23 - Anxiety Disorders

Question 1

How can psychological abnormality be defined? ‘4 d’s’

Answer 1

1. Deviant (different, unusual, extreme, bizarre)
2. Distressing (unpleasant, upsetting to individual)
3. Dysfunctional (inability to conduct daily activities)
4. Dangerous (to oneself or others)

Question 2

What did Szasz imply about ‘the myth of mental illness’?

Answer 2

Only physical diseases exist so a disease of the mind is impossible

Question 3

ICD-10 classification of mental disorders?

Answer 3

Organic disorders

Psychoactive substance use

Psychotic disorders

Mood, stress, & anxiety disorders

Physiological disorders

Development disorders

Disorders of childhood

Question 4

What is the gender gap in mental illness?

Answer 4

Higher rates in women, with young women becoming a key high risk group.

The gender gap in mental illness had become most pronounced in young
people, and there is evidence that this gap has widened in recent years.

Question 5

What did the Adult Psychiatric Morbidity Survey in 2016 find regarding the prevalence of mental disorders in England?

Answer 5

Around one person in six (17%) in England had a common mental disorder (one in five women, one in eight men)

Question 6

Who did the Adult Psychiatric Morbidity Survey in 2016 find that mental disorders were more common among?

Answer 6

• Women
• Single, divorced, living alone
• In receipt of state benefits
• Comorbidity with chronic physical illness (e.g. cancer, asthma, diabetes, epilepsy, high blood pressure)

Question 7

What did the Adult Psychiatric Morbidity Survey in 2016 find were the most prevalent mental health disorders?

Answer 7

Generalised anxiety disorder (5.9%), depressive episode (3.3%), mixed anxiety and depressive disorder (7.8%)

Question 8

What % of GP consultations are regarding mental health disorders?

Answer 8

30%

Question 9

What are anxiety disorders?

Answer 9

Panic disorder

Post-traumatic stress disorder (PTSD)
- Acute stress disorder

Generalised anxiety disorder

Obsessive-compulsive disorder (OCD)

Phobias

Question 10

How can anxiety disorders be managed with a biological focus?

Answer 10

• Neurotransmitters, brain imaging

- Pharmacological management (benzodiazepines, SSRIs)

Question 11

How can anxiety disorders be managed with a psychological focus?

Answer 11

• Learning mechanisms (onset AND maintenance)

- Psychological interventions (education, relaxation, CBT)

Question 12

What is the cycle of panic disorder?

Answer 12

1. Physical sensation, thought, or image perceived as threatening
2. Anxiety
3. Physical sensations (rapid heart beat etc)
4. Catastrophic interpretation of physical symptoms
5. Amplification of physical sensations and anxiety
6. Hypervigilance

Question 13

How can panic disorders be managed?

Answer 13

• Selective attention to bodily events
• In-situation safety behaviours
• Avoidance

Question 14

What is the difference between PTSD and acute stress disorder?

Answer 14

Acute stress disorder refers to the initial traumatic symptoms that arise immediately after a traumatic event. PTSD refers to the long-term aftermath of trauma.

Question 15

What is generalised anxiety disorder?

Answer 15

Excessive and uncontrollable worry about future events & outcomes

Question 16

How many people suffer with generalised anxiety disorder?

Answer 16

1-5% of population in last 12 months

Question 17

What does generalised anxiety disorder tend to co-occur with?

Answer 17

Depression, many other medical conditions

Question 18

What is intolerance of uncertainty?

Answer 18

Results from a set of negative beliefs about uncertainty and its implications and involves the tendency to react negatively to uncertain situations and events

• Overestimate risk
• -ve consequences

Question 19

What are signs of intolerance of uncertainty?

Answer 19

• Seeking excessive reassurance
• List-making
• Double checking
• Refusing to delegate tasks to others
• Procrastination/avoidance
• Distraction

This provides temporary anxiety reduction.

Question 20

What is OCD?

Answer 20

• Obsessions (intrusion of thoughts, images, impulses that produce anxiety e.g. contamination)
• Compulsions (behaviours or rituals)

Question 21

What is a phobia?

Answer 21

Irrational fear of specific objects or situations

Question 22

Describe classical conditioned acquisition of needle phobia

Answer 22

Signal (CS): sight of needle

Trauma (UCS): injection/pain

Reaction (UCR): fright/withdrawal

Result (CR): needle phobia

Question 23

What is negatively reinforced maintenance?

Answer 23

Escape of avoidance of aversive event leads to reduction in fear

Question 24

What is agoraphobia?

Answer 24

Fear of crowded/enclosed places and open spaces (fear of panic attack & resultant embarrassment)

Question 25

What is social phobia (social anxiety disorder)?

Answer 25

Extreme and persistent fear of embarrassment and humiliation leading to avoidance of social and public activities

Question 26

When does social phobia typically onset?

Answer 26

Teens, affects more men

Question 27

How prevalent is social phobia?

Answer 27

7-12% lifetime prevalence in community samples, higher in primary care samples

Question 28

What are common simple phobias?

Answer 28

Animals (spiders, dogs, birds)

Natural phenomena (height, darkness, thunder)

Injury, illness (hospital, dentist, needle)

Blood

Question 29

How prevalent are simple phobias?

Answer 29

20-30% mild fears, 1% severe phobia

Question 30

What are other ways of acquiring phobias?

Answer 30

• Parents
• Peers
• Media

Question 31

What is systematic desensitisation?

Answer 31

A form of behaviour therapy with graded exposure to feared object/situation (imagined or actual exposure)