GAD is characterized by persistent, uncontrollable worry about ordinary, everyday situations. Functional
neuroimaging studies of GAD show increased activation of the amygdala and reduced activation in the
prefrontal cortex, indicating heightened activation of the fear response with diminished capacity for reasoning.
Last at least 6 months Medications for anxiety: escilatopram (Lexapro), paroxetine (Paxil), duloxetine
(Cymbalta; Zoloft also good, Buspirones effectiveness is limited but low adverse effects and interactions like
others. Beta blockers are good for panic attack and social phobias. Benzo’s are not first line treatment.
Cognitive behavioral therapy is recommended with medication. Silexan is a branded extract of lavender that is
available by prescription in many countries and over the counter as CalmAid
The DSM-5-TR defines social anxiety disorder as an individual's fear of acting in a way that might cause
judgment by others (American Psychiatric Association [APA], 2022). Anxiety leads to avoidance of social
situations which disrupts an individual's relationships and daily routines. The anxiety is persistent, lasting
greater than six months. Rarely occurs give beta blocker or benzo, happens often give meds and cognitive
behavioral therapy
A panic attack is a brief episode of acute anxiety during which an individual develops an intense fear of
negative outcomes accompanied by a feeling of imminent danger. Panic attacks can be unpredictable, often
occurring in familiar places where there are no apparent threats. The feelings are often accompanied by
physiological symptoms. While symptoms typically peak within ten to twenty minutes, some may last for hours.
Treatment may include exposure therapy, cognitive behavioral therapy, medications, or a combination of
modalities. SSRIs are a safe, economical pharmacologic treatment for panic disorder (Roy-Byrne, 2021).
Benzodiazepines may be used in emergencies.
The DSM-5 classifies adjustment disorder as a trauma- and stressor-related disorder; however, symptoms of
adjustment disorder with anxiety are similar to those found in anxiety disorders. Adjustment disorder with
anxiety presents with nervousness, worry, or jitteriness. Symptoms begin within three months of the stressor and
typically last no more than six months.
Brief screening tool used only when assessment must be done quickly
always rule out physical causes for mental health symptoms first
labs for ruling out are CBC, TSH, urine toxicology, urinalysis, for depression, confusion or manic like behavior
refractory anxiety – not responsive or barely responsive to SSRI’S OR SNRI’S. BENZOS can only be used for
so long due to withdrawals and addiction
Causes can be pseudo lack of adherence or true resistance sleep deprivation environmental stressors or other
stimulants or bipolar disorder tendency’s “add mood stabilizers”
GAD7 – scores range from 0 – 21the higher the more severe. 0-4 min., 5-9 mild, 10-14 moderate, 15-21 severe.
(assesses the severity of anxiety symptoms (self-reported); strengths: ease of use, widely used, clear scoring
system, good sensitivity and specificity, link to diagnostic criteria, monitors changes over time, validated in
various settings, quick administration; shortcomings: solely self reported, not diagnostic, limited specificity,
cultural considerations, doesn’t capture all anxiety disorders, single dimension, limited in assessing functional
impairment)
HAMA is to document the results of treatment HAM-A (assesses the severity of anxiety symptoms; strengths: it
is comprehensive, clinician administered, standardized scoring, long-standing use; high reliability and good
validity; shortcomings: subjectivity, limited cultural sensitivity, emphasis on physical symptoms, not self
reported, limited in assessing functional impairment, and inadequate coverage of specific anxiety disorders)
OCD : Clients with obsessive-compulsive disorder may experience obsessions, compulsions, or both. Typically,
clients with obsessions or compulsions recognize that the thoughts and behaviors are excessive or irrational. Clients
may feel the need to control their thoughts and place high importance on perfectionism. OCD is most often
diagnosed by age 35. Adverse childhood events are associated with an increased risk of developing OCD
Hair-pulling disorder, or trichotillomania, involves the client pulling out hair on their scalp, eyebrows,
eyelids, or any other area where hair grows. Clients who have trichotillomania may pull their hair intermittently
or for hours at a time
This study source was downloaded by 100000899194722 from CourseHero.com on 06-06-2025 16:14:31 GMT -05:00
https://www.coursehero.com/file/250060784/GAD-is-characterized-by-persistentdocx/
, Excoriation involves a client picking at their skin. Clients may pick at pimples, scabs, or healthy skin (APA,
2022). Clients may pick with their fingernails or with a tool and spend a significant amount of time picking
(APA, 2022). Skin picking is more common in women than men and often begins with puberty.
