Anxiety Disorders Overview

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Questions and Answers

What is a primary characteristic that distinguishes Generalized Anxiety Disorder (GAD) from other anxiety disorders?

Worry about specific phobias.

Worry primarily about significant life events.

Excessive and persistent worry about minor, everyday life events. (correct)

Fear of social situations.

Which of the following is NOT one of the diagnostic criteria for Generalized Anxiety Disorder?

Exclusion of substances or medical conditions.

Worry is about serious, long-term events. (correct)

Duration of more days than not for at least 6 months.

Symptoms cause notable distress or impairment.

Which symptom is required for children to be diagnosed with Generalized Anxiety Disorder?

Restlessness or feeling keyed up/on edge. (correct)

Three or more associated symptoms.

Muscle tension.

Difficulty concentrating.

In older adults, which area of concern is they likely to focus on in Generalized Anxiety Disorder?

Health issues. Signup and view all the answers

What is a common emotional symptom associated with Generalized Anxiety Disorder?

Irritability. Signup and view all the answers

What difficulty do individuals with Generalized Anxiety Disorder often face?

Controlling their worry. Signup and view all the answers

Which aspect is considered clinically significant in individuals with Generalized Anxiety Disorder?

Notable distress or impairment. Signup and view all the answers

Exclusion of which factor is necessary when diagnosing Generalized Anxiety Disorder?

Substance effects. Signup and view all the answers

What factor is most strongly associated with the risk of developing Generalized Anxiety Disorder (GAD)?

Childhood adversities Signup and view all the answers

Which age group typically exhibits more severe symptoms of GAD?

Young adults Signup and view all the answers

What is a common worry characteristic in children with GAD?

Worries about performance and punctuality Signup and view all the answers

What concern is common among the elderly suffering from GAD?

Chronic physical diseases Signup and view all the answers

Which behavioral factor describes a tendency to be reserved in new situations?

Behavioral inhibition Signup and view all the answers

Which treatment method is considered more effective in the long term for GAD?

Cognitive behavioral therapy Signup and view all the answers

Which disorder is characterized by anticipatory anxiety in social settings, making it distinct from GAD?

Social Anxiety Disorder Signup and view all the answers

What differentiates GAD from Obsessive-Compulsive Disorder (OCD)?

OCD includes intrusive thoughts, while GAD focuses on future worries Signup and view all the answers

What is a key characteristic of worries associated with Generalized Anxiety Disorder (GAD)?

They are excessive and interfere with daily life. Signup and view all the answers

Which physical symptom is commonly associated with GAD?

Muscle tension Signup and view all the answers

What distinguishes GAD from normal anxiety?

GAD worries are pervasive and significantly disruptive. Signup and view all the answers

What is the global prevalence of GAD according to the data provided?

1.3% Signup and view all the answers

What demographic is more likely to suffer from GAD based on gender differences?

Women and girls experience GAD at higher rates. Signup and view all the answers

At what age is the mean onset of GAD most commonly observed in North America?

35 years Signup and view all the answers

Which of the following is NOT a condition often associated with GAD?

Bipolar disorder Signup and view all the answers

How do GAD symptoms typically fluctuate over time?

They persist chronically but fluctuate in severity. Signup and view all the answers

What is a necessary condition for diagnosing panic disorder?

Experiencing at least one unexpected panic attack Signup and view all the answers

Which symptom is NOT included in the diagnostic criteria for a panic attack?

Persistent concern about future attacks Signup and view all the answers

Which of the following factors is NOT typically linked to high comorbidity with panic disorder?

Neurocognitive disorders Signup and view all the answers

What does a significant anxiety about the implications of panic attacks indicate?

An associated risk factor for future attacks Signup and view all the answers

Which symptom can be excluded when diagnosing a panic attack due to cultural specificity?

Tinnitus Signup and view all the answers

What is a typical behavioral change following a panic attack?

Avoidance of exercise or unfamiliar situations Signup and view all the answers

What distinguishes panic disorder from generalized anxiety disorder (GAD)?

Panic disorder involves specific anxiety about future panic attacks Signup and view all the answers

Which condition is least likely to be comorbid with panic disorder?

