153 Cards in this Set
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DSM 5 sections of anxiety disorders
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1. anxiety disorders
2. obsessive-compulsive related disorders
3. trauma and stressor-related disorders
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How common are anxiety d/o's in youth?
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most common d/o
10% by age 18; 5
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DSM 5 anxiety categories:
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1. SAD
2. specific phobias
3. social phobias
4. OCD
5. PTSD
6. GAD
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LOOK UP
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Intense, persistent fear(s) that are developmentally inappropriate, difficult to change through reason, and cause impairment
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Fear
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anxieties elicited in the presence of a specific stimulus
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worries
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anxieties about possible future events
Common: health, school, personal harm
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girls exhibit more fears than others
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TRUE
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girls exhibit more intensity in fears than boys
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TRUE
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fears decline with age
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TRUE
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worry becomes more prevalent and complex with age
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TRUE
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fears coincide with different stages of development
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TRUE
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few cultural differences in etiology of anxiety d/o's
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TRUE
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Types of coping strategies
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1. emotional - crying, etc.
2. cognitive - thinking of something else
3. behavioral - avoidance, asking for help
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anxiety sensitivity characteristics
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hypervigilance/attention to bodily sensation
tend to focus on weak/infrequent sensations
disposed to react to somatic sensations w/ distorted cognitions
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anxiety sensitivity
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a kind of distress tolerance where high anxiety sensitivity involves a decreased capacity to tolerate anxiety states and sensations, and vice versa
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Anxiety d/o's have a high comorbidity w/ each other
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TRUE
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anxiety d/o's have high comorbidity with depression
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TRUE
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anxiety d/o's have especially high comorbidity with depression til age 10
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TRUE
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anxiety d/o's have what % comorbidity w/ externalizing probs
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30%
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anxiety d/o's appear how?
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appears to be stable, but are fluid
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SAD involves what?
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excessive anxiety when separated from attachment figure
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SAD prevalence
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4% of children
1-2% of adolescents
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how long does SAD have to last for dx?
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4 weeks or more
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SAD effects who more?
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more girls than boys
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SAD usually dx'd when?
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usual onset: age 7
early onset: before age 6
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Feature of SAD: when apart from attachment figure, child may experience worries about ______.
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things that would prevent reunion, such as illness or harm
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Feature of SAD: May be tearful, tantrum, have somatic complaints, and/or have difficulty sleeping (nightmare). All of which may shift with age.
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TRUE
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Feature of SAD: School phobia and _____ are common.
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avoidance
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Feature of SAD: school phobia and avoidance are often sequelae/consequences of other d/o's
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TRUE
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Feature of SAD: Family factors come into play like ______.
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close-knit families, anxious parents
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Feature of SAD: How it is handled makes great difference in treatment. ____ is key.
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Routine
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Etiology of SAD:
1. _____ temperament
2. Poor attachment
3. Enmeshment
4. Reinforcement
5. Modeling
6. May be genetic (family concordance)
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Anxious
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Etiology of SAD:
1. Anxious temperament
2. _____ attachment
3. Enmeshment
4. Reinforcement
5. Modeling
6. May be genetic (family concordance)
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Poor
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Etiology of SAD:
1. Anxious temperament
2. Poor attachment
3. _________________
4. Reinforcement
5. Modeling
6. May be genetic (family concordance)
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Enmeshment
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Etiology of SAD:
1. Anxious temperament
2. Poor attachment
3. Enmeshment
4. _______________
5. Modeling
6. May be genetic (family concordance)
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Reinforcement
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Etiology of SAD:
1. Anxious temperament
2. Poor attachment
3. Enmeshment
4. Reinforcement
5. __________
6. May be genetic (family concordance)
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Modeling
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Etiology of SAD:
1. Anxious temperament
2. Poor attachment
3. Enmeshment
4. Reinforcement
5. Modeling
6. May be _________ (family concordance)
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genetic
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Treatment - SAD:
