Term
| define anxiety due to general medical condition |
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Definition
| symptoms of anxiety, fear, avoidance, or increased arousal due to direct effect of general medical condition |
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Term
| define substance induced anxiety disorder |
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Definition
| symptoms of anxiety, fear, avoidance, or increased arousal due to direct effect of medication, drug abuse, or toxin |
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Term
| define psychotic or mood disorder |
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Definition
not an anxiety disorder
symptoms of anxiety, fear, avoidance, or increased arousal with 6mo+ of excessive worry and associated symptoms occuring exclusivley during a mood or psychotic episode |
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Term
| define seperation anxiety disorder |
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Definition
symptoms of anxiety, fear, avoidance, or increased arousal due to concern with seperation from figures
onset in childhood |
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Term
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Definition
| symptoms of anxiety, fear, avoidance, or increased arousal with unexplained panic attacks and worry about attacks or change in behavior |
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Term
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Definition
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Term
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Definition
| anxiety about being in places from which escape might be difficult or embarassing in the event of a panic attack |
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Term
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Definition
| symptoms of anxiety, fear, avoidance, or increased arousal due to severe traumatic event with re-experiencing of event, arousal, and avoidance of associated stimuli for 1 mo+ |
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Term
| what if someone shows PTSD signs for less than a month |
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Definition
| its called acute stress disorder |
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Term
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Definition
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Term
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Definition
| symptoms of anxiety, fear, avoidance, or increased arousal with complusions or obsessions |
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Term
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Definition
| equal in male and females |
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Term
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Definition
| symptoms of anxiety, fear, avoidance, or increased arousal with 6mo+ of excessivel worry plus associated symptoms |
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Term
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Definition
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Term
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Definition
| symptoms of anxiety, fear, avoidance, or increased arousal due to specific object or situation (if social consider avoidant personality disorder) |
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Term
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Definition
| equal in males and females |
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Term
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Definition
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Term
| define adjustment disorder with anxiety |
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Definition
| symptoms of anxiety, fear, avoidance, or increased arousal that does not meet criteria for other anxiety disorders and developed from response to stressor |
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Term
| define anxiety disorder not otherwise specified |
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Definition
| symptoms of anxiety, fear, avoidance, or increased arousal that do not meet criteria for specific anxiety disorder |
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Term
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Definition
intense fear and discomfort with 4+ of these...
palpitations, increased HR
sweating
trembling or shaking
SOB/smothering
feeling of choking
nausea or abdominal distress
dizzy, unsteady, lt headed, faintness
de-realization, depersonalization
fear of loosing control or going crazy
fear of dying
paresthesias
chills or hot flashes
reoccuring unexpected attacks
w/ or w/o agorophobia |
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Term
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Definition
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Term
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Definition
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Term
| to diagnose panic disorder the attack must be followed by 1mo+ of one of these |
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Definition
persistent concern of additional attacks
worry about implications of attack or consequences
change in bahavior related to attacks |
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Term
| panic disorder cannot have association with |
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Definition
| substance abuse, medication, hyperthyroidism, other medical condition, mental disorder, social phbia, phobia, OCD, PTSD, seperation enxiety |
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Term
| what are the comorbidities with panic disorder |
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Definition
depression
other enxiety disorders |
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Term
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Definition
avoidance of situation where escape is difficult
safety or stress reducing behaviors in crowded situations like finding escape, going with friends
periods of exacerbation and remission |
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Term
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Definition
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Term
| tx first steps agoraphobia |
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Definition
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Term
| tx second steps in agoraphobia |
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Definition
| SNRI/SSRI (+BDZ if needed) > BDZ > TCA |
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Term
| how do you tx someone with agoraphibia and comorbid depression |
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Definition
| use antidepression with different mechanism (SSRI + buproprion) |
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Term
| what are the goals of CBT for agoraphobia |
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Definition
focus on negative/irrational thoughts
give homework or joirnaling and imagry and talk about event, thoughts, emotions, and behaviors
situational or graded exposure to feared stimuli
incorporate: exercise, relaxation, techniques (breathing), spirituality
psychodynamic therpay: talks about defense mechanisms |
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Term
| what is the prognosis of agoraphobia |
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Definition
33% recover
50% have limited impairment
20% have major impairment |
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Term
| what are predictors of poor prognosis for agorphobia |
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Definition
more severe, initial panic attacks or agoraphobia
longer duration of illness
comorbid depression
hx seperation from parent (death, divorce)
high interpersonal sensitivity
single marital status |
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Term
| what signs are requided for all PTSD diagnosis |
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Definition
symptoms for 1mo+, acute <3mo, chronic >3mo
may be delayed onset >6mo
social occupational other impairment due to experiencing, witnessing, confronting event with threatened death or injury to self or others with response of intense fear, helplessness, horror
(agitation and disorganized behavior in kids) |
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Term
| for PTSD the pt must have at least 1 rexperiencing sign, what are they |
