Comprehensive Guide to Anxiety, Depression, and School Refusal Disorders in Youth

What are anxiety disorders characterized by?

Anxiety disorders are characterized by cognitive distress, physiological distress, and behavioral distress.

What is a common cognitive symptom of anxiety?

Rumination and catastrophizing.

What distinguishes different types of anxiety disorders?

The object of fear/avoidance and related cognitive ideation.

What is the core fear of Separation Anxiety Disorder?

Excessive anxiety and fear concerning separation from home or caregivers.

What are common worries in Separation Anxiety Disorder?

Fears of being kidnapped, getting lost, and harm coming to parents or caregivers.

What physiological symptoms are associated with Separation Anxiety Disorder?

Distress, tantrums, nightmares, avoidance, headaches, stomachaches, nausea, or vomiting.

What is one DSM-5 criterion for Separation Anxiety Disorder?

Recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated.

How long must symptoms persist for a diagnosis of Separation Anxiety Disorder in children?

At least 4 weeks.

What is the core fear of Generalized Anxiety Disorder?

Extreme, uncontrollable worry about several events and activities.

What are common worries in Generalized Anxiety Disorder?

Concerns about general life issues, competence, and future events.

What is a physiological symptom of Generalized Anxiety Disorder?

Accelerated heart rate, shortness of breath, dizziness, sweating, nausea, diarrhea.

What is one DSM-5 criterion for Generalized Anxiety Disorder?

Excessive anxiety and worry occurring more days than not for at least 6 months.

What is the core fear of Social Anxiety Disorder?

Marked and persistent fear of social situations involving scrutiny by others.

What are common worries in Social Anxiety Disorder?

Fear of being disliked, judged, or offending others.

What physiological symptoms are associated with Social Anxiety Disorder?

Crying, tantrums, freezing, refusal to speak.

What is one DSM-5 criterion for Social Anxiety Disorder?

Marked fear or anxiety about one or more social situations where the individual is exposed to possible scrutiny.

What is the core fear of Panic Disorder?

Recurrent unexpected panic attacks and the fear of future attacks.

What are common symptoms experienced during a panic attack?

Palpitations, sweating, trembling, shortness of breath, feelings of choking.

What is one DSM-5 criterion for Panic Disorder?

Recurrent unexpected panic attacks followed by at least one month of persistent concern about having more attacks.

What is a safety behavior commonly associated with anxiety disorders?

Reassurance seeking.

How does Separation Anxiety Disorder typically change with age?

It tends to go away or decrease with age.

What can be a common associated characteristic of Social Anxiety Disorder?

Struggles with peers and poor social skills.

What is a common comorbidity with Generalized Anxiety Disorder?

Depression.

What strategies can parents use to help children with Separation Anxiety Disorder?

Stay calm during separations, avoid dramatic goodbyes, and encourage independence.

What is a common symptom of anxiety related to uncertainty?

Creating negative beliefs about uncertain events.

What is the prevalence of Social Anxiety Disorder in females?

More prevalent in females compared to males.

What is a common outcome for individuals with untreated anxiety disorders?

Lower quality of life and increased distress in social, academic, or occupational functioning.

What defines a panic attack?

A discrete period of intense fear or discomfort with at least 4 physiological symptoms.

List three physiological symptoms of a panic attack.

Palpitations, sweating, trembling.

What is the DSM-5 criterion A for Panic Disorder?

Recurrent unexpected panic attacks.

What must follow at least one panic attack according to DSM-5 criterion B?

Persistent concern about additional attacks or significant maladaptive behavior change.

What does criterion C of the DSM-5 for Panic Disorder state?

The disturbance is not attributable to physiological effects of a substance or another medical condition.

What is the role of avoidance in anxiety disorders?

Avoidance provides short-term relief but ultimately maintains anxiety.

What is cognitive restructuring?

A process to identify, challenge, and change maladaptive thoughts.

What are the three C's in cognitive restructuring?

Catch, Check, Change.

What is the purpose of exposure therapy?

To stay with the core fear long enough to learn it is not dangerous.

What is response prevention in anxiety treatment?

Blocking behaviors that attempt to neutralize anxiety.

What is TIPP in DBT?

A distress-tolerance strategy involving Temperature, Intense Exercise, Paced Breathing, and Progressive Muscle Relaxation.

What is the goal of psychoeducation in anxiety treatment?

To inform parents, kids, and teachers about anxiety and its management.

What is the significance of self-monitoring in anxiety management?

Helps individuals recognize their own patterns of triggers and responses.

What is the purpose of using the SUDS scale?

To measure subjective units of distress.

Describe the steps involved in desensitization techniques.

Gradual exposure to the fear stimulus until sensitivity diminishes.

What is the Multidimensional Anxiety Scale for Children (MASC-2)?

An assessment tool used to measure anxiety symptoms in children.

What factors should be considered when assessing a child for anxiety disorders?

Risk factors, symptom onset, context, and family history.

What is the role of classroom observation in assessing anxiety?

To identify safety behaviors and the impact of anxiety on school performance.

What is the significance of identifying automatic thoughts in anxiety treatment?

It helps to understand the emotions and behaviors associated with anxiety.

What is the role of behavioral assessment in anxiety disorders?

To evaluate the frequency, intensity, and duration of anxiety symptoms.