Tourette’s – remember this is closely related to OCD and anxiety (a neurological disorder characterized by
repetitive, involuntary movements and vocalizations called tics; Tics are sudden, rapid, and stereotyped
movements or sounds that people with Tourette’s cannot control)
o Typically, treatment for OCD requires high doses; a common dose of fluoxetine for OCD is 80 mg.
Exposure and response prevention (ERP) is a specific type of cognitive-behavioral therapy beneficial
for clients with OCD.
YBOC (evaluates the severity of symptoms in people with OCD; strengths: comprehensive, structured format,
quantitative measurement, clinical utility, standardization, specificity to OCD, established validity and
reliability; shortcomings: limited coverage of OCD symptoms, subjectivity, focus on frequency and severity,
limited assessment of insight, not a standalone diagnostic tool, may not reflect changes in insight or coping
mechanisms, limited cultural sensitivity)
Psychosis is a symptom! Medical causes outweigh Psych. Top cause is delirium, hypoglycemia, hypoxia, UTI,
medication disturbances or withdrawal, sepsis (CMP), diabetes, dementia (Lewy body), Parkinson’s,
encephalopathy, vitamin b deficiency, cancer metasis, to the brain, or substance abuse.
Psych causes for psychosis – Bipolar I (thought to be more sever, causes hallucinations and psychotic
behavior). Depression with psychotic features (think of postpartum), Schizoaffective (schizo with a mood
disorder), schizophrenia, peripartum during pregnancy and up to 4 weeks after.
Psychosis definition – A loss of touch with reality.
Schizophrenia, schizoaffective disorder (this has the presence of a mood disorder)) and schizophreniform.
Positive symptoms hallucinations and delusions. Negative symptoms poor motivation, apathy, social
withdrawal, reduced speech and loss of symptoms, these are usually the prodromal symptoms. Catatonia, motor
abnormalities, childlike behavior, grimacing.
Definition of cognitive domain – has issue with only information storage and mental manipulation of
information. Issues with attention, speed of processing (they slow down to nothing) visual special
learning.
Brief psychotic disorder is an acute psychosis, often precipitated by stress. Symptoms last for less than 1
month and clients experience full remission with a full return to function.
Schizophreniform disorder is characterized by schizophrenia-like symptoms that last for more than 1
month but less than 6 months. This condition is differentiated from schizophrenia based on the length of
time symptoms have been present.
Schizoaffective disorder involves symptoms of both schizophrenia and a mood disorder, such as bipolar
disorder. Schizoaffective disorder is associated with depression and is often misdiagnosed as major
depressive disorder. Diagnosis requires at least two psychotic episodes, each lasting 2 weeks or more. One
of these episodes must happen without depressive or manic symptoms. Outcomes tend to be
better for clients with this disorder than for those with schizophrenia.
Delusional disorder involves a person having prominent delusions without hallucinations. Clients with
delusional disorder tend to have false beliefs that involve real-life situations such as the belief that they are
being followed or that others are plotting against them. Clients with delusional disorder often retain their
personalities and are more functional socially and at work than with other psychotic disorders.
Catatonia is a psychomotor syndrome that presents as a decreased reactivity to one's environment.
Catatonia typically occurs in tandem with other medical or psychiatric disorders. It is most often
associated with schizophrenia, affective disorders, autism, and infectious. Clinical signs of catatonia
include immobility, mutism, withdrawal, refusing to eat, staring, negativism, posturing, and rigidity.
Treatment: Antipsychotics (first, second gen 1st line, third generations) Olanzapine best tolerated high
metabolic risk highest risk for weight gain must increase dosage by 30% for smokers find another
medication for them, Aripiprazole (Abilify) low metabolic risk low weight gain low risk for orthostatic
This study source was downloaded by 100000899194722 from CourseHero.com on 06-06-2025 16:14:31 GMT -05:00
https://www.coursehero.com/file/250060784/GAD-is-characterized-by-persistentdocx/
neuroimaging studies of GAD show increased activation of the amygdala and reduced activation in the
prefrontal cortex, indicating heightened activation of the fear response with diminished capacity for reasoning.
