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Questions and Answers
What is a primary characteristic of generalized anxiety disorder (GAD)?
Which brain structure is most closely associated with the symptoms of restlessness in anxiety disorders?
What is the median age at onset for generalized anxiety disorder in children?
How does the prevalence of severe anxiety disorders in children compare between genders?
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What distinguishes generalized anxiety disorder from other anxiety disorders?
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Which physiological response is commonly associated with anxiety disorders?
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What distinguishes fear from anxiety according to the content provided?
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Freud's misunderstanding of the distinction between which two concepts contributed to the confusion in definitions?
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Which of the following is NOT listed as a peripheral manifestation of anxiety?
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Which brain structure is primarily associated with the fear response?
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Study Notes
Anxiety Disorders Overview
- Anxiety disorders involve excessive worry or fear, restlessness, and physical symptoms such as cold sweats and dizziness.
- Fear is a response to external threats, while anxiety involves anticipation of danger, often lacking a specific trigger.
Fear vs. Anxiety
- Fear: A reaction to known, external threats; observable in many mammals.
- Anxiety: Often linked to unconscious or repressed fears; can complicate differentiation from fear.
- Historical mistranslation by Freud conflated anxiety with fear, complicating their distinction.
Peripheral Manifestations of Anxiety
- Symptoms include diarrhea, dizziness, hyperhidrosis, hypertension, palpitations, and restlessness, among others.
Brain Circuits and Symptoms
- Key brain areas involved:
- Frontal lobe/cingulate cortex (cognitive aspects)
- Thalamus and insula (awareness and sympathetic activation)
- Basal ganglia (motor tension)
Types of Anxiety Disorders
- Generalized anxiety disorder (GAD)
- Social anxiety disorder
- Agoraphobia
- Panic disorder
- Separation anxiety disorder
- Specific phobias
Generalized Anxiety Disorder (GAD)
- Defined by excessive, irrational worry lasting over six months, affecting daily functioning.
- Symptoms include restlessness, fatigue, irritability, muscle tension, and sleep disturbances.
Epidemiology of GAD
- Approximately 1 in 4 children experience anxiety between ages 13-18.
- Median onset age for anxiety disorders is 11 years; lifetime prevalence of severe anxiety in this age group is around 6%.
Etiology of GAD
- Genetic factors influence GAD, with strong association to personality traits like neuroticism.
- High co-morbidity with major depressive disorder (MDD).
DSM-5 Diagnostic Criteria for GAD
- Requires excessive anxiety for at least six months, with difficulty controlling worry.
- Associated symptoms include restlessness, fatigue, irritability, muscle tension, and sleep disturbances.
- Significant impairment in social or occupational areas; not attributed to physical causes.
Panic Disorder
- Involves recurring panic attacks characterized by intense fear or discomfort, often without a clear trigger.
- Physical symptoms during attacks include palpitations, sweating, shortness of breath, chest pain, and feelings of choking.
Symptoms of Panic Disorder
- Includes palpitations, derealization, fear of losing control, persistent concerns about future attacks, and significant behavioral changes.
Agoraphobia
- Marked fear of situations such as public transport, open spaces, or being away from home alone.
- Avoidance behaviors are common in individuals with agoraphobia.
Social Anxiety Disorder (SAD)
- Characterized by fear of scrutiny in social situations, leading to avoidance or distress.
- Common scenarios include public speaking and social interactions.
Specific Phobia
- Excessive, irrational fear of specific objects or situations, like heights, animals, or medical procedures.
- Recognition of the fear's irrationality does not preclude significant distress or impairment.
Obsessive-Compulsive Disorder (OCD)
- Features obsessions (intrusive thoughts) and compulsions (repetitive behaviors to alleviate anxiety).
- Compulsions aim to prevent anxiety and can significantly interfere with daily life.
Treatment Options
- Psychological treatments include cognitive-behavioral therapy (CBT) and relaxation techniques.
- Pharmacological treatments encompass anti-anxiety medications, SSRIs, SNRIs, TCAs, MAOIs, and antipsychotics.
- Integrated treatment approaches combining CBT with pharmacotherapy may be most effective.
Patient Management and Referral
- Monitor patients with no physical abnormalities, emotional instability, or multiple complaints.
- Refer patients when symptoms persist without improvement, panic symptoms escalate, or when self-harm risks are present.
Conclusion
- GAD and panic disorder are common and impactful, often beginning in childhood but manageable with effective treatment approaches.
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Description
Explore the characteristics and symptoms of Generalized Anxiety and Panic Disorder in this quiz. Learn about the physiological responses associated with fear and anxiety, including their neurological underpinnings. Test your understanding of these common mental health issues.
