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Flashcards in OCD and such Deck (89):
1

What is fear?

the physical and mental response to an *imminent* threat

2

What is anxiety?

The anticipation of threat in the *future*

3

Anxiety or fear: threat is known

Fear

4

Anxiety or fear: desire to escape

Fear

5

Anxiety or fear: desire to avoid

Anxiety

6

Anxiety or fear: muscle tension and vigilance

Anxiety

7

Anxiety or fear: fight/flight/freeze response

Fear

8

True or false: both anxiety and fear can occur as part of anxiety disorders

True

9

What is the most common category of mental disorders?

Anxiety disorders

10

What is the prevalence of anxiety disorders every year?

18%

11

Are anxiety disorders more common in women or men?

Women

12

True or false: anxiety disorders tend to develop in adulthood

False--childhood

13

What is the classic course of GAD?

Chronic, waxing and waning course

14

What does avoidance lead to? Exposure?

Avoidance - Anxiety
Exposure - Extinction

15

What is the lifetime prevalence of anxiety disorders in women? Men?

Women = 30%
Men = 19%

16

What are the comorbidities of anxiety disorders?

Depression and substance abuse

17

What are the 4 criteria for specific phobias?

-Marked fear or anxiety about a specific object
-Exposure to the phobic stimulus provokes immediate fear
-The phobic object is avoided
-Fear is out of proportion to the actual danger

18

How long do phobias last for, (to meet the criteria)?

6 months

19

True or false: most people with a phobia usually do not have more than one

False--most do

20

In what age group are phobias particularly prevalent in?

Adolescents

21

True or false: excessive fears are common in young children, and often transitory--thus consider it part of normal development

True

22

What is the major difference between phobias and realistic fears?

Realistic fears are proportional to probability

23

What is the best treatment for fear?

Exposure therapy

24

What is the one exception to increased SNS with phobias?

Sight of blood

25

Is pharmacotherapy recommended for treatment of phobias? Why or why not?

No--treatment gains are not sustained

26

How long does exposure therapy have to last for?

until fear decreases

27

When is pharmacotherapy appropriate for phobias?

For one time instances (flying for one time, vs flying constantly for new job)

28

What are the criteria for social anxiety disorder? (5)

-Marked fear/anxiety of social situations
-Concern for acting in a way that is humiliating
-Exposure to social situations
-Feared situation is avoided
-Fear/anxiety is out of proportion

29

What is the time duration that is needed to diagnose social anxiety disorder?

6 months or more

30

What is the CBT treatment for social anxiety disorder?

-Correction of maladaptive thinking
-Exposure to feared social situations

31

Can CBT for social anxiety disorder be done in groups?

Yes

32

What is the pharmacotherapy for social anxiety disorder? (4)

-SSRIs/SNRIs
-Beta blockers
-MAOIs
-Benzos

33

Performance based anxiety disorders respond well to what sort of pharmacotherapy?

Beta blockers

34

What is panic disorder?

Recurrent, unexpected panic attacks (abrupt surge or intense fear or discomfort within minutes)

35

How many symptoms are needed to diagnose a panic attack?

4+

36

What is the anxiety component of panic disorders?

Persistent worry about additional attacks or their consequences, resulting in maladaptive change in behavior related to the attacks

37

Is a single episode of a panic attack diagnostic for a panic disorder?

No--need multiple

38

What is the ratio of panic attacks in females:males?

2:1

39

What is the median age at onset of panic attacks?

early 20s

40

Can panic attacks occur during sleep?

Yes--need to have one for diagnosis of panic disorder

41

There is a (__)x increase in mental disorders in first degree relatives of panic attack pts.

4-8x

42

True or false: syncopal episodes do not happen with panic attacks, and should be worked up medically

False

43

What is the first line treatment for panic attacks?

CBT and panic-focused psychodynamic psychotherapy

44

What are the pharmacotherapies for panic attacks?

-**SSRIs/SNRIs**
-TCAs
-Benzos

45

True or false: pts with panic disorders are often intensely sensitive to side effects of medications

True

46

What is agoraphobia, and what are the 5 diagnostic criteria?