1.___________ Tx
> Exposure, contingency mgmt, modeling
2. _____
> Identify cues, monitoring, coping skills
3. ___________
> Tricyclic antidepressants
> Benzodiazepines
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1. Behavioral
2. CBT
3. Medications
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Treatment - SAD:
1. Behavioral Tx
> __________, _____________ _____, _________
2. CBT
> Identify cues, monitoring, coping skills
3. Medications
> Tricyclic antidepressants
> Benzodiazepines
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Exposure, contingency mgmt, modeling
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Treatment - SAD:
1. Behavioral Tx
> Exposure, contingency mgmt, modeling
2. CBT
> ____________, __________, ________ ______
3. Medications
> Tricyclic antidepressants
> Benzodiazepines
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Identify cues, monitoring, coping skills
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Treatment - SAD:
1. Behavioral Tx
> Exposure, contingency mgmt, modeling
2. CBT
> Identify cues, monitoring, coping skills
3. Medications
> _________ ______________
> __________________
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Tricyclic antidepressants & Benzodiazepines
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Irrational fear of object or situation that produces anxious or avoidant response
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specific phobia
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Dx considerations - Specific Phobia:
1. Fear is out of ______ to real danger
2. Fear response is extreme and usually immediate
3. Has sig impact on daily life (6 months or more)
4. Resistant to tx attempts
5. Whether symptoms of anxiety are in presence of object/situation or antici…
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Proportion
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Dx considerations - Specific Phobia:
1. Fear is out of proportion to real danger
2. Fear response is _____ and ________ _________
3. Has sig impact on daily life (6 months or more)
4. Resistant to tx attempts
5. Whether symptoms of anxiety are in presence of object/situation or ant…
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extreme and usually immediate
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Dx considerations - Specific Phobia:
1. Fear is out of proportion to real danger
2. Fear response is extreme and usually immediate
3. Has sig impact on daily life (__ months or more)
4. Resistant to tx attempts
5. Whether symptoms of anxiety are in presence of object/situation or a…
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6
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Dx considerations - Specific Phobia:
1. Fear is out of proportion to real danger
2. Fear response is extreme and usually immediate
3. Has sig impact on daily life (6 months or more)
4. ______ to tx attempts
5. Whether symptoms of anxiety are in presence of object/situation or antic…
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resistant
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Dx considerations - Specific Phobia:
1. Fear is out of proportion to real danger
2. Fear response is extreme and usually immediate
3. Has sig impact on daily life (6 months or more)
4. Resistant to tx attempts
5. Whether symptoms of anxiety are in presence of object/situation or __…
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anticipation
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Specific phobia: avg age of onset
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8
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Specific phobia: prevalence
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10% in children & adolescence, more girls than boys
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Specific phobia: comorbidity w/ others characterized by...
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general fear, scanning for danger, avoidance, etc.
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Specific phobia: most common phobia in children...
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Animal phobias
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Specific phobias: most common in teens...
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blood, injection, injury
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Specific phobias: other forms...
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situational, natural/environmental or other type
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Specific phobias: when confronted, most will....
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cringe, grimace, cry, try to get away, seek support or reassurance
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Specific phobias: in extreme cases, ___ ______ are seen
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panic attacks
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Specific phobias: kids tend to make _____ statements
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negative
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Etiology - Specific phobia: may be _____ links (family concordance)
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genetic
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Etiology - Specific phobia: most likely comes from _______
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classical, operant, relational conditioning
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Tx - Specific Phobia:
1. __________ Txs
> Exposure, contingency mgmt, modeling
2. CBT
> Identify cues, monitoring, coping skills
3. Medications
> Benzos but not much support
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Behavioral
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Tx - Specific Phobia:
1. Behavioral Txs
> __________,, contingency mgmt, modeling
2. CBT
> Identify cues, monitoring, coping skills
3. Medications
> Benzos but not much support
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Exposure
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Tx - Specific Phobia:
1. Behavioral Txs
> Exposure, ________ ______, modeling
2. CBT
> Identify cues, monitoring, coping skills
3. Medications
> Benzos but not much support
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contingency mgmt
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Tx - Specific Phobia:
1. Behavioral Txs
> Exposure, contingency mgmt, __________
2. CBT
> Identify cues, monitoring, coping skills
3. Medications
> Benzos but not much support
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modeling
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Tx - Specific Phobia:
1. Behavioral Txs
> Exposure, contingency mgmt, modeling
2. ___
> Identify cues, monitoring, coping skills
3. Medications
> Benzos but not much support
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CBT
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Tx - Specific Phobia:
1. Behavioral Txs
> Exposure, contingency mgmt, modeling
2. CBT
> _______ _____, monitoring, coping skills
3. Medications
> Benzos but not much support
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indentify cues
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Tx - Specific Phobia:
1. Behavioral Txs
> Exposure, contingency mgmt, modeling
2. CBT
> Identify cues, _________, coping skills
3. Medications
> Benzos but not much support