Last at least 6 months Medications for anxiety: escilatopram (Lexapro), paroxetine (Paxil), duloxetine
(Cymbalta; Zoloft also good, Buspirones effectiveness is limited but low adverse effects and interactions like
others. Beta blockers are good for panic attack and social phobias. Benzo’s are not first line treatment.
Cognitive behavioral therapy is recommended with medication. Silexan is a branded extract of lavender that is
available by prescription in many countries and over the counter as CalmAid
The DSM-5-TR defines social anxiety disorder as an individual's fear of acting in a way that might cause
judgment by others (American Psychiatric Association [APA], 2022). Anxiety leads to avoidance of social
situations which disrupts an individual's relationships and daily routines. The anxiety is persistent, lasting
greater than six months. Rarely occurs give beta blocker or benzo, happens often give meds and cognitive
behavioral therapy
A panic attack is a brief episode of acute anxiety during which an individual develops an intense fear of
negative outcomes accompanied by a feeling of imminent danger. Panic attacks can be unpredictable, often
occurring in familiar places where there are no apparent threats. The feelings are often accompanied by
physiological symptoms. While symptoms typically peak within ten to twenty minutes, some may last for hours.
Treatment may include exposure therapy, cognitive behavioral therapy, medications, or a combination of
modalities. SSRIs are a safe, economical pharmacologic treatment for panic disorder (Roy-Byrne, 2021).
Benzodiazepines may be used in emergencies.
The DSM-5 classifies adjustment disorder as a trauma- and stressor-related disorder; however, symptoms of
adjustment disorder with anxiety are similar to those found in anxiety disorders. Adjustment disorder with
anxiety presents with nervousness, worry, or jitteriness. Symptoms begin within three months of the stressor and
typically last no more than six months.
Brief screening tool used only when assessment must be done quickly
always rule out physical causes for mental health symptoms first
labs for ruling out are CBC, TSH, urine toxicology, urinalysis, for depression, confusion or manic like behavior
refractory anxiety – not responsive or barely responsive to SSRI’S OR SNRI’S. BENZOS can only be used for
so long due to withdrawals and addiction
Causes can be pseudo lack of adherence or true resistance sleep deprivation environmental stressors or other
stimulants or bipolar disorder tendency’s “add mood stabilizers”
GAD7 – scores range from 0 – 21the higher the more severe. 0-4 min., 5-9 mild, 10-14 moderate, 15-21 severe.
(assesses the severity of anxiety symptoms (self-reported); strengths: ease of use, widely used, clear scoring
system, good sensitivity and specificity, link to diagnostic criteria, monitors changes over time, validated in
various settings, quick administration; shortcomings: solely self reported, not diagnostic, limited specificity,
cultural considerations, doesn’t capture all anxiety disorders, single dimension, limited in assessing functional
impairment)
HAMA is to document the results of treatment HAM-A (assesses the severity of anxiety symptoms; strengths: it
is comprehensive, clinician administered, standardized scoring, long-standing use; high reliability and good
validity; shortcomings: subjectivity, limited cultural sensitivity, emphasis on physical symptoms, not self
reported, limited in assessing functional impairment, and inadequate coverage of specific anxiety disorders)
OCD : Clients with obsessive-compulsive disorder may experience obsessions, compulsions, or both. Typically,
clients with obsessions or compulsions recognize that the thoughts and behaviors are excessive or irrational. Clients
may feel the need to control their thoughts and place high importance on perfectionism. OCD is most often
diagnosed by age 35. Adverse childhood events are associated with an increased risk of developing OCD
Hair-pulling disorder, or trichotillomania, involves the client pulling out hair on their scalp, eyebrows,
eyelids, or any other area where hair grows. Clients who have trichotillomania may pull their hair intermittently
or for hours at a time
This study source was downloaded by 100000899194722 from CourseHero.com on 06-06-2025 16:14:31 GMT -05:00
https://www.coursehero.com/file/250060784/GAD-is-characterized-by-persistentdocx/
, Excoriation involves a client picking at their skin. Clients may pick at pimples, scabs, or healthy skin (APA,
2022). Clients may pick with their fingernails or with a tool and spend a significant amount of time picking
(APA, 2022). Skin picking is more common in women than men and often begins with puberty.