What is the purpose of contingency management in anxiety treatment?

To change the environment to support fear confrontation.

What is the Screen for Child Anxiety Related Disorders (SCARED)?

An assessment measure for identifying anxiety disorders in children.

What is the Beck Anxiety Inventory (BAI)?

A self-report measure used to assess anxiety severity.

What does the term 'maladaptive behavior' refer to in the context of anxiety?

Behaviors that are ineffective in coping with anxiety and may worsen the condition.

What is the significance of understanding the developmental history in anxiety assessment?

It provides context for the child's anxiety symptoms and potential triggers.

How can teachers contribute to the assessment of anxiety in students?

By providing observations of behavior and reporting on classroom dynamics.

What is the minimum number of symptoms required for a diagnosis of Major Depressive Disorder (MDD)?

Five symptoms

What are the two core symptoms required for MDD diagnosis?

Depressed mood (or irritable mood for youth) and loss of interest or pleasure (anhedonia)

What mnemonic is used to remember the symptoms of Major Depressive Disorder?

SIGECAPS

What does the 'S' in SIGECAPS stand for?

Sleep changes

What does the 'I' in SIGECAPS represent?

Interest loss (anhedonia)

What does the 'G' in SIGECAPS refer to?

Guilt/worthlessness

What does the 'E' in SIGECAPS indicate?

Energy lack

What does the 'C' in SIGECAPS signify?

Concentration difficulties

What does the 'A' in SIGECAPS stand for?

Appetite changes

What does the 'P' in SIGECAPS represent?

Psychomotor agitation/retardation

What does the 'S' in SIGECAPS indicate?

Suicidal ideation

What is the duration requirement for symptoms to be considered recurrent in MDD?

A gap of 2 months between episodes

What is the prevalence of MDD among 13-18 year-olds?

2-13%

What is the prevalence of MDD in teenage girls compared to boys?

Twice the rate of boys

What are some biological factors associated with higher MDD prevalence in teenage girls?

Sexual maturation and early puberty

What is the required duration of symptoms for Persistent Depressive Disorder (PDD) in adults?

2 years

What is the required duration of symptoms for PDD in children?

At least 1 year

What are the two or more symptoms required for PDD diagnosis?

Appetite changes, sleep changes, energy lack, low self-esteem, concentration/decision-making difficulties, hopelessness

What is the role of the amygdala in Major Depressive Disorder?

Involved in emotion-regulation; smaller volume leads to greater responsivity to emotional stimuli

What is the function of the hippocampus in depression?

Consolidation of memory; smaller volume contributes to dysregulation of stress response

What does the HPA axis regulate in the context of depression?

The stress response system, including cortisol release

What is the significance of the striatum in Major Depressive Disorder?

Involved in reward processing; abnormalities can lead to anhedonia

What are common comorbid disorders associated with MDD?

Anxiety disorders, disruptive behavior disorders, substance use disorders

What is self-monitoring in the treatment of depression?

Tracking emotions and behaviors to increase awareness

What is behavioral activation?

Increasing activities to promote positive emotions and thoughts

What assessment tool is used for children aged 7-17 to measure depression severity?

Child Depression Inventory (CDI)

What is a common thinking mistake Peter engages in regarding his grandfather's death?

He feels guilt and believes he should have done more, indicating cognitive distortions

What thinking mistakes might Peter be engaging in?

Should statements, personalization, blame game

What is psychoeducation?

Providing information to help individuals understand their mental health conditions.

What is self-monitoring in the context of mental health?

Tracking one's own thoughts, feelings, and behaviors to increase awareness.

What is the Child Depression Inventory (CDI)?

An assessment tool for children aged 7-17 to measure severity of depressive symptoms.

What does the Beck Depression Inventory (BDI) assess?

It assesses depression in individuals aged 13 and older.

What is the Patient Health Questionnaire (PHQ-9)?

A tool used to assess the severity of depression, modified for teens.

What is the Revised Children's Anxiety and Depression Scale (RCADS)?

An assessment measure for anxiety and depression in children aged 8-18.

What is passive suicidal ideation?

Wishing to be dead without taking steps to kill oneself.

What is active suicidal ideation?

Expressing a desire to kill oneself.

What distinguishes active suicidal ideation with a plan?

Having a specific method in mind for suicide but not intending to act on it.

What is non-suicidal self-injury (NSSI)?

Self-harm without the intent to die.

What are the two types of emotional regulation involved in NSSI?

Up-regulation and down-regulation.

What demographic has the highest suicide rates?

Men, particularly those aged 75 and older, and American Indian/Alaska Native individuals.

What are the top two leading causes of death among adolescents and young adults in the U.S.?

Unintentional injury and suicide.

What are some individual risk factors for suicide?

Previous suicide attempts, history of depression, chronic illness, and substance abuse.

What protective factors can reduce suicide risk?

Hope for the future, effective coping skills, and strong social connections.

What is DBT?

Dialectical Behavior Therapy, a treatment that includes mindfulness and emotional regulation strategies.

What is the 'DEAR MAN' technique in DBT?

A strategy for self-assertion and effective communication.

What are the four core skill sets in DBT?

Mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness.

What are warning signs of suicidal behavior?

Statements about wanting to die, giving away belongings, and mood changes.