9. Anxiety Disorders Flashcards
What are the 3 Models of Stress?
- Biomechanical “Engineering”
- Medicophysiological
- Psychological (Transactional)
What are the Features of the Psychological (Transactional) Model of Stress?
An individuals reaction to stress will depend on a Balance between their:
1. Cognitive Processing of any Perceived Threat
2. Perceived Ability to Cope
Note - This is Interactive
What are the 2 Methods of Coping?
- Problem Focussed
2. Emotion Focussed
What is the Difference between:
- Problem Focussed Coping?
- Emotion Focussed Coping?
- Efforts are Directed toward Modifying Stressor - Tackling the problem Head On
- Modify Emotional Reaction (Mental Defence Mechanism) - Doing Yoga / Get Drunk
What are the Symptom Groups of Anxiety?
- Psychological Arousal
- Autonomic Arousal
- Muscle Tension
- Hyperventilation
- Sleep Disturbance
Note - These are the same as the “Fight or Flight Response”
What are the Components of Psychological Arousal (Anxiety Symptom Group)?
- Fearful Anticipation
- Irritability
- Sensitivity to Noise
- Poor Concentration
- Worrying Thoughts
What are the Components of Autonomic Arousal (Anxiety Symptom Group)?
- G.I. - Dry Mouth / Swallowing Difficulties / Dyspepsia / Nausea / Frequent Loose Motions
- Resp - Tight Chest / Difficulty Inhaling
- CVS - Palpitations (Missed Beats) / Chest Pain
- CNS - Dizziness / Sweating
- Genito-Urinary:
- a) Frequency / Urgency of Micturition
- b) Amenorrhoea / Dysmennorhoea
- c) Erectile Failure
What are the Components of Muscle Tension (Anxiety Symptom Group)?
- Tremor
- Headache
- Muscle Pain
What are the Components of Hyperventilation (Anxiety Symptom Group)?
- CO2 Deficit - Hypocapnia
- Numbness / Tingling in Extremities - Carpopedal Spasm
- Breathlessness
What are the Components of Sleep Disturbance (Anxiety Symptom Group)?
- Initial Insomnia
- Frequent Waking
- Nightmares / Night Tremors
What are the common Anxiety Disorders?
- General Anxiety Disorders - Occurs Persistently
- Phobic Anxiety Disorders - Specific Isolated Phobias
- Obsessive Compulsive Disorder
- Post-Traumatic Stress Disorder
Note - 1. + 2. Have the same core Anxiety Symptoms
What is the Differential Diagnosis of Anxiety Disorders?
- Depression
- Schizophrenia
- Dementia
- Substance Misuse
- Thyrotoxicosis
- Phaeochromoctoma
- Hypoglycaemia
- Asthma +/- Arrythmias
What is the Aetiology of Generalised Anxiety Disorder?
Stressor Acting on a Personality Predisposed to the Disorder by a Combination of Genetic Factors and Environmental Influences in Childhood
Note - More common in Women
How is Generalised Anxiety Disorder managed?
- Counselling - Clear Plan of Management / Explanation + Education / Advice Regarding Caffeine / Alcohol / Exercise
- Relaxation Training - Group or Individual / DVD’s or Tapes or Clinician Led
- Medications - Sedatives / Antidepressants (SSRI’s / TCA’s)
- Cognitive Behavioural Therapy - Identifying Errors, Reprocessing, and Releasing
What are the Key Features of Phobic Anxiety Disorders?
- Same Core Features as Generalised Anxiety Disorder
- Only in Specific Circumstances
- Person behaves to Avoid these Circumstances
- Sufferer also experiences Anxiety if there is a Perceived Threat of encountering the Feared Object / Situation
What are the 3 Types of Phobic Anxiety Disorder?
- Specific Phobias - e.g. Snakes
- Social Phobias - Being in Situations where person feels Observed / could be Criticized
- Agrophobia - Being afraid of leaving the House
What is the Management of Social Phobias?
- Cognitive Behavioural Therapy
- Education / Advice
- Medications - SSRI’s
What are the Core Features of Obsessive Compulsive Disorder (OCD)?
Experience of Recurrent Obsessional Thoughts and / or Compulsive Acts
What are the Features of the Obsessional Thoughts in Obsessive Compulsive Disorder (OCD)?
- Ideas / Images / Impulses
- Occuring Repeatedly - Not Willed
- Unpleasant and Distressing - Obscene / Violent / Distressing
- Recognized as the Individuals own Thoughts
- Usual Key Anxiety Symptoms arise because of the Distress of the Thoughts / Attempts to Resist
What are the Features of the Compulsive Acts / Rituals in Obsessive Compulsive Disorder (OCD)?
- Stereotypical Behaviours repeated again and again
- Not Enjoyable
- Not Helpful - do not result in useful activity
- Often viewed by the Sufferer as:
- a) Preventing some harm to Self / Others
- b) Pointless and Resisted with Key Anxiety Symptoms accompanying Resistance
What is the Management of Obsessive Compulsive Disorder (OCD)?
- Good History to exclude treatable Depressive Illness
- General Measures - Education / Involve Family
- Serotonergic Drugs - SSRI’s / Clomipramine
- Cognitive Behavioural Therapy - Exposure and Response Prevention / Examination of Evidence to Weaken Convictions
- Psychosurgery
What is the Definition of Post-Traumatic Stress Disorder?
Delayed and / or Protracted Reaction to a Stressor of Exceptional Severity - Combat / Natural Disaster / Rape / Assault / Torture / Witnessing above
What are the 3 Key elements of a Post-Traumatic Stress Disorder?
- Hyperarousal
- Re-Experiencing Phenomena
- Avoidance of Reminders
What are the Features of Hyperarousal in Post-Traumatic Stress Disorder?
- Persistent Anxiety
- Irritability
- Insomnia
- Poor Concentration
