Anxiety Flashcards
What is anxiety?
-Anxiety is a feeling of unease, worry or fear. We all feel anxious at times, but anxiety may be a mental health problem if your feelings are very strong or last a long time.
What is one form of anxiety?
-Phobias
Can anxiety be healthy?
- When being put into threatening situations
- Survival mechanisms
- Increases heart rate, blood rate increases
- Primes body for fight or flight
- Pupils dilate
What is yerkes-dobson curve?
-Shows relationship between stress and productivity
What are the different types of anxiety disorders?
- Pain disorder
- OCD
- Acute stress Disorder - receives. bad news
- PTSD - war veterans
- Social phobia - fear being around people
- simple phobia- fear of clowns and dogs
What is generalised anxiety disorder?
- Free-floating anxiety
- anything can trigger anxiety
What is anxiety often seen inconjunction with?
- Depression
- Schizophrenia
What is ICD-10 criteria for anxiety?
- At least 6 months of prominent tension, worry, and feelings of apprehension about everyday events and problems
- At least four of the following 22 symptoms must be present, at least one of which must be from the autonomic arousal cluster
What are examples of autonomic arousal symptoms?
-palpitations or pounding heart or accelerated heart rate; sweating; trembling or shaking; dry mouth (not due to medication or dehydration)
What are anxiety symptoms involving the chest and abdomen?
- difficulty in breathing; feeling of choking; chest pain or discomfort; nausea or abdominal distress
What are the symptoms involving mental state?
- feeling dizzy, unsteady, faint or lightheaded; derealization or depersonalization; fear of losing control, ‘going crazy’, or passing out; fear of dying
What are general symptoms for anxiety?
- hot flushes or cold chills; numbness or tingling sensations
What are the symptoms of tension?
- muscle tension or aches and pains; restlessness and inability to relax; feeling keyed up, or on edge, or mentally tense; a sensation of a lump in the throat, or difficulty in swallowing
What are the clinical features of anxiety?
- Free floating
- Not a feature of another disorder
- Co morbidity with depression and other psychiatric disorder
What is epidemiology?
- Life-time prevalence 5.7%
- Increased risk
Female
Middle-aged
Low income - Decreased risk
African American, Asian, Hispanic
What is issue with anxiety diagnosis?
-Can be difficult to separate out from other disorders
What is the unique profile of GAD?
- High negative affect and anxiety
- Low physiological arousal and depression
What is aetiology of anxiety disorders?
- Genetic
- Five times more prevalent in first-degree relatives
- No difference in twin studies
- Modest role,
- genetic more linked to depression
- Neurobiological mechanisms
- Noradrenergic systems
- HPA axis
Describe noradrenergic nervous system in people with anxiety?
- Resting catecholamine levels are normal
- Subnormal response to stimulation and blockade
- Implication is down-regulation of receptors
Describe HPA axis
- Cortisol released in response to stress, with negative feedback on pituitary and hippocampus
- In rats, chronic exposure to stress or steroids, downregulates the negative feedback
- Reduced dexamethasone suppression seen in 1/3 of GAD
- Unable to bring cortisol levels
What part of the brain is involved in brain?
-amygdala
What does MRI of children amygdala show?
- MRI of children and adolescents with GAD showed volume increases
- maybe change in amygdala is linked to anxiety conditions
What is psychology aetiology of anxiety?
- Diminished sense of control over themselves and over their life
- trauma and insecure attachment to primary caregivers
- parenting style
- giving child attention
- encouragement of the child to explore and manipulate the environment
- Life stress
- 52% of GAD suffers have experience a PTSD like event c/f to 21% of non GAD sufferers
What is prognosis of anxiety?
- remission rate 38% at 5 years
- relapse rate 27% at 3 years
- poor prognosis
- poor life satisfaction
- poor relationship with spouse and anxiety
- Cluster C personality (anxious, fearfulcluster. It includes the Avoidant, Dependent, and Obsessive-CompulsivePersonalityDisorders)
What are Pharmacological treatment for anxiety?
-Benzodiazepines - addictive
-Buspirone - serotonin
-Anti-depressants - SSRI and SNRI
-Pregabalin - Voltage gated pre-synaptic calcium channel
Reduces glutamate release
What are psychological treatments or anxiety?
- CBT
- Psychoeducation
- Relaxation
- Exposure