Tourette’s – remember this is closely related to OCD and anxiety (a neurological disorder characterized by
repetitive, involuntary movements and vocalizations called tics; Tics are sudden, rapid, and stereotyped
movements or sounds that people with Tourette’s cannot control)
o Typically, treatment for OCD requires high doses; a common dose of fluoxetine for OCD is 80 mg.
Exposure and response prevention (ERP) is a specific type of cognitive-behavioral therapy beneficial
for clients with OCD.
YBOC (evaluates the severity of symptoms in people with OCD; strengths: comprehensive, structured format,
quantitative measurement, clinical utility, standardization, specificity to OCD, established validity and
reliability; shortcomings: limited coverage of OCD symptoms, subjectivity, focus on frequency and severity,
limited assessment of insight, not a standalone diagnostic tool, may not reflect changes in insight or coping
mechanisms, limited cultural sensitivity)
Psychosis is a symptom! Medical causes outweigh Psych. Top cause is delirium, hypoglycemia, hypoxia, UTI,
medication disturbances or withdrawal, sepsis (CMP), diabetes, dementia (Lewy body), Parkinson’s,
encephalopathy, vitamin b deficiency, cancer metasis, to the brain, or substance abuse.
Psych causes for psychosis – Bipolar I (thought to be more sever, causes hallucinations and psychotic
behavior). Depression with psychotic features (think of postpartum), Schizoaffective (schizo with a mood
disorder), schizophrenia, peripartum during pregnancy and up to 4 weeks after.
Psychosis definition – A loss of touch with reality.
Schizophrenia, schizoaffective disorder (this has the presence of a mood disorder)) and schizophreniform.
Positive symptoms hallucinations and delusions. Negative symptoms poor motivation, apathy, social
withdrawal, reduced speech and loss of symptoms, these are usually the prodromal symptoms. Catatonia, motor
abnormalities, childlike behavior, grimacing.
Definition of cognitive domain – has issue with only information storage and mental manipulation of
information. Issues with attention, speed of processing (they slow down to nothing) visual special
learning.
Brief psychotic disorder is an acute psychosis, often precipitated by stress. Symptoms last for less than 1
month and clients experience full remission with a full return to function.
Schizophreniform disorder is characterized by schizophrenia-like symptoms that last for more than 1
month but less than 6 months. This condition is differentiated from schizophrenia based on the length of
time symptoms have been present.
Schizoaffective disorder involves symptoms of both schizophrenia and a mood disorder, such as bipolar
disorder. Schizoaffective disorder is associated with depression and is often misdiagnosed as major
depressive disorder. Diagnosis requires at least two psychotic episodes, each lasting 2 weeks or more. One
of these episodes must happen without depressive or manic symptoms. Outcomes tend to be
better for clients with this disorder than for those with schizophrenia.
Delusional disorder involves a person having prominent delusions without hallucinations. Clients with
delusional disorder tend to have false beliefs that involve real-life situations such as the belief that they are
being followed or that others are plotting against them. Clients with delusional disorder often retain their
personalities and are more functional socially and at work than with other psychotic disorders.
Catatonia is a psychomotor syndrome that presents as a decreased reactivity to one's environment.
Catatonia typically occurs in tandem with other medical or psychiatric disorders. It is most often
associated with schizophrenia, affective disorders, autism, and infectious. Clinical signs of catatonia
include immobility, mutism, withdrawal, refusing to eat, staring, negativism, posturing, and rigidity.
Treatment: Antipsychotics (first, second gen 1st line, third generations) Olanzapine best tolerated high
metabolic risk highest risk for weight gain must increase dosage by 30% for smokers find another
medication for them, Aripiprazole (Abilify) low metabolic risk low weight gain low risk for orthostatic
This study source was downloaded by 100000899194722 from CourseHero.com on 06-06-2025 16:14:31 GMT -05:00
https://www.coursehero.com/file/250060784/GAD-is-characterized-by-persistentdocx/