Conduct disorder Signup and view all the answers

What is necessary for the diagnosis of panic disorder regarding the occurrence of panic attacks?

There must be more than one unexpected panic attack. Signup and view all the answers

Which of the following is a common concern for individuals suffering from panic disorder?

Fear of severe health issues from mild symptoms. Signup and view all the answers

What does the term 'nocturnal panic attacks' refer to?

Panic attacks occurring upon waking from sleep. Signup and view all the answers

How does panic disorder prevalence vary among different ethnic groups in the U.S.?

Lower among Latinx compared to non-Latinx Whites. Signup and view all the answers

What behavioral change might result from attempts to avoid panic attacks?

Increased avoidance of public places. Signup and view all the answers

Which gender is more commonly affected by panic disorder?

Females are affected about 2:1 compared to males. Signup and view all the answers

What is a characteristic of unexpected panic attacks?

They can happen even during calm states. Signup and view all the answers

Which of the following is an associated feature of panic disorder?

Persistent worry about health and panic attacks. Signup and view all the answers

Study Notes

Generalized Anxiety Disorder (GAD)

GAD is characterized by excessive worry about minor, everyday events, often shifting focus.
GAD presents with symptoms like muscle tension, mental agitation, fatigue, irritability, and sleep difficulties.
Children with GAD typically worry about academic, athletic, or social performance, as well as family issues.
Older adults often worry about health and experience sleep problems, exacerbating anxiety.

Panic Disorder (PD)

PD involves unexpected panic attacks that can feel life-threatening or like losing control.
Panic attacks are distinguished by an abrupt surge of intense fear or discomfort, peaking within minutes.
Common attack symptoms include: palpitations, sweating, trembling, shortness of breath, choking sensations, chest pain, nausea, dizziness, chills, tingling, derealization, fear of losing control, and fear of dying.
Individuals with PD worry about future attacks and their consequences, interpreting attacks as signs of imminent death or incapacity.
Nocturnal panic attacks, waking from sleep in panic, may indicate a more severe form of the disorder.
Frequency and severity of panic attacks varies, from weekly to daily occurrences.
Worry about the attacks often includes concerns about physical health, social judgments, and mental health, leading to behavioral changes to avoid panic.

Prevalence

GAD:
Adolescents: 0.9%
Adults: 2.9% in the US, global mean: 1.3%.
Lifetime risk in the US: 9.0%.
Women and girls are twice as likely to have GAD.
Older adults (75+) have a 12-month prevalence of 2.8% to 3.1%.
Higher prevalence among Europeans than Asians/Africans.
High-income countries report more GAD symptoms.
PD:
12-month prevalence: 2%–3% among adults/adolescents in the US and Europe.
Global lifetime prevalence: 1.7%.
Lower among Latinx, African Americans, Caribbean Blacks, and Asian Americans compared to non-Latinx Whites.
U.S. prevalence in American Indians: 2.6%–4.1%.
Rates in Asian, African, and Latin American countries: 0.1%–0.8%.
Women are affected about 2:1 compared to men.

Development and Course

GAD:
Mean age of onset: 35 years, rarely before adolescence in North America.
Onset varies, typically older in lower-income countries.
Early symptoms manifest as an anxious temperament.
Symptoms often persist chronically, fluctuating between severe and milder forms.
Lower remission rates.
Early onset linked to more comorbidity and impairment.
Younger adults experience more severe symptoms than older adults.
Symptoms remain consistent across the lifespan, with age-appropriate worry content.
Children and adolescents worry about performance, punctuality, and catastrophic events.
Perfectionistic tendencies, seeking excessive reassurance.
In the elderly, concerns about chronic physical diseases trigger excessive worry.
Safety concerns, especially about falling, may limit activities in frail elderly.
PD:
Age of onset in early to mid-adulthood
Can persist for years, with periods of remission and relapse
Nocturnal panic attacks may worsen the disorder.
Symptoms may differ across cultures and genders

