Term
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Definition
-is characterized by clinically significant anxiety provoked by exposure to cewrtain types of social or performance situations where people are exposed to unfamiliar ppl or to scrutiny by others
-the individual fears that he or she will act in a way that will be humiliating or embarrassing
-duration at least 6 months |
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Term
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Definition
-normal response
-natural, innate or build in system
-anxiety occurs when we begin to anticipate danger
-readiness alarm goes off in response to perceived future threat
-three axes: physical, cognitive (mental), behavioral
-physical: fight or flight
-cognitive: worry and anticipation, attention to threat, panning for response
-behavioral: avoidance (anxiety), escape (fear) |
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Term
| How is Anxiety different from Fear? |
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Definition
ANXIETY
• NORMAL response
• Future Oriented
• Perceive POSSIBLE threat
• Inc Cognitive Activity
• Motivates avoidance or preventative behaviors
FEAR
• NORMAL response
• Present Oriented
• Perceive ACTUAL threat
• Dec Cognitive Activity
• Motivates escape or defensive behaviors |
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Term
| Anxiety vs. Anxiety Disorder |
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Definition
• Anxiety = normal
• Anxiety Disorder
Pervasive and Persistent
Excessive Distress in Absence of Real Danger
Intensive Need for Excess Avoidance
Interference in Daily Life Functioning |
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Term
| What Causes Anxiety Disorders? |
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Definition
• Cultural
• Biological
-GABA, HPA axis, Fight/Flight
-”overactive” alarm system
• Excessive Distress
in Absence of Real Danger
• Psychological -perceptions of control • Social |
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Term
| Differential Diagnosis of Anxiety Disorders |
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Definition
• Separation Anxiety Disorder
• Selective Mutism
• Specific Phobia
• Social Anxiety/Phobia
• Panic Attack
• Panic Disorder
• Agoraphobia
• Generalized Anxiety Disorder
• Substance/Medication Induced Anxiety Disorder
• Anxiety Disorder Due to another medical condition
• Other Specified Anxiety Disorder
• Unspecified Anxiety Disorder |
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Term
| Anxiety Disorders: THREE Separate Categories in DSM 5 |
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Definition
• (1) Anxiety Disorders (separation anxiety disorder, selective mutism, specific phobia, social anxiety disorder/social phobia, panic disorder, agoraphobia, generalized anxiety disorder, substance/medication-induced, and anxiety due to another medical condition).
• (2) Obsessive-Compulsive Disorders (obsessive-compulsive disorder, body dysmorphic disorder, hoarding disorder, trichotillomania, and excoriation disorder).
• (3) Trauma and Stressor-Related Disorders (reactive attachment disorder, disinhibited social engagement disorder, PTSD, acute stress disorder, and adjustment disorder). |
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Term
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Definition
-panic disorder defined as the occurrence of unexpected panic attacks
-Longer than 1 month persistent worry about (1) having another attack, (2) implications of the attack, (3) a significant change in behavior related to the attack
v Symptoms: At least 4 of the following
•Palpitations, pounding heart, tachycardia
•Sweating
•Muscle trembling, shaking
•Shortness of breath, sensations of smothering •Choking sensations
•Chest pain or discomfort
•Nausea, abdominal distress
•Dizzy, lightheaded, instability, feeling faint •Derealization, depersonalization
•Fears of losing control or going crazy
•Fear of dying
•Numbness, tingling sensations
•Chills, hot flushes |
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Term
| Panic Disorder course and prevalence |
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Definition
-age at onset fore panic disorder varies but lay between late adolescence and mid-30s
-lifetime prevalence of panic disorder reported to be hihg as 3/5% and one year prevalence rate are between .5% and 1.5%
-duration at least one month |
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Term
| Panic Disorder--Treatment |
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Definition
• Imipramine (TCA):
– Starting dose: 25 mg/HS; daily dose 50-100 mg; max 150 mg.
• Phenelzine (MAOI)
– Starting dose: 15 mg/BID; daily 30-90 mg; max 90 mg.
• Fluoxetine (SSRI)
– Starting dose: 10 mg; daily 20-40 mg; max 60 mg.
• Paroxetine (SSRI)
– Starting dose: 10 mg; daily 20-40 mg; max 60 mg.
• Sertraline (SSRI)
– Starting dose: 25 mg; 25-150 mg; max 200 mg.
• Alprazolam (Benzo)
– Starting dose: 0.25-0.5 mg TID; 1.5-4 mg; max 6 mg.