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Definition
recurrent distressiing recollections(images, thoughts, perceptions) (kids may occur with theses from trauma)
recurrent dreams of event in kids they may not have no recollection and will dream and wake up scared
feeling as if the event were reoccuring(reliving, hallucinations, illusions, flash backs) awake or intoxicated
psychological distress on exposure to event cues
psysiological reactivity to event cues |
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Term
| to diagnose PTSD they need to have 3+ avoidance or numbing symptoms, what are they |
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Definition
avoiding thoughts, feelings, or conversation associated with event
avoiding activities, places, or people associated with event
cannot recall important aspects of event
diminished interest in significant activities
feeling detached from others
restricted range of affect (unable to love)
sense of fore shorted future (no expectation of career, marriage, children) |
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Term
| to diagnose PTSD they need to have 2+ increased arousal symptoms, what are they |
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Definition
difficulty falling or staying asleep
iritability or ourbursts of anger
difficulty concentrating
hypervifilence
exaggerated starte response |
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Term
| what are the risk factors for PTSD |
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Definition
post trauma prior to initiating trauma
hx PTSD, depression, anxiety disorder
family hx of anxiety or parental PTSD
cormorbid axis II disorder
disrupted parental attachments
high premorbid intelligence may be protective |
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Term
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Definition
| depression, OCD, panic, phobia |
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Term
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Definition
| education and CBT focusing on negatice/catastrophic thoughts, exposure to behavorial tx, anxiety/anger, group therapy |
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Term
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Definition
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Term
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Definition
| often symptomatic for decades |
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Term
| perdictors for bad prognosis PTSD |
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Definition
greater number of symptoms
psychiatric hx of ther anxety/mood disorder
higher numbing or hyperarousal to stress
cormobid medical illness
female, childhood teauma, alcohol abuse |
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Term
| what are the required obsessive symptoms of OCD |
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Definition
reicrrent rhoughts, impulses, or images that are intrusive and inappropirate causing anxiety or distress
thoughts, impulses, images not just excessive worry about real life problems
attmpt to neutralize thoughs, imulses, images with actions or thoughts
recognizes impulses, thoughts, or images are a product of their own mind |
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Term
| what are the required compulsion symptoms of OCD |
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Definition
repetitive behaviors or mental acts in response to obsession or according to rules
acts are to reduce distress or prevent some event but are not connected in realisit way and are more to neutralize thoughts |
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Term
| define OCD with poor insight |
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Definition
| some point in time the person does not realize obsessions and compulsions are excessive or unreasonable |
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Term
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Definition
| CBT, education, graded exposure |
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Term
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Definition
SSRI high doses, clomipramine, both
add anti-psychotic if severe |
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Term
| what percautions need to be taken with clomipramine |
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Definition
| requies EKG, BP, HR, blood level monitoring esp in combo with other meds |
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Term
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Definition
50% progressive disease
80% improve in 40 yrs
25% fluctuating course
15% phasic course with periods of complete remoission |
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Term
| what are signs of worse OCD prognosis |
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Definition
ealy age of onset, longer duration
obsessions and compulsions
poor baswline social function
magical thinking |
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Term
| GAD must have 3+ of these symptoms for _____ |
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Definition
6 mo+
rstlessness or on edge
easily fatigued
difficulty concentrating or mind blands
irritability
muscle tension
sleep disturbance
no other axis 1 disorder, general medical condition, mood disorder, psychotic disorder, developmental disorder
impairment in social, occupational, or other areas of functioning |
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Term
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Definition
CBT, relaxation therapy, psychodynamic therapy, breathing therapy
SNRI/SSRI (venlafaxine XR DOC)
may adjust for individual symptoms or metabolic profile |
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Term
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Definition
major depression
other anxiety disorders |
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Term
| symptoms of social phobia |
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Definition
anxiety of unfamillar people, possible scrutiny, showing anxiety, doing something embarassing (kids unable to have relationships with famillar people, peers, adults)
exposure to situation causes anxiety (in kids causes crying, tantrum, freezing, shrinking)
recognizes fear is excessive (except in kids)
social situations or performance avoided interfering with normal routine, occupation, or relationships
>6mo if under 10yo
not due to substances, general medical condition, other mental disorder or is unrelated to it |
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Term
| comorbidities with social phobia |
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Definition
2x risk of alcohol dependence
6x risk of mood disorders |
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Term
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Definition
CBT > SNRI/SSRI > BDZ > TCA
B blockers for acute/performance
social skills training (role play, rehersal, imagry, visualization) |
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Term
| prognosis of social phobia |
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Definition
if onset is early it is chronic course
50% recovery by 25 yo |
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Term
| signs of poor prognosis in social phobia |
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Definition
onset before 8-11 yo
psychiatic or medical comorbidity
more symptoms oat baseline
low education status |
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Term
| what are signs of a phobia |
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Definition
cured by object or situational removel
exposure inavairably provokes immediate anxiety
children: crying, tantrums, freezing, clinging
recognition that fear is excessive
avoiding phobia, interferes with reoutine, occupation, relationship
if <18 yo lasts more than 6mo
not explained by OCD, PTSD, seperation anxiety, social phobia, panic disorder, agoraphobia |
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Term
| what are the types of phobia |
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Definition
animal
natural: heights, storms
blood injection
situational: airplane, elevator
choking
vomiting
illness
loud sounds
costumed characters |
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Term
| comorbidities with phobia |
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Definition
depression
somatoform disorders |
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