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Flashcards in Anxiety and Stress Disorders Deck (54)
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1

Define the following:
Fear?
Anxiety?

1. Fear: a response to a real or perceived immediate threat

2. Anxiety: expectation of future threat, feeling of fear, worry, and uneasiness to an overreaction to a situation that is only subjectively seen as menacing

2

1. When is anxiety normal?

2. When does it become a disorder?

1. Necessary warning signal of danger

2. Becomes a disorder when symptoms interfere with a persons daily life or ability to function

3

Symptoms of Anxiety include what? 5

1. Muscle tension
2. Poor memory
3. Sweaty hands
4. Fear or confusion
5. Constant worry

4

Causes of Anxiety? 3

Risk Factor? 3

Causes
1. Heart disease
2. Diabetes
3. Thyroid problems

Risk Factors
1. Being female
2. Trauma
3. Stress due to an illness

5

Experiencing anxiety has 2 components
2

1. Awareness of physiological sensations (palpitations and sweating)

2. Awareness of being nervous or frightened

6

Emotional symptoms of Anxiety? 4

Physical symptoms of Anxiety?
5

Emotional
1. Excessive fear & worry
2. Feelings of apprehension
3. Trouble concentrating
4. Feeling tense

Physical
1. Pounding heart
2. Sweating
3. Stomach upset
4. Frequent urination
5. SOB

7

PP of Anxiety: 3 systems that affect this?

1. Major neurotransmitters
2. Autonomic nervous system
3. Sympathetic nervous system

8

What are the major NT involved in anxiety? 4

1. Norepinephrine
2. Serotonin
3. Dopamine
4. GABA

9

Treatments for Anxiety: Therapy? 2

1. Cognitive-Behavioral Therapy (CBT)
2. Exposure Therapy

10

Describe the three components of exposure therapy?

1. Desensitization: Combines relaxation with a gradual exposure to whatever provokes the anxiety

2. Flooding: Involves intense and prolonged exposure to the feared stimulus

3. Modeling: Involves the witnessing of another handle a feared stimulus without anxiety

11

Treatment for Anxiety: Medications? 4

1. Selective Serotonin Reuptake Inhibitors (SSRIs)
2. Serotonin-Norepinephrine
Reuptake Inhibitors (SNRIs)
3. Benzodiazepines
4. Tricyclic Antidepressants

12

Treatment for Anxiety: Alternative treatments? 5

1. Stress and Relaxation Techniques
2. Meditation
3. Yoga
4. Acupuncture
5. Kava

13

In the DSM-5 what are the three categories of anxiety type disorders?

1. Anxiety Disorders

2. Obsessive-Compulsive Disorder

3. Trauma and Stressor-Related Disorders

14

What are the specific disorders that are categorized in the following:
1. Anxiety Disorders

2. Obsessive-Compulsive Disorder

3. Trauma and Stressor-Related Disorders

1. Separation anxiety disorder, selective mutism, specific phobia, social phobia, panic disorder, agoraphobia, and generalized anxiety disorder

2. Obsessive-compulsive disorder, body dysmorphic disorder, hoarding disorder, trichotillomania, and excoriation disorder

3. Reactive attachment disorder, disinhibited social engagement disorder, PTSD, acute stress disorder, and adjustment disorder

15

What are the Anxiety Disorders?
9

1. Post-Traumatic Stress Disorder
2. Acute Stress Disorder
3. Generalized Anxiety Disorder
4. Panic Disorder
5. Agoraphobia
6. Specific Phobia
7. Social Phobia
8. Obsessive Compulsive Disorder
9. Anxiety Disorder Due to a General Medical Condition

16

1. What is PTSD?

2. What does this cause trouble with?

3. Age?

1. A debilitating condition that can occur in people who have experienced or witnessed a natural disaster, serious accident, terrorist incident, sudden death of a loved one, war, violent personal assault such as rape, or other life-threatening events