Risk and Prognostic Factors

GAD:
Behavioral/Personality Factors:
Behavioral Inhibition (reserved in new situations)
Negative Affectivity (high neuroticism)
Harm Avoidance (avoid potential dangers)
Reward Dependence (seeking approval and reward)
Attentional Bias to Threat (focusing on negative information)
Environmental Factors:
Childhood adverse experiences (abuse, neglect, trauma)
Overprotective or controlling parenting styles
Genetic Factors:
One-third of risk for GAD is genetic, shared with negative affectivity and other anxiety/mood disorders.
PD:
Family history of panic disorder
History of childhood trauma or abuse
Certain personality traits, such as neuroticism and anxiety sensitivity

Treatment

GAD:
Medications:
Benzodiazepines are often prescribed but only for short periods due to potential risks.
Psychological therapy is generally more effective long-term.
Cognitive Behavioral Therapy (CBT) helps identify and challenge negative thoughts and learn coping mechanisms.
Exposure therapy gradually confronts feared situations to reduce anxiety.
Mindfulness-based therapies promote present-moment awareness to manage anxiety.
Relaxation techniques (yoga, meditation) can reduce muscle tension and stress.
Lifestyle changes (exercise, healthy diet, adequate sleep) can improve overall well-being.
Support groups offer a safe space for sharing experiences and encouragement.
PD:
Medications:
Antidepressants (SSRIs, SNRIs) can reduce panic attacks and anxiety symptoms.
Benzodiazepines can provide short-term relief from panic, but they are not a long-term solution.
Beta-blockers can help manage physical symptoms like rapid heartbeat.
Psychological therapy:
CBT is effective for teaching coping skills and challenging negative thoughts.
Exposure therapy helps individuals confront situations they normally avoid due to anxiety.
Panic control therapy (PCT) involves learning about panic attacks, practicing relaxation techniques, and gradually exposing individuals to panic-provoking situations.
Lifestyle changes (exercise, healthy diet, adequate sleep) are important for managing stress and supporting recovery.
Support groups can create a safe and understanding community for people with panic disorder.

Differential Diagnosis

GAD

Distinguishing GAD from Other Disorders:
Social Anxiety Disorder: Anticipatory anxiety in social situations.
Separation Anxiety Disorder: Excessive worry about separation from attachment figures.
Specific Diagnoses:
Panic Disorder: Includes unexpected panic attacks.
Illness Anxiety Disorder: Fear focuses solely on personal health.
Obsessive-Compulsive Disorder: Obsessional thoughts differ from GAD worry.
Posttraumatic Stress Disorder: Anxiety linked to trauma.
Differentiating Factors:
GAD worry focuses on future events, while OCD involves intrusive thoughts.
Anxiety in PTSD may mask GAD symptoms.
Adjustment Disorder:
Anxiety related to identifiable stressors within 3 months, lasting up to 6 months.
Comorbidity with Other Disorders:
GAD may coexist with depressive, bipolar, or psychotic disorders if anxiety is severe.

PD

Distinguishing PD from Other Disorders:
Agoraphobia: Fear of situations where escape might be difficult or help unavailable.
Specific Phobias: Fear of specific objects or situations.
Social Anxiety Disorder: Fear of social situations.
Generalized Anxiety Disorder (GAD): Excessive worry about a range of issues, without panic attacks.
Substance Use Disorder: Panic symptoms can occur due to substance withdrawal.
Medical Conditions: Certain medical conditions can cause panic-like symptoms.

Comorbidity

GAD:
High: Anxiety and unipolar depression, linked to negative affectivity.
Shared Risk: Genetic, environmental, and temperamental factors.
Low: Substance use, conduct, psychotic, neurodevelopmental, and neurocognitive disorders.
PD:
Depression is a common comorbidity, and the two conditions often share underlying biological and psychological vulnerabilities.
Other common comorbidities include:
Agoraphobia
Substance use disorders
Other anxiety disorders
Obsessive-compulsive disorder
Posttraumatic stress disorder.

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Description

This quiz covers the key aspects of Generalized Anxiety Disorder (GAD) and Panic Disorder (PD). It explores symptoms, affected populations, and the psychological implications of these conditions. Test your understanding of these common anxiety disorders and their impacts.