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monitoring
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Tx - Specific Phobia:
1. Behavioral Txs
> Exposure, contingency mgmt, modeling
2. CBT
> Identify cues, monitoring, _____ ____
3. Medications
> Benzos but not much support
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coping skills
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Tx - Specific Phobia:
1. Behavioral Txs
> Exposure, contingency mgmt, modeling
2. CBT
> Identify cues, monitoring, coping skills
3. _________
> Benzos but not much support
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Medications
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Tx - Specific Phobia:
1. Behavioral Txs
> Exposure, contingency mgmt, modeling
2. CBT
> Identify cues, monitoring, coping skills
3. Medications
> _______ but not much support
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Benzos
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Fear of contact with unknown people or of negative appraisal by others
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Social phobia
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Social phobia: avoidance of ppl/social situations can be _______
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generalized
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Dx considerations: Social phobia has to occur for at least _ months or more
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6
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Dx considerations: Social phobia avg onset
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age 10
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Dx considerations: Social phobia overlaps a lot with ____ refusal
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school
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Dx considerations: Social phobia __% prevalence for kids & adolescents, with more occurring in adolescence
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7
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Features of Social Phobia: withdrawn & timid, more than just being ___
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shy
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Features of Social phobia: Shaking, hiding, clinging to familiar others, not _________
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speaking
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Features of Social phobia: _______ complaints
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somatic
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Features of Social phobia: ____ problems
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peer
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Features of Social phobia: difficulties ____________
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concentrating
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Features of Social phobia: perfectionism and hypersenstivity to criticism,
esp. related to ___ ___-____
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low self-esteem
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Etiology - Social Phobia: shy or ______- temperament
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difficult
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Etiology of Social phobia: learning or ____ disabilities
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speech
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Etiology of Social phobia: Poor ___ skills and social failures early on which ______
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social; exacerbate
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Etiology of Social phobia: parental ____
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reinforcement
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Etiology of Social phobia: reinforcement of ________
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avoidance
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Etiology of Social phobia: concordance with ________ in mothers
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anxiety
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Tx - Social Phobia
1. _______
> contingency mgmt, modeling and shaping of social skills, desensitization
2. CBT for individual and family
3. Medications
> Antidepressants
> Anxiolytics
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Behavioral
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Tx - Social Phobia
1. Behavioral
> _________ _______, modeling and shaping of social skills, desensitization
2. CBT for individual and family
3. Medications
> Antidepressants
> Anxiolytics
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contingency mgmt
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Tx - Social Phobia
1. Behavioral
> contingency mgmt, _______ and shaping of social skills, desensitization
2. CBT for individual and family
3. Medications
> Antidepressants
> Anxiolytics
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modeling
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Tx - Social Phobia
1. Behavioral
> contingency mgmt, modeling and shaping of social skills, ___________
2. CBT for individual and family
3. Medications
> Antidepressants
> Anxiolytics
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desensitization
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Tx - Social Phobia
1. Behavioral
> contingency mgmt, modeling and shaping of social skills, desensitization
2. CBT for individual and ________
3. Medications
> Antidepressants
> Anxiolytics
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family
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Tx - Social Phobia
1. Behavioral
> contingency mgmt, modeling and shaping of social skills, desensitization
2. CBT for individual and family
3. Medications
> ____________
> ____________
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Antidepressants; Anxiolytics
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Intense anxiety in places where individuals feel insecure, trapped, or not in control
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Agoraphobia
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Agoraphobia is ____ in kids/adolescents, more girls than boys
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rare
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OCD LOOK UP
Obsessions
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Persistent thoughts that are intrusive and cause distress
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OCD Prevalance
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1% in children
2% in adolescents
May be underestimated/underdiagnosed
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Considerations for OCD
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In childhood, there are more boys...but it evens out
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Considerations for OCD: avg age onset ___
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12
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Considerations for OCD: comorbid with Tourette's, MR, _____, and more
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MDD
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Considerations for OCD: many children display prefs and rituals that are ____ _________
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Not pathological (bed time, etc.)
