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NUSC 3P14 WEEK 7 EXAM LATEST UPDATE
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NUSC 3P14 WEEK 7 EXAMLATEST UPDATE
Anxiety disorders include - Answer - GAD
-Panic Disorder
-Social Anxiety Disorder
-PTSD
-OCD
-Phobias
GAD- BIOLOGICAL OR GENETIC - Answer - highly heritable condition
- first-degree relatives of GAD-increased risk for mood and anxiety disorders. (Twin
studies risk ranged from 30%-32% (studied on >3000 Twin pair).
- first-degree relatives of panic disorder (PD) increased risk
- 7times for PD, (Twin studies suggest 30% to 40% risk for PD
GAD- BEHAVIOURAL THEORY - Answer Behavioural theory:
• anxiety is learned from environmental stimuli or behaviours of others
• somatic symptoms-to get the needs met-sick role-secondary gain
GAD- COGNITIVE THEORY - Answer -dysfunctional thoughts lead to extreme emotions.
(eg: individual believes that won't do well on the exam-failure will strengthen the belief)
GAD-NEUROBIOLOGICAL - Answer - The emotional processing-"limbic system"
(amygdala & hypothalamus).
- The orbitofrontal cortex (OFC)- regulate/controls impulses, mood, emotions,
behaviour
- Prefrontal area-executive function (decision making etc.). - Anxiety
disorders-disruption in the emotional centers of the brain could alter higher cognitive
centers.
GAD- NEUROTRANSMITTER PATHWAYS - Answer - GABA (Gamma-aminobutyric
acid-inhibitory neurotransmitter)- dysregulation/underactivity- *feeling of anxiousness.
, - *GABA also impact function of several neurotransmitter (norepinephrine, serotonin &
dopamine) - GABA regulatory drug-benzo are choice of treatment.
- Benzo are high addiction potential and potentially fatal adverse effect.
GAD- SOCIO-CULTURAL - Answer -Ethnic, racial, & cultural factors-e.g. panic
attack-considered as magic or witchcraft etc.
• Cambodians-anxiety-disturbed body functions "inner wind" and blood flow. (DSM-5-
"wind attacks" one of the cultural concepts).
• Chinese-anxiety states- organ dysfunction, e.g. "weak kidney" or a "weak heart"
• South Asian, South America, the Pacific Islands, & Southern European-value
social/group harmony- deviation of social rules-self blame, guilt, shame
GAD-ENVIRONMENTAL - Answer - Parenting style: e.g. overly protective/overly critical
or under-responsive parenting, exposure to traumatic event etc.
THE DSM-V (GAD) - Answer -Excessive anxiety and worry about life circumstances at
least 6 months.
TREATMENT FOR GAD - Answer • Remember GABA role:
- GABA is the major inhibitory neurotransmitter in the CNS;
- hypothesized that anxiety symptoms may partly be related to underactivity of GABA
systems
• Benzodiazepines
- enhance the inhibitory effects by targeting the GABAreceptors.
- bind to GABA receptors at the alpha-1, 2, 3 and 5 subtypes
- most effective-somatic and autonomic symptoms (muscle tension, dry mouth,
increase sweat) - psychic symptoms (apprehension and worry)
GAD- BENZODIAZEPINES - Answer -Clonazepam (Rivotril) 0.25-0.5mg twice daily
-Lorazepam (Ativan) 0.5-2mg two - three times daily
-Diazepam (Valium) 5mg two - three times daily
-ANYTHING ENDING IN "PAM"
ANXIETY ASSESSMENT TOOL - Answer Assessment: past & current history, MSE
- General assessment of symptoms
- Hamilton Anxiety Scale (rating scales) 12.9
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