Behav. Sci. Anxiety 2

Question 1

OCD criteria

Answer 1

• presence of obsessions and compulsions
• time consuming (more than 1 hr per day)
• significant distress
• not substance induced or explained by another syndrome

Question 2

obsession definition

Answer 2

recurrent/persistent thoughts, urges, and/or images that are intrusive and unwanted (ego dystonic- know it’s bad) - cause the person anxiety/distress and they try to ignore/suppress these intrusive thoughts OR try to neutralize them with thought or action (counting to 120)

Question 3

compulsion definition

Answer 3

repetitive behavior or activity that the patient performs in response to an obsession or as a set of rules that must be strictly adhered to (typically undoes or reduces anxiety over an obsession)

Question 4

occurrence/prognosis of OCD

Answer 4

men and women EQUALLY affected

long but variable course prognosis - hardest anxiety to treat

Question 5

comorbidities with OCD

Answer 5

MDD, tourette’s syndrome, suicide risk high

Question 6

treatment of OCD

Answer 6

psychotherapy (CBT, exposure and response prevention, acceptance and commitment therapy (?))
pharm - best results when combined with psychotherapy
-1st line SSRIs (need higher dosage than MDD)
-2nd line clomipramine (TCA - side effects)
-3rd line antipsychotics

Question 7

which medication does not work at all with OCD?

Answer 7

benzodiazepine sedatives

Question 8

DD for OCD

Answer 8

• tourette’s (has vocal and/or motor tics with OCD common)
• temporal lobe epilepsy (repetitive motor movements which may look like a compulsion)
• obsessive compulsive personality disorder - have no insight into their behavior as patients with OCD do

Question 9

OCPD

Answer 9

do not have insight into their behavior - rigid, moralistic, workaholic, list oriented, pattern oriented
don’t really have repetitive discrete behaviors to undo anxiety

Question 10

what is the most common thing to cause PTSD? most likely thing to cause?

Answer 10

MC: death of loved one

most likely: assault (combat)

Question 11

greatest variable associated with PTSD?

Answer 11

proximity, harm by another human, severity, repetition

Question 12

criteria for PTSD

Answer 12

• exposure to actual or threatened traumatic event (death, serious injury, sexual violence)
• symptoms present for more than 1 month
• symptoms cause sig distress/impairment and not result of substance/medical issue
• more than 1 “intrusion symptom” - reliving of event (distressing memories, dreams/nightmares, dissociative reactions during which the patient feels and/or acts as if the events are recurring)
• avoidance of stimuli
• negative changes in cognition and mood
• alterations of arousal//reactivity

Question 13

modes of exposure in PTSD

Answer 13

directly, witnessing, learning that a family member/friend experienced such an event, directly experiencing repeated/extreme exposure to horrific details of an event

Question 14

ASD

Answer 14

same as PTSD except only persisting for 3 days-1month after exposure - PTSD precursor

Question 15

better prognosis for ASD/PTSD if…..

Answer 15

rapid onset of symptoms, good pre-morbid functioning, no other psych conditions

Question 16

comorbidities of ASD/PTSD

Answer 16

depressive disorders, substance-related, anxiety, bipolar, personality disorders

Question 17

treatment of PTSD

Answer 17

psychotherapy: crisis intervention - initial support, grounding, validation of feelings
pharmacotherapy: 1st SSRIs, 2nd TCAs, 3rd MAOi