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Anxiety&etc Disorder

Psych E3

Somatization Manifestation of psychological distress as physical symptoms that may result in functional changes, somatic descriptions, or both
Hypochondriasis Preoccupied with developing a serious illness based on their misinterpretation of body sensations
Alexithymia Difficulty identifying & expressing emotions; preoccupied with external events & concrete thinkers
Munchausen's Syndrome Most severe form; fabrication illness, recurrent hospitalizations, doctor shopping
Malingering Intentionally producing illness symptoms motivated by another self-serving goal (ex: avoiding death)
Pseudologia Fantastica False stories of personal triumph that are not entirely improbable and contain matrix of truth and falsehood
Mild Anxiety Focused (Ex: performer anxiety before concert)
Moderate Anxiety Narrowed perceptual field, can follow commands but trouble w/ attention (short, direct commands)
Severe Anxiety Unable to attend to surroundings, physical symptoms (sweating & palps) goal is relief
Panic Anxiety Terror, communication impossible, only concern is escape
Separation Anxiety Disorder Excessive fear concerning separation (symptoms 4 weeks in children & 6 months in adults)
Generalized Anxiety Disorder Excessive anxiety that is difficult to control (Increased physical symptoms)
GAD Caused by GABA/NE dysregulation, Autoimmune Nervous System Activation, Genetics Childhood onset
Agoraphobia Fear of being alone or in public place
Social phobia fear of being humiliated or embarrassed in public
Specified phobia fear of specific objects, animals, situations that isn't either of the other two types (ex: claustrophobia)
Primary Gain Relief from emotional conflict and freedom from anxiety achieved via defense/coping mechanisms
Secondary Gain External gain derived from illness (ex: disability benefits/attention)
Obsessive Compulsive Disorder Plagued by time-consuming, persistent behaviors to perform repetitive actions to reduce anxiety
Hoarding Disorder Difficulty letting go of possessions & discarding, cluttered living space, impaired areas of life, and unsafe environment (abnormal anterior cingulate cortex & insula)
Body Dysmorphic Disorder Preoccupation with exaggerated "defect"
Trichotillomania Hair pulling disorder
Adjustment Disorder Emotional or behavioral rxn to stressor w/n 3 months of stressor (once stressor ends, shouldn't last >6months)
Acute Stress Disorder Exposure to death, injury, sexual violation, witnessing events (3 days to 1 month)
Reactive Attachment Disorder Developmentally inappropriate attachment (9months-5years age)
Posttraumatic Stress Disorder Intrusion symptoms(flashbacks/nightmares), persistent avoidance, alterations in cognition and mood, hyperarousal &reactivity symptoms following traumatic event or amygdala dysfunction
Somatic Symptom Disorder Deemphasizes role of medical symptoms and emphasizes + s/s
Illness Anxiety Hypochondriasis
Factitious Disorder Feigned illness to assume sick role
Conversion Disorder Alteration in voluntary motor or sensory function that suggests a physical disorder, but instead is an expression of a psychological need or conflict
La belle Indifference Expresses little concern about distressing disorder because anxiety relieved by conversion
Somatic Symptom Disorder One or more somatic symptoms (distressing & interferes with life), excessive thoughts/feelings/behaviors, and chronic
Dissociative Disorder Types Depersonalization, Dissociative Identity disorder, and dissociative amnesia
Depersonalization Derealization disorder; high anxiety levels and appears hazy/unreal
Derealization Outside world
Depersonalization Definition Unreality of one's sense of self
Dissociative Identity Disorder AKA multiple personality disorder, unable to recall important personal information too extensive to be explained by ordinary forgetfulness; not r/t physiological effects substance/medical condition
Dissociative Amnesia Unable to recall important information too extensive to be explained by ordinary forgetfulness and causes distress/impairment
Phobias Interventions include accepting fears, increase insight, confirm behaviors have purpose, don't use logic, don't urge self cotrol
