Intro
What is the complex state of psychological distress that reflects emotional, behavioral, physiological, and cognitive reactions to threatening stimuli?
Anxiety
The hallmark characteristic of Generalized Anxiety Disorder (GAD) is ___________ _____________ that is excessive worry about the future (Table 11.8)
apprehensive expectation
Which anxiety disorder is the most closely associated with depression?
GAD is more closely associated with depression than any of the other anxiety disorders (Goldberg et al. 2009). First, GAD and major depressive disorder show high comorbidity in older children and adolescents. Approximately 50% of youths with GAD also have depression. Factor analysis has shown that GAD and depressive symptoms tend to naturally co-occur in the general population (Michl et al., 2013)
In the CAMS study, which treatment had the highest success rate?
Combined treatment with sertraline (SSRI (Selective Serotonin Reuptake)) + CBT, with an 81% response rate (Wehry, 2015).
According to the Wehry article, what medical condition should clinicians rule out because it can mimic anxiety symptoms?
Hyperthyroidism
Children’s anxiety exists on a _______________ from developmentally expected and adaptive to developmentally divergent and maladaptive. Three characteristics of maladaptive anxiety: Firstly, it tends to be more ______ to the threat that triggered the anxiety response. Secondly, it tends to be ________ . Thirdly, maladaptive anxiety interferes with ability to _____________________ (50pt per correct answer)
Children’s anxiety exists on a continuum from developmentally expected and adaptive to developmentally divergent and maladaptive. Firstly, it tends to be more intense and out of porportion to the threat that triggered the anxiety response. Secondly, it tends to be chronic. Thirdly, maladaptive anxiety interferes with ability to perform daily tasks
______________ is characterized by recurrent anxiety about places or situations from which escape or help is not possible without considerable effort or embarrassment
agorphobia
Children's internalizing symptoms can be divided into two groups based on how they typically co-occur: __________ symptoms and _________ - ________ symptoms
fear symptoms
anxious-misery symptoms
What are the three disorders that make up the "pediatric anxiety disorder triad"?
Generalized Anxiety Disorder (GAD), Social Anxiety Disorder (Social Phobia), and Separation Anxiety Disorder (SAD). (Wehry, 2015)
Most phobias fall into 5 broad categorgies try to name one specific phobia in each category (40pts each)
1. Animals
2. Natural enviroment
3. Specific situations
4. Other stimuli
5. Blood, injections, and injuries
Animals: fear of snakes, spiders, dogs, birds
Nature: fear of thunderstorms, heights, water
Blood, injections, and injuries: fear of receiving injections (needles), seeing blood
Specific situations: fear of airplanes, elevators, enclosed spaces
Other stimuli: fear of choking, costumed characters
List as many of the anxiety disorders that are identified by the DSM-5 and can be diagnosed in children, adolescents, and adults (25pt per correct answer).
(1) separation anxiety disorder (SAD) (2) selective mutism (3) specific phobia (4) social anxiety disorder (5) generalized anxiety disorder (GAD) (6) agoraphobia (7) panic disorder (8) Unspecified Anxiety Disorder (9) Other Specified Anxiety Disorder (10) Social Anxiety Disorder (Social Phobia) (11) Anxiety Disorder Due to Another Medical Condition (12) Substance/Medication-Induced Anxiety Disorder
Diagnostic Criteria (A) for Panic Disorder: Criteria A for Panic Disorder is recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense discomfort that reaches a peak within ten minutes and during which time four or more of the following symptoms occur?
1. sweating
2. palpitations, pounding heart, or accelerated HR
3. trembling or shaking
4. sensations of shortness of breath
5. feelings of choking
6. chest pain or discomfort
7. nausea or abdominal distress
8. feeling
9. chills or heating sensations
10. paresthesias (numbness or tingling sensation)
11. derealization or depersonalization
12. fear of losing control
13. fear of dying
According to _________ __________ theory, worrying helps people avoid emotionally and physically distressing mental images. Worrying, therefore, is a form of avoidance and is negatively reinforcing
cognitive avoidance theory
Which three disorders were removed from the Anxiety Disorders section in DSM-5?
Obsessive-compulsive disorder, acute stress disorder, and post-traumatic stress disorder (Park & Kim, 2020).
Which of these situations is most feared by children with social anxiety disorder. (Figure 11.4, Weiss Txtb pg. 342)
1) Going to parties
2) Musical or athletic performances
3) Eating in school cafeteria
4) Reading alound in front of classmates
1) Going to parties (~45%)
2) Musical or athletic performances (~60%)
3) Eating in school cafeteria (~25%)
4) Reading alound in front of classmates (~70%)
Approximately _______ % of children and adolescents will develop an anxiety disorder before reaching adulthood making it one of the most frequently diagnosed psychiatric conditions in children and adolescents (Connolly, Suarez, Victor, et al., 2015).
20%
Children with selective mutism are at risk for other psychiatric disorders later in childhood and adolescence. As many as 94% who do not receive treatment will develop __________________ (Genstahler et al., 2016).
Social anxiety disorder
What are the four components of CBT for adolescents with panic disorder
1. relaxation
2. interoceptive exposure
3. cognititve restructuring
4. graded in vivo exposure
(Connolly et al., 2015; Simon, 2016)
The DSM-5 both "split" and "lumped" anxiety-related diagnoses compared to DSM-IV. What is one example of splitting and one example of lumping? Expain what team your on for fun!
Splitting: Panic Disorder and Agoraphobia were separated into distinct diagnoses because evidence suggested they can occur independently and have different clinical courses and treatment outcomes.
Lumping: Separation Anxiety Disorder and Selective Mutism were moved into the broader Anxiety Disorders category because they share core anxiety-related features with other anxiety disorders.
(Park & Kim, 2020)
Longitudinal studies indicate that selective mutism is a long-term condition. Without treatment the average duration of the condition is approximately _____ years.
8 years
Which 3 anxiety disorders typically emerge in late adolescents or adulthood and which 4 typically emerge in early or middle childhood.
According to which theory selective mutism arises because of classical conditioning, when children associate speaking in certain situations with heightened arousal and psychological distress. Selective mutism is maintained over time, however, because of negative reinforcement. These children learn that they can lower their arousal and avoid distress by remaining silent making them less likely to break the cycle and speak out.
Mowrer’s two-factor theory of anxiety
What is Arachibutyrophobia the fear of :)
Peanut butter on roof of the mouth
Pt. 1: Do you think "splitting" Panic Disorder and Agoraphobia into splitting diagnoses may improves diagnostic accuracy, or does it risk creating too many categories of mental disorders?
Pt. 2: Do you think DSM-5 made the right decision to "lump" Separation Anxiety Disorder and Selective Mutism with other anxiety disorders, or should they have remained separate developmental disorders? Why?
Up to you!
The disorder agoraphobia gets its name from the word agora, which was the central meeting place in what ancient city
Greece