NFDN 2007 Mental health Final Exam Units 7-12
Questions With Correct Answers
Fear & Anxiety - ANSWER -fear & anxiety are distinct but related emotions that function
to signal danger, threat, or motivational conflict and to trigger appropriate adaptive
responses
-anxiety & fear key difference between the two relate the the stimulus and/ or the trigger
-worry is a symptom of fear & anxiety
Anxiety - ANSWER -FUTURE ORIENTATED
-an emotion characterized by the apprehension or dread of a potentially threatening or
uncertain outcome
-most basic of emotions
S&S: nausea, lack of appetite, sleep disturbances, heart racing/ palpitations, restless,
sweating/ shivering, dizzy, lightheaded, trembling
Fear - ANSWER -emotional response to a specific and proximal threat to an organism's
life or integrity
-fear relates to the stimulus
Family of Anxiety Disorders - ANSWER -all anxiety disorders share excessive fear or
anxiety as their core symptom
-differ from one another based on their key features
Generalized Anxiety Disorder
Social Anxiety Disorder
Panic Disorder
Specific phobia
-most important factor when assessing person with anxiety disorder is the degree of
impairment in the person's life
Anxiety Disorders - ANSWER -most common mental illnesses
-lifetime prevalence of anxiety disorders to be as high as 31%
,-most treated disorder in childhood and adolescence
-often begins in adolescence
-more common in females (5.6%) rather than males (4.2%)
-anxiety can exist as a primary disorder however it often co-exists with other conditions
Generalized Anxiety Disorder (GAD) - ANSWER -worry excessively and uncontrollably
about daily life events and activities
-impacts the person's functioning
-associated with physical symptoms
-prevalence is 2.6% in Canada
-onset of GAD is early in life
-feel powerless to change, frustrated with life, demoralized, and hopeless
-comorbidity = depression
DSM-5 Generalized Anxiety Disorder - ANSWER -more days than not for past 6 months
-anxiety & worry are associated with three or more of following symptoms
1. restlessness or on edge
2. easily fatigued
3. difficulty concentrating or mind going blank
4. irritability
5. muscle tension
6. sleep disturbances (difficulty falling or staying asleep)
Generalized Anxiety Disorder Assessment - ANSWER > 10= probably diagnosis of
GAD, confirm by further evaluation
5= mild anxiety
10= moderate anxiety
15= severe anxiety
-cognitive behavioural and SSRI/ SNRI agents are effective in reducing symptoms in up
to 50% of patients
-if a 50% or more decrease in treatment does not occur within 3 months of treatment a
different or adjunctive treatment should be offered
Panic Disorder - ANSWER -recurrent unexpected panic attacks and fear of another
attack
-sudden periods of intense fear or discomfort
-response to a serious threat or "out of the blue"
-temporarily impair mental ability to function socially, occupationally, and interpersonally
-prevalence in Canada is 3.7%
-> in women ages 30-59 years
-can occur with or without agoraphobia (fear of public places)
-symptoms resemble that of myocardial infarction
DSM-5 Panic Disorder - ANSWER Recurrent unexpected panic attacks that reaches a
peak within minutes and during that time four or more of the following occur:
-irregular HR/ palpitations
,-sweating, trembling/shaking
-sensation of SOB/ smothering
-feelings of choking
-chest pain / discomfort
-nausea / abdominal distress
-dizzy/ faint/ unsteady
-chills or heat sensations
-tingling/ numbness (parathesis)
-feeling of unreality (derealization)
-feeling detached from oneself (depersonalization)
-fear of losing control/ "going crazy"
-fear of dying
Panic Disorder S&S - ANSWER -nausea, chest pain, racing heart, sweating, trembling,
shortness of breath
Panic - ANSWER -can be normal but extreme overwhelming form of anxiety
-often initiated when a person is put in a real or perceived life threatening situation
-sudden sensation of fear
Panic Disorder - Risk Factors - ANSWER -gender = female
aged 30-59 years
mean age of onset is 23 years
-previously triggered panic attack
-a family history of psychological difficulties
-childhood trauma
-history of mood disorders
-adolescents at a higher risk for suicide thoughts or attempts
Panic Disorder! VS Heart Attack - ANSWER -sharp stabbing pain in the middle of the
chest
-sudden onset or onset due to extreme distress
-pain that gets better over time
-symptoms resolve in 20-30 minutes
-SOB
-sweating
-shakiness
-tingling in the hands
Panic Disorder VS Heart Attack ! - ANSWER -squeezing pain & pressure in chest
