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Psychotherapy: 115b - Anxiety Disorders

Psychology15 CardsCreated about 1 month ago

This flashcard set outlines diagnostic criteria for Obsessive-Compulsive Disorder (OCD)—requiring time-consuming obsessions or compulsions with insight—as well as the neuroanatomy of fear and anxiety, involving the amygdala, hippocampus, and related systems. It also notes that specific phobias often present in childhood or early adulthood, with earlier onset linked to higher remission rates.

What is required to diagnose OCD?

  • Presence of either obsessions or compulsions (or both)

  • Individual has realized that the obsessions and/or compulsions are unreasonable (has insight)

  • Symptoms are time consuming

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Key Terms

Term
Definition

What is required to diagnose OCD?

  • Presence of either obsessions or compulsions (or both)

  • Individual has realized that the obsessions and/or c...

Which parts of the brain are important for regulating fear and anxiety states?

Amygdala

Also hippocampus, locus coeruleus, hypothalamic/pituitary/adrenocortical axis

When does specific phobia usually present?

Bimodal onset: Childhood or early adulthood

Early onset cases are more likely to remit

Which medications can be used to manage panic disorder?

  • SSRIs

  • Benzos (2nd line, should not be used long-term)

    • May serve a a bridge since SSRIs take awhile to star...

Which parts of the DSM-5 criteria are similar for all anxiety disorders?

Symptoms must be:

  • Persistent

  • Out of proportion to the threat/danger

  • Cause clinically significant distre...

Which areas of the brain have increased activity in patients with OCD?

  • Cingulate

  • Caudate

  • Prefrontal cortex

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TermDefinition

What is required to diagnose OCD?

  • Presence of either obsessions or compulsions (or both)

  • Individual has realized that the obsessions and/or compulsions are unreasonable (has insight)

  • Symptoms are time consuming

Which parts of the brain are important for regulating fear and anxiety states?

Amygdala

Also hippocampus, locus coeruleus, hypothalamic/pituitary/adrenocortical axis

When does specific phobia usually present?

Bimodal onset: Childhood or early adulthood

Early onset cases are more likely to remit

Which medications can be used to manage panic disorder?

  • SSRIs

  • Benzos (2nd line, should not be used long-term)

    • May serve a a bridge since SSRIs take awhile to start working

Which parts of the DSM-5 criteria are similar for all anxiety disorders?

Symptoms must be:

  • Persistent

  • Out of proportion to the threat/danger

  • Cause clinically significant distress or impariment

Which areas of the brain have increased activity in patients with OCD?

  • Cingulate

  • Caudate

  • Prefrontal cortex

“Chronic daily worry” is a symptom of which anxiety disorder?

Generalized anxiety disorder

Which anxiety disorder is most likley to benefit from surgical intervention if medical management is unsuccessful?

OCD

We understand more about the neural circuitry: OCD results from overactive cingulate, caudate, and prefrontal cortex

Which neurotransmitters have a role in anxiety?

  • GABA

    • Too little GABA = anxiety

  • Serotinin

    • Too little serotonin = anxiety

  • NE

    • Poor regulation w/Bursts of NE = anxiety

What is the most common obsession found in OCD?

Uncleanliness obsessions

In general, what is the prognosis for anxiety disorders?

Chronic illness, but many improve with treatment

  • 80% remit or improve

    • 30% remit

    • 50% improve

  • 20% remain significantly ill

Varies with specific disorder, setting of treatment

What physical causes are on the ddx for panic attack?

  • Cardiac (arrhythmia, angina)

  • Endocrine (pheochromocytoma, hyperthyroid, hypoglycemia)

  • Resiratory distress

  • Drug withdrawal

  • Seizure disorder

  • Vestibular dysfunction

The point is: evaluate all possible causes so you don’t miss something!

When does panic disorder usually onset?

Adolescence - 30’s

(later than other anxiety disorders)

What is necessary to diagnose a panic disorder?

  • Recurrent or unexpected panic attacks

  • At least 1 of the attacks has been followed by 1 month+ of either:

    • Persistent concern about additional attacks

    • Maladaptive change in behavior related to attacks

Not everyone who has had a panic attack has a panic disorder!

Which treatments are most helpful for OCD?

  • Response prevention/flooding

  • TCAs, SSRIs

  • Atypical antipsychotics (as an ad-junct)

  • Surgical

    • May be helpful in refractory cases