Anxiety Dx: Symptoms & Epidemiology
Trauma Dx: Symptoms & Epidemiology
Etiology
Treatment
100
What is "special" about the panic attacks that a person with panic disorder has?
They are uncued. [What does "uncued" mean -- what is the person with panic disorder afraid of? How can panic attacks contribute to the development of agoraphobia?]
100
Identify the symptom: “It’s not like I wake up suddenly. Not scared or anything. But upset for sure. I never used to be able to remember them before, but I remember bits of them now. Pushing down, hard. Holding pressure on him…and just waiting. Waiting and waiting, seems like forever. Til the copter gets there. Every morning, I wake up tense and upset.”
What are nightmares related to the trauma? [Could you recognize vignettes of other symptoms?]
100

Based on existing research, exposure to combat increased the rates of PTSD by _____ in discordant MZ twins.

What is 9 times! [What else have we learned about the genetic contributions to PTEs and PTSD from twin studies?]

100
A form of cognitive restructuring that we use when a patient has "snowballing" worries.
What is decatastrophizing?
200
Other than type of trigger, what is the difference between the symptoms of specific phobia and those of social anxiety disorder.
Social anxiety disorder requires that the person has fears of negative evaluation. [What are the rest of the symptoms of these 2 disorders? What is the specifier for social anxiety disorder?]
200
Explain what a flashback is, making sure to distinguish it from experiencing strong emotions when faced with a reminder of a traumatic event.
A flashback is when the person reacts "as though" they are back in the middle of the traumatic event. It is not feeling distressed by a reminder, it is a reliving of the event when faced with a reminder. [What cluster of posttraumatic symptoms do flashbacks belong to, and how many from this cluster does a patient need to have a diagnosis of PTSD?]
200

Describe something that makes a person more likely to experience a PTE (though not necessarily more likely to develop PTSD).

Being male, being younger, being high on extraversion, having a tendency to engage in externalizing behavior.  [What makes a person more likely to develop PTSD after a PTE?]

200

What 2 treatment techniques are used to teach patients about the differences between anxiety-related and neutral/baseline physiological states?

What are progressive muscle relaxation (PMR) and breathing retraining? [What "pieces" of physiological arousal do these techniques help patients learn about? What particular disorder is PMR most likely to be used as part of treatment for, and why?]

300
Based on epidemiological research, describe one sociodemographic difference in prevalence rates for anxiety disorders.
Women are more likely to experience GAD, social anxiety, panic disorder, and agoraphobia -- but no difference for OCD. African Americans have higher rates of agoraphobia, GAD, and social anxiety disorder -- but not OCD or panic disorder. [Which anxiety disorders have the highest prevalence rates? Which have the lowest?]
300
Explain the role of the 2 dissociative symptoms in PTSD and what these symptoms are.
Derealization is when the event is experienced as being surreal or unreal -- like it doesn't make sense. Depersonalization is when the event is experienced in an "out of body" way -- like the person is witnessing something happening to them. These are not part of any symptom cluster and are not required for diagnosis, but do lead to the specifier "with dissociative symptoms."
300

Little Billy is very scared of dogs.  His Aunt Carrie has a really big dog, and he has to go to her house every week.  When he goes over, Billy always takes his stuffed bear with him, to protect him.  Billy knows that he won't get hurt when his bear is there, but he is terrified if he ever has to go without his bear.  When Billy takes his bear with him to Aunt Carrie's house, he is engaging in...

A safety behavior.

[How do safety behaviors maintain phobias?]

300

Because this is the most common response to a potentially traumatic event, there are many individuals who never need to seek treatment.

Resilience

400
What are the two components of the symptom of Obsessions?
Obsessions are recurrent, unwanted thoughts, urges, images, impulses that are distressing to the person. They must cause the person to want to suppress or get rid of them. [What are the two components of compulsions? How are obsessions different from worries? How do compulsions "work?"]
400
Provide 2 differences between PTSD and acute stress disorder.
Acute stress disorder is of shorter duration. PTSD requires a certain number of symptoms from each of the 4 clusters, but acute stress disorder does not. Dissociative symptoms don't "count" toward a PTSD diagnosis.
400

Explain what is happening in the Rebound Effect.

An initial possible threat is noticed and a message about it reaches the amygdala.  The amygdala checks in with the front lobes to see if it really is a threat.  The frontal lobes say "no threat; calm down." But all it accidentally does is restimulate the amygdala, which then resends its message, and so on in a vicious cycle.

[What is thought suppression?]

400

Explain the 3 purposes of exposure exercises. How are they supposed to help patients overcoming anxiety?

They help the patient learn if/when something is actually dangerous. They allow the patient to practice tolerating anxiety, until they are able to habituate to their triggers. They build the patient's confidence that they are capable of coping with anxiety when it happens. [What are the types of exposure exercises? Which are particularly important for people with panic attacks, and why?]

500

Provide JUST enough symptoms to warrant a diagnosis of GAD, via a set of patient statements and/or observations that a therapist might make. Make sure to address duration criteria as well.

Patient must experience excessive worry about at least 2 life domains and perceive the worry to be uncontrollable; in addition, they need at least 3 of the following: sleep disturbance, muscle tension, feeling restless/keyed up, irritability, difficulty concentrating, fatigue. And must last at least 6 months. [Can you do this for all of the other anxiety disorders?]

500
Choose any of the Mood/Cognition symptoms of PTSD. Provide a mini-vignette that expresses/reflects that symptom.
Many possible answers. [How many symptoms are needed from this cluster? What are some of the others symptoms in this cluster?]
500

Explain Barlow's theory of Catastrophic Misinterpretation and how it contributes to the development of panic attacks.

When a person notices the onset of physiological arousal symptoms, known as a false alarm, AND they interpret this as their body telling them that something is wrong or threatening (catastrophic misinterpretation), this escalates the physiological arousal to the point of panic. [Considering the biopsychosocial model, catastrophic misinterpretation is an example of what kind of factor? What is anxiety sensitivity, and how does it contribute to Barlow's theory? What are the psychological and biological factors associated with OCD?]

500

Provide one benefit of using benzodiazepines and two drawbacks.

Benefits: They work fast and are effective at reducing strong anxiety, and so for that reason psychiatrists prescribe them often and they are easy for patients to get.  Drawbacks: They can be habit-forming and you can overdose on them.  Also, they prevent psychotherapy for anxiety from working, and they have unpleasant and potentially dangerous side effects.

[What other types of medications can we use to treat anxiety disorders?]

M
e
n
u