Transcript OCD/Anxiety Powerpoint: Tic/Tourette Center Support Group

UNDERSTANDING OCD AND
ANXIETY DISORDERS
Amy Drahota, Ph.D.
RCHSD-Autism Discovery Institute
Child & Adolescent Services Research Center
San Diego State University, Dept. of Psychology
4/26/2016
Understanding Anxiety: Conclusions

OCD and anxiety disorders are common in
children.
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OCD and anxiety disorders commonly occur
together with Tourette syndrome.

These disorders may interfere with the daily lives
of children who experience them.

Children suspected of having anxiety disorders
should be referred to mental health professionals.
OCD, Anxiety and Tourette Syndrome
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OCD and anxiety disorders are common
comorbidities in children with Tourette syndrome
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OCD affects 30-66% of individuals with a diagnosis of
Tourette syndrome (American Psychiatric Association, 2013;
Hirschtritt et al., 2015)

Anxiety disorders affect 36% of individuals with a diagnosis
of Tourette syndrome (Hirschtritt et al., 2015)
Understanding Anxiety
Fear and anxiety is linked with threat
 Anxiety is brain-based: Studies show that the
limbic system and especially the amygdala are
sensitive to cues of danger in the world
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 Once
triggered by perception or worry about
danger (even just being laughed at in a social
situation) these brain structures set off the
“fight/flight/freeze reflex”

Anxiety is experienced by everyone, but
becomes are problem when interferes with one
or more areas of life
Understanding Childhood Anxiety

OCD and Anxiety disorders are among the most common
psychiatric disorders affecting children and adolescents
(Albano et al., 2003)

Estimated collective prevalence rate: 6 to 15% (Benjamin et al.,
1990; Briggs-Gowan, 2000; Costello, 1989)
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Anxiety disorders involve:
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Behavior: Avoidance of feared things
Cognitions: Fearful beliefs and attributions
Affect: Negative affect and physiological arousal
Anxiety disorders: Separation anxiety, Selective mutism,
Social phobia, Generalized anxiety, Specific phobia and
Panic disorders.
OCD is its own diagnosis category
Obsessive-Compulsive and Related
Disorders
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Core Features
Age of Onset
Common Behaviors
Obsessive-Compulsive Disorder

Core features
Obsessions are recurrent and persistent intrusive and
unwanted thoughts, urges, or images
 Compulsions are repetitive behaviors or mental acts that an
individual feels driven to perform in response to an
obsession or according to rules that must be applied rigidly
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Average age of onset is 19½ years; 25% of cases start
by age 14 years old. Boys typically have earlier onset
than girls
Common behaviors
Time-consuming
 Causing clinically significant distress or impairment
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Specific Anxiety Disorders
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•
Core Features
Age of Onset
Common Behaviors
Separation Anxiety Disorder
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Core features
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Overwhelming fear of losing or being separated from
parents or caregivers through catastrophic means
Most prevalent anxiety disorder in kids younger than
12 years; can occur at any age & into adulthood
Common behaviors
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Difficulty transitioning from home to other places or refusal
to leave home or separate from caregiver
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May consistently feel sick upon arrival to appointment
Multiple requests to leave the appointment
 Avoidance of activities with peers or others
 Difficulty concentrating due to worry for self or caregiver
 Distress and preoccupation with separation
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Selective Mutism
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Core features
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Development & Course
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Children do not initiate speech or reciprocally respond when
spoken to by others in specific social situations
Yet, children generally have normal language skills
Prevalence: 0.03% to 1%, depending on study settings & ages
Onset often before 5 years old but interference noticed at school
Clinical observations suggest that kids may “outgrow” SM but
empirical data is lacking
Common behaviors
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Refuse to speak in social situations
Clingy behavior to caregivers or trusted adults
Mild oppositional behavior and temper tantrums
Social Phobia / Social Anxiety
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Core features
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Marked fear and panic while in or anticipatory anxiety about
1+ social situations in which there could be embarrassment,
rejection, or scrutiny
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For children, must occur in peer setting & not just with adults
Social situations are avoided or endured with intense fear
 Most often diagnosed in adolescents but does occur in
earlier childhood
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Common behaviors
Crying and/or temper tantrums
 Freezing or shrinking in social situations
 Clinging
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Generalized Anxiety
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Core features
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Excessive worry about a number of events or activities,
which is difficult to control and has associated physical
symptoms (restlessness, fatigue, difficulty concentrating,
irritability, muscle tension, sleep problems)
Common behaviors
Repeated or “out-of-the-blue” questions/comments about
the worried event/activity
 Distraction and interference with the task at hand
 Refusal to try tasks; perfectionism
 Trembling, twitching, shaking, muscle aches and soreness
 Somatic symptoms & exaggerated startle response
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Understanding Anxiety: Conclusions

OCD and anxiety disorders are common in
children.

OCD, anxiety disorders and mood disorders
commonly occur together.

These disorders may interfere with the daily lives
of children who experience them.

Children suspected of having anxiety disorders
should be referred to mental health professionals.
THANK YOU!
Any questions or discussion?