Anxiety and OCD

What shared features are common to all the Anxiety Disorders of the DSM-5-TR?

Excessive fear and anxiety, related behavioral disturbances

What category of mental disorders is the most prevalent worldwide?

Anxiety disorders

What is the approximate range of heritability estimates for anxiety disorders based on family and twin studies?

30 - 50%

Separation Anxiety Disorder involves developmentally inappropriate fear or anxiety concerning ___

Separation from attachment figures

What is the minimum duration of symptoms required for a diagnosis of Separation Anxiety Disorder in adults?

At least six months

What is the minimum duration of symptoms required for a diagnosis of Separation Anxiety Disorder in children and adolescents?

At least four weeks

What is often the initial treatment goal when Separation Anxiety Disorder presents with school refusal?

Getting the child back to school to reduce the risk of secondary impairments

The effectiveness of CBT for children with Separation Anxiety Disorder is increased when combined with ___

Parent training

A diagnosis of Specific Phobia requires that the fear or anxiety must be persistent, ordinarily lasting for at least how long?

At least six months

What specifier for Specific Phobia applies to a fear of elevators or bridges?

Situational

What is the mean age of onset for Specific Phobia?

10 years old

According to neuroimaging, phobic responses are linked to reduced activity in which two brain regions?

Ventromedial prefrontal cortex (vPFC) and ventral anterior cingulate cortex (vACC); involved in emotion and fear regulation

In Mowrers’ two-factor theory of phobias, ___ accounts for the acquisition of the fear, while ___ accounts for its maintenance

Classical conditioning; operant conditioning

In Mowrer’s two-factor theory, how does operant conditioning maintain a phobia?

Avoidance behaviors are negatively reinforced because they allow escape from the anxiety-provoking stimulus

What is the primary goal of exposure and response prevention (ERP) for Specific Phobia?

To extinguish the conditioned anxiety response by exposing the patient to feared stimuli while preventing avoidance

What is the key difference between flooding and graded exposure as types of ERP?

Flooding: immediate exposure to the most feared stimulus

Graded: gradual progression from less-feared to more-feared stimuli

For the blood-injection-injury subtype of specific phobia, ERP is most effective when combined with ___

Applied tension to prevent fainting

What is the core fear in Social Anxiety Disorder?

That one’s symptoms will be negatively evaluated by others

What are the two first-line treatments for Social Anxiety Disorder?

1. Cognitive behavior therapy (CBT)

2. Antidepressant medications (SSRIs and SNRIs)

For Panic Disorder, at least one panic attack must be followed by one month or more of ___

Either persistent concern about additional attacks, or a significant maladaptive change in behavior related to the attack

A panic attack is defined as:

An abrupt surge of intense fear or discomfort that reaches a peak within minutes, and involves at least four of 13 characteristic symptoms

What type of exposure is a key component of panic control treatment, which involves deliberately inducing physical symptoms of a panic attack?

Interoceptive exposure

A diagnosis of Agoraphobia requires marked fear or anxiety in at least ___

Two of five specified situations

What is the central concern for individuals with Agoraphobia regarding the situations they fear or avoid?

That escape will be difficult or help will be unavailable if they develop panic or other incapacitating symptoms

Research suggests that the key contributor to the effectiveness of exposure for agoraphobia is learning to ___

Tolerate high levels of fear and anxiety

The diagnosis of Generalized Anxiety Disorder (GAD) requires excessive anxiety and worry occurring on most days for at least ___

Six months

In adults, a GAD diagnosis requires at least three associated symptoms. How many are required for children?

Only one

What is the most common lifetime comorbid disorder for individuals with GAD?

MDD

According to the cognitive avoidance theory, what function does worry serve for individuals with GAD?

Worry, a verbal-linguistic activity, helps them avoid more distressing mental imagery and the associated negative emotions

What does the contrast avoidance model for GAD propose?

That individuals with GAD engage in chronic worry to avoid sudden emotional shifts from a neutral or positive state to a negative one

According to the intolerance of uncertainty model, what are the four factors that characterize the worry associated with GAD?

1. Intolerance of uncertainty

2. Negative problem orientation

3. Positive beliefs about worry

4. Cognitive avoidance of mental images

What class of medications are ordinarily used only for immediate, short-term relief from acute anxiety in GAD due to risks of tolerance and dependence?

Benzodiazepines

What are obsessions in the context of OCD?

Recurrent and persistent thoughts, urges, or images experienced as intrusive and unwanted

What are compulsions in the context of OCD?

Repetitive behaviors or mental acts that a person feels driven to perform to reduce anxiety or prevent an undesirable situation

For an OCD diagnosis, obsessions or compulsions must be time-consuming or cause significant distress or impairment. How much time is the specified threshold?

More than one hour each day

How does the prevalence of OCD differ between males and females in childhood versus adulthood?

Males have a slightly higher prevalence in childhood, while females have a slightly higher prevalence in adulthood

Neuroimaging has identifies hyperactivity in what brain pathway for individuals with OCD?

The cortico-striato-thalamo-cortical (CSTS) pathway

What is the first-line therapy for OCD?

Exposure and Response Prevention (ERP); involves exposing patients to anxiety-arousing stimuli while preventing them from engaging in ritualistic behaviors

For children and adolescents with OCD, how does the effectiveness of ERP alone compare to ERP combined with an SSRI?

ERP alone and ERP combined with an SSRI are more effective than an SSRI alone

Body Dysmorphic Disorder involves a preoccupation with a perceived defect in physical appearance that is ___

Not observable or appears minor to others

People with Body Dysmorphic Disorder often have what type of delusions?

Ideas / delusions of reference; they believe others are mocking or taking special notice of their appearance