2. Have trouble with relationships with family & friends

3. Can occur at any age

17

PTSD: Signs and Symptoms

1. Re-experiencing symptoms? 3

2. Avoidance symptoms? 5

3. Hyperarousal symptoms? 4

4. Children? 4

1. Re-experiencing symptoms
-Flashbacks
-Bad dreams
-Frightening thoughts

2. Avoidance symptoms
-Staying away from events, places, objects
-Feeling emotional numb
-Feeling strong guilt, depression, worry
-Losing interest in activities
-Having trouble remembering the dangerous event

3. Hyperarousal symptoms
-Being easily startled
-Feeling tense
-Difficulty sleeping
-Having angry outburst

4. Children
-Bedwetting
-Forgetting how or being able to talk
-Acting out event during playtime
-Being unusually clingy

18

Clinical Presentation (think TRAUMA!)
6

Traumatic event
Re-experience
Avoidance
Unable to function
Month long or more duration of symptoms
Arousal is increased

19

PTSD diagnosis criteria?
4

1. Symptoms usually begin within 3 months of incident and last more than a month

A person must have all the following for at least 1 month:
2. At least one re-experiencing symptom
3. At least three avoidance symptoms
4. At least two hyperarousal symptoms

20

PTSD treatment

1. Therapy? 1

2. Medications? 2

1. Psychotherapy (combo/mono 1st line)
-6-12 weeks
-Cognitive Behavioral Therapy
(Exposure therapy, Cognitive restructuring, Stress inoculation training)

2. Medications
First line (combo/mono)
-SSRI
-SNRI

21

1. An episode of Acute Stress Disorder must last for how loing?

2. Must occur within the ___ weeks of the traumatic event?

3. How would you think of this in regards to PTSD?

1. An episode of ASD must last for a minimum of 3 days and a maximum of 4 weeks

2. 4 weeks

3. So think of PTSD on a short vacation!
After 4 weeks it is diagnosed as PTSD

22

ASD Treatment?
2

Treatment
1. CBT
2. Benzodiazepines
Clonazepam 0.5-2mg/day

23

Generalized Anxiety Disorder
1. Applies to which kind of people?
2. What things are they always expecting or thinking about? 2

3. Average age of onset?

1. Applies to people who are worried or anxious about almost everything

2.
-Think things will always go badly
-The worrying causes impaired functioning

3. Average age of onset is 31 y/o

24

GAD
Signs and Symtpoms? 6

1. Can’t relax
2. Startle easily
3. Have difficulty concentrating
4. Trembling
5. Irritability
6. sweating

25

GAD
Dx?

Worries excessively about a variety of everyday problems for at least 6 months

26

GAD Treatment first line? 2

Alternative? 1

Combo/mono
1. Psychotherapy (CBT)
-Alone or with SSRI
2. SSRI
-Paroxetine, Sertraline, Citalopram

3. SNRI
-Alternative to First-Line

27

Second line treatment for GAD? 2

1. TCAs
2. Benzo's

28

Which TCA would you chose for GAD?

Which Benzos would use for GAD? 4

1. Tricyclic antidepressants
-Imipramine

2. Benzo’s
Short ½ life
-Alprazolam (11.2 hours)
-Lorazepam (12 hours)
Longer ½ life
-Diazepam (45-100 hours)
-Flurazepam (74-90 hours)

29

1. Panic disorder: What is it?
2. What is it chracterized by?

3. Why do these patients often feel ashamed and discouraged?

4. Onset is usually when?

1. People have sudden and repeated attacks of fear that last for several minutes
2. “Panic Attacks” Characterized by a fear of disaster or of losing control even when there is no real danger

3. Become discouraged and feel ashamed b/c they cannot carry out simple task

4. Begins in late adolescence or early adulthood

30

Panic disorder Signs and Symtpoms?
5

1. Sudden and repeated attacks of fear
2. Feeling of being out of control during a panic attack
During attack:
3. Pounding or racing heart
4. Sweating
5. Weakness or dizziness