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Four distinct dimensions of OCD:
1. _____________
2. Sexual and aggressive obsessions
3. Superstitions
4. Hoarding/ordering/somatic concerns
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Compulsions
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Four distinct dimensions of OCD:
1. Compulsions
2. Sexual and ___________ ____________
3. Superstitions
4. Hoarding/ordering/somatic concerns
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aggressive obsessions
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Four distinct dimensions of OCD:
1. Compulsions
2. Sexual and aggressive obsessions
3. ______________
4. Hoarding/ordering/somatic concerns
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Superstitions
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Four distinct dimensions of OCD:
1. Compulsions
2. Sexual and aggressive obsessions
3. Superstitions
4. ___________/ordering/somatic concerns
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Hoarding
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Four distinct dimensions of OCD:
1. Compulsions
2. Sexual and aggressive obsessions
3. Superstitions
4. Hoarding/_________/somatic concerns
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ordering
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Four distinct dimensions of OCD:
1. Compulsions
2. Sexual and aggressive obsessions
3. Superstitions
4. Hoarding/ordering/_______ concerns
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somatic
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Features of OCD: Less severe/transient O and C are common in ______
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childhood
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Features of OCD: Topics often include ________, hoarding, urges to count or check
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neatness
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Features of OCD: Topics often include neatness, _________, urges to count or check
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hoarding
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Features of OCD: Topics often include neatness, hoarding, urges to ____ or ____
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count; check
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Features of OCD: Many times ____ is a theme
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guilt
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Features of OCD: Often there's a lack of ability to ____ or ______ on anything
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attend; concentrate
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Features of OCD: Many times ______ or _____ _____ is involved
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superstitious; magical thinking
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Etiology of OCD:
1. ________
> Serotonin
> Basal ganglia
> Frontal lobe cortex
> Concordance
2. Behavioral
3. Psychodynamic
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Biological
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Etiology of OCD:
1. Biological
> _________
> Basal ganglia
> Frontal lobe cortex
> Concordance
2. Behavioral
3. Psychodynamic
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Serotonin
|
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1. Biological
> Serotonin
> ______ ganglia
> Frontal lobe cortex
> Concordance
2. Behavioral
3. Psychodynamic
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Basal
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Etiology of OCD:
1. Biological
> Serotonin
> Basal ganglia
> _______ _____ cortex
> Concordance
2. Behavioral
3. Psychodynamic
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frontal lobe
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Etiology of OCD:
1. Biological
> Serotonin
> Basal ganglia
> Frontal lobe cortex
> _____________
2. Behavioral
3. Psychodynamic
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Concordance
|
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Etiology of OCD:
1. Biological
> Serotonin
> Basal ganglia
> Frontal lobe cortex
> Concordance
2. ____________
3. Psychodynamic
|
Behavioral
|
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Etiology of OCD:
1. Biological
> Serotonin
> Basal ganglia
> Frontal lobe cortex
> Concordance
2. Behavioral
3. __________________
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Psychodynamic
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Tx of OCD:
1. ____________
> Exposure, response prevention, contingency management, modeling (March and Mulle)
2, CBT
> Challenging thoughts is main cognitive piece
3. Medications
> SSRIs
> Benzos
**ERP/MEDS seem best
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Behavioral
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Tx of OCD:
1. Behavioral
> ________, response prevention, contingency management, _________ (March and Mulle)
2, CBT
> Challenging thoughts is main cognitive piece
3. Medications
> SSRIs
> Benzos
**ERP/MEDS seem best
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Exposure; modeling
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Panic D/o is __ ____ in youth
|
not common; 9% in clinical teens
|
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Considerations for Panic d/o: Frequent (more than__) panic attacks
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2
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Considerations for Panic d/o: Fear of losing _____, going crazy, or death
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control
|
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Considerations for Panic d/o: ______ arousal (dizzy, heart pounding)
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physiological
|
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Considerations for Panic d/o: Can lead to __________
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Agoraphobia
|
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Considerations for Panic d/o: Worry bout future attacks LOOK UP
Diagnostic Considerations - PTSD:Development of ______ and _______ symptoms following a traumatic event
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Intrusive; avoidant
|
|
Diagnostic considerations - PTSD: Must ________ arousal and avoidance
|
re-experience
|
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Diagnostic Considerations -PTSD: Must last more than ____ ____
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one month
|
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Diagnostic Considerations -PTSD: Specific if begins _ months after stressor
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6
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Diagnostic Considerations -PTSD: High percentages of children with ____ meet criteria
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trauma
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Features of PTSD: Reoccurrence is varied
> _______, enactments, dreams, etc.
