Anxiety Disorders (finished editing)

What is anxiety?

An emotion that serves as an adaptive response to threatening or harmful stimuli.

When does anxiety become a disorder?

When the protective fear response is prolonged and inappropriate to the actual threat level

And gets in the way of daily routines

what is the difference between fear and anxiety?

fear is the physiological response to something factual or real

anxiety is the physiological response to things that MAY happen that aren't present in the moment

What are some impacts of anxiety disorders on daily life?

They can negatively impact the ability to engage in occupations such as ADLs, work, school, and socialization.

List the anxiety disorders classified in the DSM-5.

- Separation anxiety disorder

- selective mutism

- specific phobias

- social anxiety disorder

- panic disorder

- agoraphobia

- generalized anxiety disorder (GAD)

What characterizes separation anxiety disorder?

Excessive fear or anxiety about separation from home or primary figures, and worry about potential harm to attachment figures or themselves

What is the onset of separation anxiety?

there is no onset and can occur across the lifespan

What is required to meet the criteria for a separation anxiety diagnosis?

symptoms persisting for 4 weeks in children and 6 months in adults.

What is selective mutism?

Inability to speak in social situations despite being able to speak in other situations, often due to high social anxiety.

t/f selective mutism can also be called social anxiety or fear of public speaking

false

Define phobia.

Irrational fears that lead to avoidance of certain objects or situations, with marked PERSISTENT fear or anxiety that is out of proportion to the actual risk.

How long does the fear and anxiety of a phobia last?

at least 6 months

3 multiple choice options

can phobias be cured?

no they are constant and linear

What are the five categories of phobias?

- Situational

- natural environment

- blood-injection injury

- animals

- other types (e.g., clowns).

fear of flying (aerophobia or aviophobia) is an example of what type of phobia?

situational phobia

fear of heights (acrophobia) or fear of bridges (gephyrophobia) is an example of what type of phobia?

natural environment phobia

What is social anxiety disorder?

Persistent fear or anxiety regarding being scrutinized in social situations, with symptoms like blushing and trembling.

t/f fear of public speaking is in a separate category from social anxiety disorder

true

What defines panic disorder?

Characterized by panic attacks that involve an abrupt surge of intense fear or discomfort, leading to persistent worry about future attacks.

what is the average onset for panic disorder?

20-24 y/o

3 multiple choice options

t/f panic attacks are the same in frequency and severity

false

panic disorder symptoms

- heart palpitations/increased HR/pounding heart

- sweating

- shaking trembling

- SOB

- feeling of choking/difficulty swallowing

- chest discomfort or pain

- nausea

How many symptoms need to be present to be considered a panic attack?

4 or more

3 multiple choice options

What are the 2 frequency criteria of panic attacks to be considered a panic disorder?

- 4 panic attacks in 1 month

- 1 panic attack followed by excessive worrying for 1 month or longer

What is agoraphobia?

Fear or marked anxiety in situations where escape may be difficult or help unavailable, often related to open spaces or crowds.

fear or anxiety caused by 2 out of 5 situations can be considered agoraphobia:

- use of public transportation

- being in an open space

- being in an enclosed space

- being in a crowd or standing in line

- alone outside of the home

Your client reports severe anxiety about being in vast fields or forests, using the public bus system, and waiting in long lines at supermarkets. The client is demonstrating signs of what anxiety disorder?

agoraphobia

Why do people with agoraphobia avoid distressing situations?

Thoughts of not being able to escape, or help may not be available during signs of panic

What is generalized anxiety disorder?

Excessive worry and anxiety present for at least 6 months, with symptoms like restlessness, fatigue, and difficulty concentrating.

What are the possible symptoms of generalized anxiety disorder?

- feelings of being on edge/restless

- easily fatigued

- difficulty concentrating/mind going blank

- irritability

- muscle tension

- difficulty with sleep due to constant worrying

How many symptoms of anxiety need to be present to be considered generalized anxiety disorder?

3 out of 6 symptoms for at least 6 months

3 multiple choice options

What does the "generalized" part of GAD refer to?

worry through a greater range of life circumstances than other anxiety disorders, not related to other conditions

What factors contribute to the etiology of anxiety disorders?

- Genetic factors

- environmental influences

- adverse childhood experiences (ACEs)

- temperament (shyness, inhibition, withdrawal, avoidance)

How prevalent are anxiety disorders in women compared to men?

