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3rd Year - Psychiatry > 9. Anxiety Disorders > Flashcards

9. Anxiety Disorders Flashcards

1
Q

What are the 3 Models of Stress?

A
  1. Biomechanical “Engineering”
  2. Medicophysiological
  3. Psychological (Transactional)
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2
Q

What are the Features of the Psychological (Transactional) Model of Stress?

A

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

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3
Q

What are the 2 Methods of Coping?

A
  1. Problem Focussed

2. Emotion Focussed

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4
Q

What is the Difference between:

  1. Problem Focussed Coping?
  2. Emotion Focussed Coping?
A
  1. Efforts are Directed toward Modifying Stressor - Tackling the problem Head On
  2. Modify Emotional Reaction (Mental Defence Mechanism) - Doing Yoga / Get Drunk
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5
Q

What are the Symptom Groups of Anxiety?

A
  1. Psychological Arousal
  2. Autonomic Arousal
  3. Muscle Tension
  4. Hyperventilation
  5. Sleep Disturbance
    Note - These are the same as the “Fight or Flight Response”
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6
Q

What are the Components of Psychological Arousal (Anxiety Symptom Group)?

A
  1. Fearful Anticipation
  2. Irritability
  3. Sensitivity to Noise
  4. Poor Concentration
  5. Worrying Thoughts
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7
Q

What are the Components of Autonomic Arousal (Anxiety Symptom Group)?

A
  1. G.I. - Dry Mouth / Swallowing Difficulties / Dyspepsia / Nausea / Frequent Loose Motions
  2. Resp - Tight Chest / Difficulty Inhaling
  3. CVS - Palpitations (Missed Beats) / Chest Pain
  4. CNS - Dizziness / Sweating
  5. Genito-Urinary:
  6. a) Frequency / Urgency of Micturition
  7. b) Amenorrhoea / Dysmennorhoea
  8. c) Erectile Failure
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8
Q

What are the Components of Muscle Tension (Anxiety Symptom Group)?

A
  1. Tremor
  2. Headache
  3. Muscle Pain
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9
Q

What are the Components of Hyperventilation (Anxiety Symptom Group)?

A
  1. CO2 Deficit - Hypocapnia
  2. Numbness / Tingling in Extremities - Carpopedal Spasm
  3. Breathlessness
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10
Q

What are the Components of Sleep Disturbance (Anxiety Symptom Group)?

A
  1. Initial Insomnia
  2. Frequent Waking
  3. Nightmares / Night Tremors
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11
Q

What are the common Anxiety Disorders?

A
  1. General Anxiety Disorders - Occurs Persistently
  2. Phobic Anxiety Disorders - Specific Isolated Phobias
  3. Obsessive Compulsive Disorder
  4. Post-Traumatic Stress Disorder
    Note - 1. + 2. Have the same core Anxiety Symptoms
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12
Q

What is the Differential Diagnosis of Anxiety Disorders?

A
  1. Depression
  2. Schizophrenia
  3. Dementia
  4. Substance Misuse
  5. Thyrotoxicosis
  6. Phaeochromoctoma
  7. Hypoglycaemia
  8. Asthma +/- Arrythmias
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13
Q

What is the Aetiology of Generalised Anxiety Disorder?

A

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

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14
Q

How is Generalised Anxiety Disorder managed?

A
  1. Counselling - Clear Plan of Management / Explanation + Education / Advice Regarding Caffeine / Alcohol / Exercise
  2. Relaxation Training - Group or Individual / DVD’s or Tapes or Clinician Led
  3. Medications - Sedatives / Antidepressants (SSRI’s / TCA’s)
  4. Cognitive Behavioural Therapy - Identifying Errors, Reprocessing, and Releasing
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15
Q

What are the Key Features of Phobic Anxiety Disorders?

A
  1. Same Core Features as Generalised Anxiety Disorder
  2. Only in Specific Circumstances
  3. Person behaves to Avoid these Circumstances
  4. Sufferer also experiences Anxiety if there is a Perceived Threat of encountering the Feared Object / Situation
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16
Q

What are the 3 Types of Phobic Anxiety Disorder?

A
  1. Specific Phobias - e.g. Snakes
  2. Social Phobias - Being in Situations where person feels Observed / could be Criticized
  3. Agrophobia - Being afraid of leaving the House
17
Q

What is the Management of Social Phobias?

A
  1. Cognitive Behavioural Therapy
  2. Education / Advice
  3. Medications - SSRI’s
18
Q

What are the Core Features of Obsessive Compulsive Disorder (OCD)?

A

Experience of Recurrent Obsessional Thoughts and / or Compulsive Acts

19
Q

What are the Features of the Obsessional Thoughts in Obsessive Compulsive Disorder (OCD)?

A
  1. Ideas / Images / Impulses
  2. Occuring Repeatedly - Not Willed
  3. Unpleasant and Distressing - Obscene / Violent / Distressing
  4. Recognized as the Individuals own Thoughts
  5. Usual Key Anxiety Symptoms arise because of the Distress of the Thoughts / Attempts to Resist
20
Q

What are the Features of the Compulsive Acts / Rituals in Obsessive Compulsive Disorder (OCD)?

A
  1. Stereotypical Behaviours repeated again and again
  2. Not Enjoyable
  3. Not Helpful - do not result in useful activity
  4. Often viewed by the Sufferer as:
  5. a) Preventing some harm to Self / Others
  6. b) Pointless and Resisted with Key Anxiety Symptoms accompanying Resistance
21
Q

What is the Management of Obsessive Compulsive Disorder (OCD)?

A
  1. Good History to exclude treatable Depressive Illness
  2. General Measures - Education / Involve Family
  3. Serotonergic Drugs - SSRI’s / Clomipramine
  4. Cognitive Behavioural Therapy - Exposure and Response Prevention / Examination of Evidence to Weaken Convictions
  5. Psychosurgery
22
Q

What is the Definition of Post-Traumatic Stress Disorder?

A

Delayed and / or Protracted Reaction to a Stressor of Exceptional Severity - Combat / Natural Disaster / Rape / Assault / Torture / Witnessing above

23
Q

What are the 3 Key elements of a Post-Traumatic Stress Disorder?

A
  1. Hyperarousal
  2. Re-Experiencing Phenomena
  3. Avoidance of Reminders
24
Q

What are the Features of Hyperarousal in Post-Traumatic Stress Disorder?

A
  1. Persistent Anxiety
  2. Irritability
  3. Insomnia
  4. Poor Concentration
25
Q

What are the Features of Re-Experiencing Phenomena in Post-Traumatic Stress Disorder?

A
  1. Intense Intrusive Images
  2. Flashbacks when Awake
  3. Nightmares during Sleep
26
Q

What are the Features of Avoidance of Reminders in Post-Traumatic Stress Disorder?

A
  1. Emotional Numbness
  2. Cue Avoidance
  3. Recall Difficulties
  4. Diminishes Interests
27
Q

What is the management of Post-Traumatic Stress Disorder?

A
  1. Watchful Waiting
  2. Trauma-Focussed Cognitive Behavioural Therapy
  3. Eye Movement Desensitisation and Reprocessing
  4. Medication - SSRI’s / TCA’s / Sedatives

3rd Year - Psychiatry (23 decks)

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