Adaptive Coping Solves problem and decreases anxiety
Palliative Coping Temporarily relieved, but doesn't solve problem
Maladaptive Coping Unsuccessful to solve and decreased functioning
Dysfunctional Coping No success to any degree and barely functioning
Obsessive Compulsive Disorder Characteristics Relaxation difficult, task oriented, rigid thinking, higher brain metabolic rate
OCD Interventions Interventions include giving alternative activities to focus on, expressing feelings, providing time, recognizing nonritualisticbehaviors, avoid paraphrasing/reflecting
Hoarding Disorder Tx SSRIs and CBT best
PTSD Interventions Interventions include debriefing, CBT, EMDR, and prolonged exposure therapy
Prolonged exposure therapy Talking through trauma
EMDR Therapist directed rapid eye movements thy are simultaneously a/w distressing or traumatic thoughts/memories
Conversion Disorder Minimizes problems
Somatoform Disorder Dramatizes problems
Conversion Disorder Defense Mechanisms Repression and Conversion
Somatic Symptom Disorder Intervention Interventions include avoiding unnecessary tests, being matter of fact, verbalizing feelings, using + reinforcement, use diversion (mileu therapy), don't push for insight
Personality Dx Criteria Cognition, affectivity. Interpersonal functioning, impulse control
Common Characteristics of Personality Dx Inflexible/Maladaptive response to stress, disability in working/loving, ability to evoke interpersonal conflict, capacity to "get under skin"
Paranoia Interventions Interventions include establishing trust, being neutral, matter of fact, respectful, giving info, and not being too nice
Schizoid Interventions Interventions include giving task by task and not being too nice
Schizotypal Interventions Interventions include avoiding eye contact, keeping speech loose and vague, and respecting needs for isolation
Borderline Personality Paranoia during extreme stress, fear of rejection, high suicide risk
Borderline Interventions Interventions include setting limits and avoid rejecting/rescuing
Avoidant Interventions Don't push into social situations, be friendly, teach socialization with + feedback
OCD Defense Mechanisms Intellectualization, rationalization, and reaction formation
Self Care Deficit Interventions Be firm, set short term goals, don't use "should/shouldn't"
Somatic Symptom Biologic Theory Decreased neuroactivity, hypometabolism, chronic HPA activation
Somatic Symptom Psych Theory Alexithymia and learned behavior
Somatic Symptom Social Theory Asians: moral issue rather than psych problem; Latins describe depression as headaches, guilt, nerves
Somatic symptom tx MAOIs, SSRIs, Benzodiazepines(short term only), BuSpar
Somatic Symptom Goals Decrease PCPs, majority of tx nonpharmacological, focus on staying healthy (lifelong problem)
Conversion DX Symptoms Decreases(coordination, swallowing, urinary, senses), hallucinations, and seizures
Body Dysmorphic Tx SSRI and Antidepressants
Anorexia Defense Mechanisms Denial and Intellectualization/Frequent regression and repression
Anorexia Intervention Stabilizing physiological integrity and nutritional status; gain 1/2lb-1lb outpatient/week or 2-3lbs/week inpatient
Anorexia Tx SSRIs&Antianxiety (decrease food obsession, rigidity), Antipsychotics (lessen obsessions), Periactin (appetite stimulant)
Bulimia S/S Paroid Swelling "Chipmunk cheeks", Calluses "Russell's Sign", Esophageal tears "Mallory-Weiss tears"
Bulimia Interventions Medical stabilization, identify triggers
Bulimia Tx Florentine/Prozac (decrease cravings & increase serotonin), Sertraline/Zoloft (reduce binges), Topiramate/Topamax (decrease binges & preoccupation)
Anorexia Key issue is not food but desire for approval/attention
Anorexia Symptoms Edema, Low T3 &T4, Ketosis (body digesting fat as E), low temperature, kidney damage, hypercarotinemia (yellow skin), low testosterone in males
CAGE Cut down need? Annoyed by criticism? Guilty? Eye opener?
Substance Abuse Defense Mechanisms Denial, rationalization, projection, minimization
Alcohol symptoms Decrease (relaxed, slurred speech, sleep, nystagmus)
Alcohol Withdrawal Increase (Hallucinations, tachycardia, seizures, delirium, tremors, fever
Created by: TedMed