Anxiety disorders are diagnosed in women almost twice as often as in men.

What is the prevalence of anxiety disorders in individuals with ASD?

The prevalence rate is approximately 50% in individuals with Autism Spectrum Disorder (ASD).

How do anxiety disorders impact occupational performance?

They can significantly affect individuals' ability to engage in meaningful social interactions and daily activities.

what specific occupation is affected because of anxiety disorders?

sleep hygiene

what kind of impairments may elevate anxiety levels?

cognitive impairments in attention, reduced recall, time management, problem-solving, decision-making

what kind of sensory factors can be seen in anxiety disorders?

sensory avoiding and sensory sensitivity

What role do medications play in the management of anxiety disorders?

- Benzodiazepines for short-term treatment in acute settings

- antidepressants like SSRIs are commonly prescribed.

What are some other medical treatments for anxiety disorders?

- Electroconvulsive therapy (ECT)

- repetitive transcranial magnetic stimulation (rTMS)

- deep brain stimulation

when is the only time ECT may be considered as an alternative treatment?

in extreme cases when there is no response to medications

What MOHO assessment tools are used in occupational therapy for anxiety disorders?

- Role Checklist

- Occupational Self-Assessment (OSA)

- Canadian Occupational Performance Measure (COPM)

what is the main focus of OT interventions for anxiety disorders?

changing performance deficits in occupations, and changing maladaptive thought patterns

What intervention strategies are used in occupational therapy for anxiety disorders?

- Cognitive Behavioral Therapy (CBT)

- sensory processing approaches

A 10-year-old child has been experiencing intense distress every morning before school for the past five weeks. They cry when separated from their parents, constantly worry that something terrible will happen to their parents while they are away, and refuse to attend sleepovers due to fear of being apart from home. Which anxiety disorder best fits this scenario?

Separation Anxiety Disorder

3 multiple choice options

A 32-year-old woman has experienced persistent anxiety for the past seven months whenever she has to travel for work. She becomes extremely distressed when away from her partner, worries that something bad will happen to him while she is gone, and frequently cancels trips to avoid being separated. Which anxiety disorder best fits this scenario?

Separation Anxiety Disorder

3 multiple choice options

A 6-year-old child speaks freely and comfortably at home with family members but becomes completely silent at school, despite understanding the language and knowing the teacher well. The child appears very anxious when expected to speak in class or with peers. Which disorder best fits this presentation?

Selective Mutism

3 multiple choice options

A 17-year-old girl faints at the sight of blood and becomes extremely anxious whenever she anticipates getting a vaccine or even sees medical supplies. To avoid these situations, she refuses routine checkups and becomes distressed when required to visit a clinic. Her fear has remained strong and unchanged for over six months. Which diagnosis best fits this presentation?

Specific Phobia

3 multiple choice options

A 20-year-old college student becomes extremely anxious when attending social gatherings. She worries constantly that others are judging her, and during group interactions she begins to blush, tremble, and sweat. Although she wants to make friends, she frequently avoids events where she might have to interact with unfamiliar people. Which diagnosis best fits this presentation?

Social Anxiety Disorder

3 multiple choice options

A 23-year-old woman reports experiencing sudden episodes of intense fear that peak within minutes. During these episodes, she feels her heart racing, begins to sweat, trembles, and has trouble catching her breath. She has had four of these episodes in the past month and now constantly worries about having another one, avoiding activities that might trigger an attack. Which diagnosis best fits this presentation?

Panic Disorder

3 multiple choice options

A 35-year-old man avoids taking public transportation and refuses to stand in crowded lines at stores. He reports feeling intense anxiety in these situations because he worries that if he begins to experience panic-like symptoms, he will not be able to escape or get help. His fear is out of proportion to the actual risk, and he often chooses to stay home to avoid these scenarios. Which diagnosis best fits this presentation?

Agoraphobia

3 multiple choice options

A 28-year-old woman reports feeling constantly worried about multiple areas of her life, including work performance, family responsibilities, and finances. She says the anxiety has been present most days for the past eight months. She feels restless, has trouble concentrating, becomes easily fatigued, and struggles with falling asleep. Her worries are difficult to control and not tied to any specific situation or other disorder. Which diagnosis best fits this presentation?

Generalized Anxiety Disorder

3 multiple choice options