Anxiety

Question 1

What are the Anxiety sub-types?

Answer 1

• Specific phobia
• Social anxiety disorder
• Generalised anxiety disorder
• Panic disorder
• Agoraphobia
• Separation anxiety disorder
• Selective mutism

Question 2

Specific phobia is when

Answer 2

there is a marked fear or anxiety about a specific object or situation.

Question 3

Social anxiety disorder is when

Answer 3

Persistent fear or anxiety about 1 or more social or performance situations that is disproportionate

Question 4

GAD is when

Answer 4

there is excess worry about a number of events or activities and difficulty controlling this

Question 5

Separation anxiety disorder is when there is

Answer 5

excessive fear or anxiety focussed on separation from home or attachment figures

Question 6

Selective mutism is when there is

Answer 6

Consistent failure to speak in social situations when there is an expectation to do so

Question 7

Panic disorder is when there are recurrent

Answer 7

unforeseen panic attacks ~ i.e. an abrupt surge of intense fear

Question 8

Agoraphobia is when you have

Answer 8

marked fear or anxiety about situations where escape might be difficult

Question 9

In many cases, the presentation of anxiety is ____ and it is difficult to _________ between disorders. Also, __-_______ is very common

Answer 9

complex
differentiate
co morbidity

Question 10

What are some risk factors for anxiety?

Answer 10

• female
• unmarried
• unemployed
• stressful life events
• family history
• younger age
• poor physical or mental health
• specific personality traits
• certain parenting styles e.g. over-protective, lacking emotional warmth etc

Question 11

What are some presenting symptoms of anxiety?

Answer 11

Apprehension (low mood, loss of interest)
Irritability
Cued or spontaneous panic attacks
Poor concentration
Poor sleep
Avoidance

Question 12

Obsessive Compulsive Disorder is a

If compulsion is resisted, anxiety levels are _____

Answer 12

time consuming obsession and compulsion which interferes with a person’s day to day functioning, work or relationship.
increased

Question 13

Post Traumatic Stress Disorder is intense and prolonged and can be delayed response to a particular trauma. It is characterised by

Answer 13

emotional numbness, detachment, flashbacks, recurring memories and vivid dreams.
You do not have to be personally involved - can be a bystander or rescue worker

Question 14

What are some symptoms in anxiety?

Answer 14

Dry mouth
Difficulty swallowing
Increased heart rate
Palpitations
Awareness of missed beats
Lack of libido
Failure of erection
Sweating 
Tremor
Sighing
Avoidance
Sleep disturbances

Question 15

It is normal to have anxiety as a means of overcoming or responding to a crisis e.g. exams. However, in anxiety disorders, the anxiety

Answer 15

remains after the stress has ceased

Question 16

MECHANISM OF ANXIETY:

What are the two brain systems involved in fear and anxiety?

Answer 16

Defence system - responds to both learned and unlearned threats; can initiate fear, fight, flight or freeze behaviour

Behavioural Inhibition System - responsible for avoidance. System to regulate avoidance in response to punishment/ threat

Question 17

Treatment options for anxiety?

Answer 17

• self help
• psychological therapy
• pharmacological therapy

Question 18

What do you offer for GAD if they ask for drug treatment?

What do you NOT offer?

Answer 18

Sertraline
SSRI
BDZs (don’t give in primary or in secondary) / antipsychotic (don’t give in primary)

Question 19

What are first line interventions?

First line pharmacological treatment?

Answer 19

Self-help, CBT
SSRI - however can increase anxiety at start of treatment
Pregabalin can be used as an alternative or an adjunct
BZDs used for immediate relief for certain situations