Podcast
Questions and Answers
Which level of anxiety is characterized by a narrowing of focus and selective attention?
What is NOT a symptom of Generalized Anxiety Disorder (GAD)?
Which of the following is an intervention for Panic Disorder?
Which type of phobia involves a fear of social situations?
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What are the persistent, intrusive thoughts in Obsessive-Compulsive Disorder (OCD) known as?
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Which medication class is commonly used for short-term relief in Generalized Anxiety Disorder (GAD)?
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What is a common characteristic of severe anxiety?
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What is considered a primary therapeutic approach to managing phobias?
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Which symptom is primarily associated with hoarding disorder?
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What is a common intervention for trichotillomania?
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Which neurotransmitter is commonly implicated in anxiety disorders?
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How do OCD symptoms generally progress over time?
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Which area of the brain is central in processing fear and anxiety?
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What distinguishes Obsessive-Compulsive Personality Disorder (OCPD) from OCD?
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Which medication type is often used to help reduce compulsive urges in disorders like trichotillomania?
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Which neurotransmitter's reduced activity is associated with heightened anxiety?
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What is the primary purpose of compulsions in OCD?
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Which of the following criteria must be met for a diagnosis of OCD?
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What is the most common pharmacologic treatment for OCD?
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Which subtype of OCD involves fear of germs or dirt?
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In cases of treatment-resistant OCD, which medication might be added to SSRIs?
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What cognitive behavioral technique is commonly used for OCD treatment?
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What is a characteristic behavior associated with Body Dysmorphic Disorder (BDD)?
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Which SSRI is NOT mentioned as commonly used for OCD treatment?
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Study Notes
Anxiety and OCD Lecture Notes
- Anxiety: A universal human experience characterized by feelings of apprehension, unease, uncertainty, or dread, resulting from a real or perceived threat. It differs from fear, which is a reaction to a specific danger.
Levels of Anxiety
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Mild Anxiety: Normal and necessary for survival. Helps focus attention and problem-solving.
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Moderate Anxiety: Focus narrows, selective attention increases, but thinking is less clear.
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Severe Anxiety: Perception is greatly reduced; individuals may feel overwhelmed and have difficulty concentrating.
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Panic: The most extreme level. Individuals may be unable to process the environment, experiencing dissociation, confusion, or terror.
Anxiety Disorders
1. Generalized Anxiety Disorder (GAD)
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Symptoms: Chronic, excessive worry about various life domains for at least 6 months, along with physical symptoms like restlessness, muscle tension, fatigue, and irritability.
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Interventions:
- Psychotherapy (CBT)
- Pharmacotherapy (SSRIs, SNRIs, occasionally benzodiazepines for short-term relief)
- Lifestyle modifications (exercise, sleep hygiene, relaxation techniques)
2. Panic Disorder
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Symptoms: Recurrent, unexpected panic attacks marked by intense fear or discomfort, physical symptoms including chest pain, dizziness, palpitations, shortness of breath, and feelings of impending doom.
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Interventions:
- CBT (particularly with exposure therapy)
- Pharmacotherapy (SSRIs and benzodiazepines)
- Patient education on the physical effects of anxiety to reduce fear during an attack.
3. Phobias
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Specific Phobia: Fear of specific objects or situations (e.g., heights, flying).
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Social Anxiety Disorder (Social Phobia): Fear of social situations where there is potential scrutiny by others. Leads to avoidance of social events.
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Agoraphobia: Fear of open spaces or situations where escape might be difficult, like public transportation or crowded places.
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Interventions:
- Systematic desensitization (gradual exposure)
- CBT (to reframe irrational fears)
- Medications (SSRIs or beta blockers, especially for performance-related anxiety)
Obsessive-Compulsive Disorder (OCD)
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Obsessions: Persistent, intrusive thoughts, urges, or images causing anxiety (e.g., fear of contamination, intrusive sexual or aggressive thoughts).
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Compulsions: Repetitive behaviors or mental acts performed in response to obsessions (e.g., excessive handwashing, checking).
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Diagnostic Criteria (DSM-5):
- Presence of obsessions, compulsions, or both.
- Symptoms are time-consuming (more than 1 hour per day) or cause significant distress or impairment.
- Symptoms are not attributable to substance use or other medical conditions.
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Common Subtypes:
- Contamination and Cleaning
- Harm Obsessions and Checking
- Symmetry, Order, and Counting
- Taboo or Forbidden Thoughts
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Interventions:
- CBT with Exposure and Response Prevention (ERP) to expose patients to feared situations without allowing compulsions.
- SSRIs are first-line medications.
Other Disorders
- Body Dysmorphic Disorder (BDD): Preoccupation with an imagined or exaggerated defect in appearance, leading to excessive grooming, mirror checking, or seeking cosmetic surgery.
- Hoarding Disorder: Difficulty discarding possessions, regardless of value, leading to clutter disrupting living spaces and daily functioning.
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Trichotillomania (Hair-Pulling Disorder) and Excoriation (Skin-Picking Disorder): Repeated pulling of hair or picking of skin, leading to noticeable hair loss or skin lesions.
- Interventions include CBT focusing on habit-reversal techniques and medications like SSRIs to reduce compulsive urges
Neurobiology
- Amygdala: Central in processing fear and anxiety, hyperactivity linked to anxiety disorders.
- Prefrontal Cortex: Regulates amygdala's response to anxiety, role in OCD.
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Neurotransmitters:
- Serotonin: Dysregulation linked to OCD and anxiety.
- Norepinephrine: Involved in the "fight or flight" response.
- GABA: Primary inhibitory neurotransmitter, reduced activity linked to heightened anxiety.
Course and Prognosis
- OCD is a chronic condition with waxing and waning symptoms.
- Early treatment (CBT and/or medication) improves long-term outcomes.
- Partial remission (50-60%) is common with treatment.
Differential Diagnosis
- OCPD: General preoccupation with orderliness and control, lacks intrusive obsessions and compulsions.
- Other Anxiety Disorders: (e.g., generalized anxiety disorder, specific phobias) with excessive worry, unlike repetitive behaviors in OCD.
- Tic Disorders: Some individuals with OCD may also have tics (e.g., Tourette's syndrome).
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Description
Explore the intricacies of anxiety and OCD in this informative quiz. Learn about the different levels of anxiety, the symptoms of various anxiety disorders, and how they affect daily life. This is an essential resource for understanding mental health.
