Anxiety, OCD, trauma disorders
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| is anxiety normal? | yes. everyone experiences it.
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| this is a warning of internal or external threat (brain's alarm system), prompts a person to take steps to prevent the threat or lessen its consequences (ex: running way from a burning bldg, studying for exam to prevent failure) | anxiety
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| is normal anxiety long lived or short lived? | short lived
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| what are two categories of manifestations of anxiety? | psychological, physical
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| what are three types of psychological manifestations of anxiety? | emotional, cognitive, behavioral
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| what is an example of emotional anxiety? | patient feels sad/scared
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| what is an example of cognitive anxiety? | patient feels like they will die or have a heart attack
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| what is an example of behavioral manifestation of anxiety? | patient doesn't leave the house because he/she is scared
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| describe the Yerkes-DOdson Law | It describes anxiety. you have to have some anxiety to reach a peak performance, but after a certain point, too much anxiety hurts you
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| does any real physical or psychological danger exist in anxiety disoders? | no. the emotional reaction is excessive or disproportionate to the actual danger.
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| do anxiety disorders have both a physical and psychological component? | yes
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| list some anxiety disorders | panic disorder, OCD, phobia, body dysmorphic disorder, hoarding disorder, trichotillomania, excoriation, and many more
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| describe the genetic factors of anxiety disorders | increased rate in first degree relatives, more common in monozygotic than dizygotic twins, more common in women than men
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| what are some differential diagnoses you can add to your list, when considering anxiety disorders? | medical disorders (hyperthyroidism, hypoglycemia, pheochromocytoma), substance abuse (amphetamines, caffeine, medicaitons, alcohol withdrawal) other psychiatric conditions (depression, psychosis, hypochondria)
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| this anxiety disorder is marked by a fear or anxiety of a specific object or situation. provokes immediate fear or anxiety. avoided or endured with intense fear or anxiety, and anxiety is out of proportion to the actual danger posed by the object | specific phobia
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| list some specific phobia types | animal type, natural environment type, blood injection type, situational type, other types (ex: choking, vomitting, illness, etc)
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| what is the key feature of phobias? | irrational fear of specific object or situation object or situation is avoided or endired with intense anxiety
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| what is more common: specific phobia or social phobia? | specific phobia
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| what is another name for social anxiety disorder | social phobia
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| describe social phobia | anxiety in social siutations in which the individual is exposed to possible scruity by others. they fear they will act in a way or show anxiety symptoms that will be negatively evaluated. social situations almost always provoke fear or anxiety.
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| this type of anxiety disorder is described by an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four or more of many symptoms (palpitations, sweatin) can occur. There is no particular trigger. | panic attack specifier
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| In this disorder, there are recurrent unexpected panic attacks. at least one of the attacks has been followed by one month or more of persistent concern about additional panic attacks, or significant maladaptive changes in behavior related to the attack | panic disorder (not attributable to substance or other mental disorder)
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| what is the onset of panic disorder? which sex is mostly involved? | late adolescence and early adulthood. females
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| is there genetic component to panic disorder? | yes, but we don't know much about it
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| this disorder is described as marked fear or anxiety about two (or more) of the following five situations: using public transportation, being in open spaces, being in enclosed spaces, standing in line or being in a crowd, being outside of the home alone | Agoraphobia. You are afraid of being in a situation because escape might be difficult
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| what is the underlying pathology of Agoraphobia | individual fears or avoids these situations because of thoughts that escape might be difficultor help might not be available in the evento f developing panic like symptoms or other incapacitating or embarassing symptoms
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| in this disorder, there is excessive anxiety and worry, more days than not for at least six months about a number of events or activities. It is difficult to control worry | Generalized Anxiety disorder. must have three or more of following: restlessness or feeling keyed up or on edge, easily fatigued, difficulty concentrating/ mind going blank, irritability, muscle tension, sleep disturbance
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| when is the usual onset of GAD? | early adulthood, although most report feeling anxious their entire life.
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| describe the temperamental risk for GAD | bahavioral inhibition, negative affectivity and harm avoidance
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| this disorder describes the presence of obsessions, compulsions, OR both. it is time consuming (more than one hour per day) or cause clinically significant distress. must rule out substance or other disorder | obsessive compulsive disorder
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| these are recurrent/persistnet thoughts, urges, or images that are experienced as intrusive and unwanted that cause anxiety/distress. person attempts to ignore or suppress such thoughts or to neutralize them with some other thought or action (compulsion) | obsessions
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| these are repetitive behaviors or mental acts that the person feelsdriven to perform in response to an obsession or according to rules that must be applied rigidly. | compusions
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| in OCD, do the compulsive acts have to match the obsession? | NO
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| describe the temperamental risk of OCD | greater internalizaing symptoms, higher negative emotionality, behavioral inhibition in childhood
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| in this disorder, there is preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others. performed repetitive behaviors or mental acts in response to appearance concern. | body dysmorphic disorder
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| how do you distinguish body dysmorphic disorder from an eating disorder | their symptoms are not better explained by concerns with body fat or weight in an individual whose symptoms meet diagnostic critera for an eating disorder.