-sudden onset or onset during physical exertion
-pain that radiates to the arm, jaw, or shoulder blades
-longer lasting symptoms
-SOB
-sweating
-nausea & vomiting
, Phobias - ANSWER -panic attacks can precipitate a phobia
-phobias are persistent, unrealistic fear of situations, objects, or activities
-unreasonable response to protect personal safety
-intensity of anxiety related to proximity of object and degree to which escape is
possible
Agoraphobia - ANSWER anxiety disorder that covers diverse categories of fears that
are based on the need to escape from a situation (ex. fear of open spaces)
Specific Phobias (Simple Phobia) - ANSWER -disorder marked by an irrational fear of
specific object or situation that the person realizes is unreasonable
-exposure to the stimulus object or situation causes the anxiety
-anxiety is related to the proximity of the object and the ability to escape
Social Anxiety Disorder (Social Phobia) - ANSWER -marked or intense fear of social
situations
-highly sensitive to disapproval or criticism
tend to evaluate themselves negatively
-functional impairment
-onset: early adolescence
-prevalence in Canada is 2.6% in men & 3.4% in women
-two types of social anxiety disorder: generalized social phobia, or specific social phobia
Etiologic Theories of Anxiety Disorders - genetic theories - ANSWER -focus on genetic
vulnerabilities, genetic component
Etiologic Theories of Anxiety Disorders - neurobiology of anxiety - ANSWER -fear
conditioning affects the hippocampus and amygdala, FMRI increased amygdala activity
Etiologic Theories of Anxiety Disorders - neurotransmitter & neuropeptides - ANSWER
serotonin, norepinephrine, corticotropin releasing hormones, cholescytokinin
Etiologic Theories of Anxiety Disorders - neuroimaging - ANSWER MRI show decrease
in grey matter and white matter
abnormal activation patterns in response to provocation
Etiologic Theories of Anxiety Disorders - psychodynamic theories - ANSWER focus on
the psychological influences
early in life experiences affect the brain and how we respond to stressors
Biologic Domain Assessment - Anxiety Disorders - ANSWER -first need to determine
that the symptoms of anxiety have affected the individuals ability to function
-assess for substance use
-assess sleep patterns
Questions With Correct Answers
Fear & Anxiety - ANSWER -fear & anxiety are distinct but related emotions that function
to signal danger, threat, or motivational conflict and to trigger appropriate adaptive
responses
-anxiety & fear key difference between the two relate the the stimulus and/ or the trigger
-worry is a symptom of fear & anxiety
Anxiety - ANSWER -FUTURE ORIENTATED
-an emotion characterized by the apprehension or dread of a potentially threatening or
uncertain outcome
-most basic of emotions
S&S: nausea, lack of appetite, sleep disturbances, heart racing/ palpitations, restless,
sweating/ shivering, dizzy, lightheaded, trembling
Fear - ANSWER -emotional response to a specific and proximal threat to an organism's
life or integrity
-fear relates to the stimulus
Family of Anxiety Disorders - ANSWER -all anxiety disorders share excessive fear or
anxiety as their core symptom
-differ from one another based on their key features
Generalized Anxiety Disorder
Social Anxiety Disorder
Panic Disorder
Specific phobia
-most important factor when assessing person with anxiety disorder is the degree of
impairment in the person's life
Anxiety Disorders - ANSWER -most common mental illnesses
-lifetime prevalence of anxiety disorders to be as high as 31%
,-most treated disorder in childhood and adolescence
-often begins in adolescence
-more common in females (5.6%) rather than males (4.2%)
-anxiety can exist as a primary disorder however it often co-exists with other conditions
Generalized Anxiety Disorder (GAD) - ANSWER -worry excessively and uncontrollably
about daily life events and activities
-impacts the person's functioning
-associated with physical symptoms
-prevalence is 2.6% in Canada
-onset of GAD is early in life
-feel powerless to change, frustrated with life, demoralized, and hopeless
-comorbidity = depression
DSM-5 Generalized Anxiety Disorder - ANSWER -more days than not for past 6 months
-anxiety & worry are associated with three or more of following symptoms
1. restlessness or on edge
2. easily fatigued
3. difficulty concentrating or mind going blank
4. irritability
5. muscle tension
6. sleep disturbances (difficulty falling or staying asleep)
Generalized Anxiety Disorder Assessment - ANSWER > 10= probably diagnosis of