Marked fear or anxiety about at least 2 of the following:
-Using public transportation
-Being in open spaces
-Being in enclosed spaces
-Standing in line or being in a crowd
-Being outside the home alone

47

What is the fear of agoraphobia usually d/t?

Not having access to help or of not being able to escape the situation

48

How long do s/sx of agoraphobia have to last for to meet the criteria for diagnosis?

6 months

49

True or false: agoraphobia often develops as a result of panic disorders

True

50

What age group is the incidence of agoraphobia the highest?

adolescence

51

What is the treatment for agoraphobia?

CBT or SSRIs

52

True or false: SSRIs are generally safe in overdose

True

53

Which type of antidepressant is more effective in the treatment in panic/agoraphobia

TCAs

54

What is the criteria for GAD? (2)

-Excessive anxiety/worry for more days than not for at least 6 months about a number of events or activities
-Difficulty controlling the worry

55

When (age wise) is the peak incidence of GAD?

Middle age

56

GAD is more common in men or women?

Women

57

True or false: GAD s/sx tend to wax and wane

True

58

What is the treatment for GAD?

-CBT
-Acceptance and commitment therapy

59

What are the components of the acceptance and commitment therapy? (3)

-Decrease avoidance
-Decrease attachment to thoughts
-Increase behavior moving towards valued goals

60

What is the pharmacotherapy for GAD?

-SSRIs/SNRIs
-Benzos (acutely)
-Buspirone

61

What is the MOA of buspirone?

serotonin 5-HT1A receptor partial agonist

62

What is the MOA of benzos?

Increases Cl channel opening frequency

63

What is the MOA of barbiturates?

Increases Cl channel opening duration

64

True or false: relapse is common in GAD in the first year after discontinuation of medication

True

65

What are obsessions?

1. Recurrent, intrusive and unwanted *thoughts*
2. Attempts are made to suppress, ignore or neutralize them with some other thought

66

What are compulsions?

1. Repetitive *behaviors* or mental acts that one feels driven to perform in response to an obsession
2. Behaviors or mental acts are aimed at preventing or reducing anxiety

67

What is characteristic of the compulsions with OCD?

The behaviors or mental acts are aimed at preventing or reducing anxiety or distress or preventing some dreaded event/situation, but they are not connected in any realistic way with what they are designed to neutralize or prevent, or are clearly excessive

68

What are the characteristics of obsessive thoughts?

Not pleasurable or voluntary--feel intrusive and undesired

69

What is the usual level of insight with OCD?

Variable

70

What is the mean age of onset for OCD? Course?

Mean age of onset is 20
Chronic, waxing and waning but 40% are self-limited

71

What is the usual comorbidity with OCD?

-Tic disorders
-Depression
-Other anxiety disorders

72

What is the treatment for OCD?

-Behavior therapy

73

What is the pharmacotherapy for OCD?

-SSRIs/SNRIs
-Clomipramine

74

Are benzos effective for OCD?

No

75

What are the criteria for OCD?

Need to take up at least an hour of the day or cause significant distress or impairment

76

What SSRI is particularly efficacious in treating OCD?

Clomipramine

77

What is body dysmorphic disorder?

Preoccupation with a perceived defect or flaw in appearance not observed by others
-Has a performed, repetitive behavior in response

78

True or false: there is usually little insight with body dysmorphic disease?

True

79

True or false: the risk of suicide is not elevated in body dysmorphic disorder, as compared to general population

False

80

What is the treatment for body dysmorphic disorder?

-SSRIs
-CBT

81

What are the diagnostic criteria for hoarding?

-Persistent difficulty discarding/parting with things, regardless of their value
-Perceived need to save, and distress associated with discarding

82

Hoarding is more common among what age group?

Old people

83

True or false: there is a strong genetic component to hoarding

True

84

What is the treatment for hoarding?

CBT (maybe)

85

What is trichotillomania?

-Recurrent pulling out of hair for gratification
-Repeated attempts to stop

86

When does Trichotillomania usually begin?

Around puberty

87

What is the treatment for Trichotillomania?

Psychotherapy and habit reversal therapy

88

What is excoriation disorder?

-Recurrent skin picking resulting in lesions
-Repeated attempts to stop

89

What is the treatment for excoriation disorder?

Psychotherapy