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| is there a genetic component to body dysmorphic disorder? | yes
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| this disorder is characterized by persistent difficulty discarding or parting with posessions, regardless of their value. due to a perceived need to save the items and to distress associated with discarding them. | hoarding disorder
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| does hoarding cause clinically significant distress? | yes. results in accumulation of posessions that substantially compromise their intended use. must rule out medical condition or other mental condition.
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| This is similar to hoarding disorder but the individual repeatedly goes out and buys excessive amounts of the same thing. | Excessive acquisition
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| epidemiologically, hoarding disorder is common to what sex? what about clinically? | epidemiologically, males. clinically, females.
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| what is the environmental risk factor for hoarding disorder? | retrospectively report stressful and traumatic life events preceding onset or causing an exacerbation
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| this disorder is characterized by recurrent pulling out of one's hair, resulting in hair loss. repeated attempts to decrease or stop hair pulling, causes clinically significant distress. | Trichotillomania (hair pulling disorder)
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| is Trichotillomania more common in men or women/ | females
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| Trichotillomania is more common in those individuals who have which other type of disorder? | OCD
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| trichotillomania is comorbid with what other illnesses? | major depressive disorder and excoriation
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| This illness is characterized by recurrent skin picking resulting in skin lesions. There are repeated attempts to decrease or stop the act. causes clinically significant distress or impairment, must rule out substance abuse or medical disorder | Excoriation
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| excoriation is more common in individuals with what other disorder? | OCD
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| PTSD is described by (criteria #1): exposure to actual or threated death, serious injury, or sexual violence in one or more of the following ways: | direct experience, witnessing in person, learning event occured to a close family member or friend (if death, violent, or accidental), repeated or extreme exposure to aversive details of traumatic events (first responders collecting human remains, etc)
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| Criteria #2 for PTSD: presenece of one or more of the following intrusion symptoms associated with the trumatic events, beginning after the event occurred: | recurrent, involuntary, an dintrusive distressing memories, recurrent distressing dreams, dissociative reactions (flashbacks) in which the person feels or acts as if the truamatic events were recurring, intense or prolonged psychological distress
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| PTSD criteria #3: persistant avoidance of stimuli associated with the trumatic events, beginning after the trumatic events occurred, as evidenced by one or both of the following: | avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic events, avoidance of or efforts to avoid external reminders that arouse distressing memories, thoughts, or feelings.
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| PTSD criteria #4: negative alternations in cognitions and mood associated with the traumatic events, beginning or worsening after it occurred, as evidenced by two or more of the following: | inability to remember an important aspect, persistent and exaggerated negative bbeliefs of epxectations about oneself, others, or the world, persistent, distorted cognitions about the cause or consequence that lead the individuals to blame himself/herself
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| PTSD criteria #5: marked alterations in arousal and reactivity associatd with the traumatic events, beginning or worsening after the traumatic event occurred, as evidenced by tow or more of the following: | irritable behavior and angry outbursts, reckless or self destructive behavior, hypervigilance, exaggerated startle response, problems with concentration, sleep disturbance
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| how many of the citeria does a patient have to meet in order to have PTSD? | must match two or more subcategories from each of the five criteria
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| what is the typical duration for PTSD? | more than one month with clinically significant distress, and must rule out substance/medical/other mental disorders
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| Acute stress disorder is characterized by exposure to actual or threatened death, serious injury, or sexual violence in one or more of the following ways... | directly experiencing, witnessing in person, learning event occured to a close family member or friend, violent, or accidental. Repeated or extreme exposure to aversive details of traumatic events (first responders, human remains, etc)
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| what is required to dignose acute stress disorder? | nine or more of the symptoms from PTSD. presents up to one month of clinically significant distress. must rule out substane or mental/medical disorder.
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| what are some prognostic factors for actute stress disorder? | tempermental: prior mental disorder, increased negative affectivity, greater perceived severity of event, avoidant coping style, catastropizing, environmental history of trauma. females at greater risk.
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| list some types of traumatic stressors | military combat, perosnal physical assault (mugging), sexual abuse or sexual assault, castastrophic disasters, serious accidents, life threatening medical events, rescue workers involved in traumatic siutations
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| this disorder is described by development of emotional or behavioral symptoms in response to an identifiable stressor occurring within three months of the onset of the stressor. | adjustment disorder
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| in adjustment disorder, symptoms or behaviors are of clinical significance as evidence dby one or both of the following: | marked distress that is out of proportion to the severity of intesity of the stress, taking into account hte external context and cultural factors that might influence symptom severity and presentation, significant impairment in social/occupational/other
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| in adjustment disorder, to the symptoms represent normal bereavement? | no. once the stressor has terminated, the symptoms do not persist for more than an additional six months.
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| list some adjustment disorder specifiers | with depressed mood, with anxiety, with mixed anxiety and depressed mood, with disturbance of conduct, with mixed disturbance of emotions and conduct, unspecified.
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