GAD, confirm by further evaluation
5= mild anxiety
10= moderate anxiety
15= severe anxiety
-cognitive behavioural and SSRI/ SNRI agents are effective in reducing symptoms in up
to 50% of patients
-if a 50% or more decrease in treatment does not occur within 3 months of treatment a
different or adjunctive treatment should be offered
Panic Disorder - ANSWER -recurrent unexpected panic attacks and fear of another
attack
-sudden periods of intense fear or discomfort
-response to a serious threat or "out of the blue"
-temporarily impair mental ability to function socially, occupationally, and interpersonally
-prevalence in Canada is 3.7%
-> in women ages 30-59 years
-can occur with or without agoraphobia (fear of public places)
-symptoms resemble that of myocardial infarction
DSM-5 Panic Disorder - ANSWER Recurrent unexpected panic attacks that reaches a
peak within minutes and during that time four or more of the following occur:
-irregular HR/ palpitations
,-sweating, trembling/shaking
-sensation of SOB/ smothering
-feelings of choking
-chest pain / discomfort
-nausea / abdominal distress
-dizzy/ faint/ unsteady
-chills or heat sensations
-tingling/ numbness (parathesis)
-feeling of unreality (derealization)
-feeling detached from oneself (depersonalization)
-fear of losing control/ "going crazy"
-fear of dying
Panic Disorder S&S - ANSWER -nausea, chest pain, racing heart, sweating, trembling,
shortness of breath
Panic - ANSWER -can be normal but extreme overwhelming form of anxiety
-often initiated when a person is put in a real or perceived life threatening situation
-sudden sensation of fear
Panic Disorder - Risk Factors - ANSWER -gender = female
aged 30-59 years
mean age of onset is 23 years
-previously triggered panic attack
-a family history of psychological difficulties
-childhood trauma
-history of mood disorders
-adolescents at a higher risk for suicide thoughts or attempts
Panic Disorder! VS Heart Attack - ANSWER -sharp stabbing pain in the middle of the
chest
-sudden onset or onset due to extreme distress
-pain that gets better over time
-symptoms resolve in 20-30 minutes
-SOB
-sweating
-shakiness
-tingling in the hands
Panic Disorder VS Heart Attack ! - ANSWER -squeezing pain & pressure in chest
-sudden onset or onset during physical exertion
-pain that radiates to the arm, jaw, or shoulder blades
-longer lasting symptoms
-SOB
-sweating
-nausea & vomiting
, Phobias - ANSWER -panic attacks can precipitate a phobia
-phobias are persistent, unrealistic fear of situations, objects, or activities
-unreasonable response to protect personal safety
-intensity of anxiety related to proximity of object and degree to which escape is
possible
Agoraphobia - ANSWER anxiety disorder that covers diverse categories of fears that
are based on the need to escape from a situation (ex. fear of open spaces)
Specific Phobias (Simple Phobia) - ANSWER -disorder marked by an irrational fear of
specific object or situation that the person realizes is unreasonable
-exposure to the stimulus object or situation causes the anxiety
-anxiety is related to the proximity of the object and the ability to escape
Social Anxiety Disorder (Social Phobia) - ANSWER -marked or intense fear of social
situations
-highly sensitive to disapproval or criticism
tend to evaluate themselves negatively
-functional impairment
-onset: early adolescence
-prevalence in Canada is 2.6% in men & 3.4% in women
-two types of social anxiety disorder: generalized social phobia, or specific social phobia
Etiologic Theories of Anxiety Disorders - genetic theories - ANSWER -focus on genetic
vulnerabilities, genetic component
Etiologic Theories of Anxiety Disorders - neurobiology of anxiety - ANSWER -fear
conditioning affects the hippocampus and amygdala, FMRI increased amygdala activity
Etiologic Theories of Anxiety Disorders - neurotransmitter & neuropeptides - ANSWER
serotonin, norepinephrine, corticotropin releasing hormones, cholescytokinin
Etiologic Theories of Anxiety Disorders - neuroimaging - ANSWER MRI show decrease
in grey matter and white matter
abnormal activation patterns in response to provocation
Etiologic Theories of Anxiety Disorders - psychodynamic theories - ANSWER focus on
the psychological influences
early in life experiences affect the brain and how we respond to stressors
Biologic Domain Assessment - Anxiety Disorders - ANSWER -first need to determine
that the symptoms of anxiety have affected the individuals ability to function
-assess for substance use
-assess sleep patterns