• Clonazepam (Benzo)
– Starting dose: 0.25 mg BID; 1.5-4 mg; max 6 mg. |
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Term
| Generalized Anxiety Disorder |
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Definition
-excessive anxiety and worry occuring more days than not for at least 6 months about number of events and activities
-individual finds it difficult to control the worry
-symptoms: restlessnes or feeling keyed up or on edge, being easily fatingued, irritability & muscle tension, sleep disturbance, difficulty concentration or mind going blank
-course and prevalence: 1 year prevalence rate for GAD is 3% and lifetime rate is 5%
-treatment: SSRI, anxiolytic, therapies (CBT, mindfulness, psychotherapy) |
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Term
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Definition
-anxiety about being in places or situations from which escape might be difficult or in which help may not be available in the event of having an unexpected panic attack or panic-like symptoms
Epidemiology
•F>M
•Mean Onset is in 20s •60% heritable
Treatment
•Systematic Desensitization and Meds
•SSRIs, TCA, MAOIs, BDZ
•Length of Treatment: typically>2 yrs. |
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Term
| social phobio course and prevalence, differential. treatment |
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Definition
-onset in mid-teens
-studies have reported a lifetime prevalence of social phobia ranging from 3% to 13%
-differential diagnosis: separation anxiety disorder, generalized anxiety disorder, schizoid personality disorder, performance anxiety stage fright and shyness
-Treatment: CBT- exposure in the form of role-play. antidepressants (TCA, MAO inhibitors, SSRIs), D-cycloserine + CBT |
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Term
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Definition
-a persistent and disproportionate fear of some specific object or situation that presents little or no actual danger to the person
-specific phobias: is characterized by clinically significant anxiety provoked by exposure of specific feared object or situation, often leading to avoidance
-specific types: antimal tyep- fear cued by animal or insect. natural environment type: fear cued by object in natural environment like storm, water or height. blood injection type: fear cued by receiving injection or seeing blood. situational type: fear cued by situation such as tunnels, bridges, elevator. other type: fear of choking, vomiting, contracting illness |
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Term
| Specific Phobia couse and prevalence, differential diagnosis, treatment |
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Definition
-age onset childhood to mid-20s
-duration at least 6 months
-differential diagnosis: social phobia, post-traumatic stress disorder, obsessive compulsive disorder, hypochondrias, anorexia nervosa and bulimia nervosa
-treatment: systematic desensitization, progressive desensitization, stress inoculation training, flooding- prolonged exposure |
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Term
| Post Traumatic Stress Disorder (PTSD) is what, symptoms, cluster |
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Definition
-characterized by re-experiencing an extremely traumatic event accompanied by the symptoms of increased arousal and by avoidance of stimuli associated with trauma
-symptoms: nightmares, sleep disturbances, startle responses, anger outburst, regressive behavior, detachment, avoidance of trauma recollections, avoidance of talk of trauma, distress at exposure to similar stimuli
-symptom cluster: intrusion (1), avoidance (1), negative alteration of mood (2), hyperarousal (2), occur at least 1 month |
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Term
| Post Traumatic Stress Disorder (PTSD) course and prevalence, duration, treatment |
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Definition
-can occur at any age including childhood
-duration: acute: less than 3 months. chronic: 3 months or longer. with delayed onset: 6 mo have passed btween the traumatic event and the onsert of symptoms
treatment: CBT, Medications (SSRIs, Tricyclics, MAOIs, negative BDZ sudies; some support for anti-convulsants, min 4-12 weeks for medicaiton effects to be seen) |
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Term
| Obsessive Compulsive Disorder OCD |
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Definition
-cahracterized by obsessions (which cause marked anxiety) and by compulsions (which serve to neutralize anxiety)
-obsession: persistent thoughts, ideas, impulses or images that seem to invade a person's consciousness
-compulsions: repetitive and rigid behavior or mental act that a person feels compelled to perform to reduce distress or anxitye: types: verbal compulsion- compel them to repeat expressions and phrases. touching rituals- must touch or avoid touching certain items. counting compulsion- driven to count the things they see around them |
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Term
| obsessive compulsive disorder course and prevalence, differential diagnosis, treatment |
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Definition
-age onset earlier in males than females, 6-15 males. 20-29 females.
-differential diagnosis: OCD is not diagnosed in the context of thoughts or activities related to other mental disorder like body dysmorphic disorder or specific phobia, major depressive disorder, generalized anxiety disorder, hypochondrias, additional diagnosis of delusional disorder or psychotic disorder not otherwise specified
-treatment: behavioral & medication therapies, SSRIs- clomipramine, Risperidone, Deep Brain stimulation |
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Term
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Definition
• Anxiety and Fear Normal
• Anxiety = Perceived threat
• Fear = Actual Threat
• Anxiety Disorder = continued, persistent response w/o threat
-Lifetime Prevalence 28.8%
-High Comorbidity with MDD
• 9 Types of Anxiety Disorders in DSM -5
• PTSD and OCD do not belong in this category
• Trauma and Stress Related Disorders: PTSD
-4 symptom clusters: Intrusion (1), Avoidance (1), Negative Alteration of Mood (2), Hyper arousal (2)
-No subjective response of fear, hopelessness or horror needed
• Obsessive Compulsive and Related Disorders: OCD
-NO loss of reality testing, EGO DYS-tonic |
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