>Avoidance is big
>Thoughts, feelings, activities, etc.
>Irritable, angry feelings common
>Also symptoms of hypervigilance
>Jumpy, poor sleep, concentration problems, etc.
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flashbacks
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Features of PTSD: Reoccurrence is varied
> Flashbacks, enactments, dreams, etc.
>___________ is big
>Thoughts, feelings, activities, etc.
>Irritable, angry feelings common
>Also symptoms of hypervigilance
>Jumpy, poor sleep, concentration problems, etc.
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avoidance
|
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Features of PTSD: Reoccurrence is varied
> Flashbacks, enactments, dreams, etc.
>Avoidance is big
>Thoughts, feelings, activities, etc.
>Irritable, angry feelings common
>Also symptoms of hypervigilance
>Jumpy, poor sleep, ____________ problems, etc.
|
concentration
|
|
Etiology of PTSD:
> Stressor or ____ occurs
> Seem to be predisposing and concurrent factors
> Biological like opoid withdrawal, increased norepinephrine , smaller hippocampus
> Insecure attachment
: Negative schema interpretation
|
trauma
|
|
Etiology of PTSD:
> Stressor or trauma occurs
> Seem to be _________ and concurrent factors
> Biological like opoid withdrawal, increased norepinephrine , smaller hippocampus
> Insecure attachment
: Negative schema interpretation
|
predisposing
|
|
Etiology of PTSD:
> Stressor or trauma occurs
> Seem to be predisposing and concurrent factors
> Biological like ____ withdrawal, increased _______ , smaller hippocampus
> Insecure attachment
: Negative schema interpretation
|
opioid; norepinephrine
|
|
Etiology of PTSD:
> Stressor or trauma occurs
> Seem to be predisposing and concurrent factors
> Biological like opoid withdrawal, increased norepinephrine , smaller hippocampus
> _________ attachment
: Negative schema interpretation
|
insecure
|
|
Etiology of PTSD:
> Stressor or trauma occurs
> Seem to be predisposing and concurrent factors
> Biological like opoid withdrawal, increased norepinephrine , smaller hippocampus
> Insecure attachment
: Negative _______ interpretation
|
schema
|
|
Tx - PTSD:
> Early treatment is important
>> But not crisis intervention/debriefing as it is ______
> Exposure is best treatment
>> Goal to integrate traumatic event in safe place, etc.
> Some other treatments, but not much support
>> However, play is good with younger children
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negative
|
|
Tx - PTSD:
> Early treatment is important
>> But not crisis intervention/debriefing as it is negative
> ________ is best treatment
>> Goal to integrate traumatic event in safe place, etc.
> Some other treatments, but not much support
>> However, play is good with younger children
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Exposure
|
|
Tx - PTSD:
> Early treatment is important
>> But not crisis intervention/debriefing as it is negative
> Exposure is best treatment
>> Goal to __________ traumatic event in safe place, etc.
> Some other treatments, but not much support
>> However, play is good with younger children…
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integrate
|
|
Tx - PTSD:
> Early treatment is important
>> But not crisis intervention/debriefing as it is negative
> Exposure is best treatment
>> Goal to integrate traumatic event in safe place, etc.
> Some other treatments, but not much support
>> However, play is good with _______ children
|
younger
|
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Diagnostic Considerations -GAD:
Excessive _____ and anxiety about a number of different things (for 6 months or >)
More signs/symptoms than other disorders
|
worry
|
|
Diagnostic Considerations -GAD:
Excessive worry and anxiety about a number of different things (for _ months or >)
More signs/symptoms than other disorders
|
6
|
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Diagnostic Considerations -GAD:
Excessive worry and anxiety about a number of different things (for 6 months or >)
____ signs/symptoms than other disorders
|
more
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|
Diagnostic Considerations -GAD: Worries tend to be _______ and/or daily
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delusional
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Diagnostic Considerations -GAD: Comorbid with ADHD and _____ phobia
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specific
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Diagnostic Considerations -GAD: equal in boys and girls, but _____ adult females then males
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more
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|
Diagnostic Considerations -GAD: avg age onset
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9
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Features of GAD: ___ range of worry topics
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large
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|
Features of GAD:
difficulties in _________ and sleeping, moodiness, restlessness, hyperarousal, ________, reassurance-seeking, somatic complaints, and avoidance (school)
|
concentrating; perfectionism
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PSYC 4620:Study Guide