “The world is completely dangerous”
Persistent distorted cognitions about the cause or consequence e.g. blame self
Persistent negative emotional state - fear, horror, anger, shame
Diminished interest or participation in significant activities
Feelings of detachment or estrangement
Persistent inability to experience positive emotions
E. Physiological arousal symptoms (two or +)
Irritability or anger outbursts
Reckless or self-destructive behaviour
Hypervigilance
Exaggerated startle response
Problems with concentrating
Sleep disturbance
F. Duration > 1 month
G. Distress or dysfunction
H. Not due to substance/medical condition
