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Psychological Medicine Block (Unsorted) > Anxiety > Flashcards

Anxiety Flashcards

1
Q

Describe how anxiety varies between individuals.

A

Anxiety is on a spectrum

It is a disorder when it impairs functioning or is distressing.

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2
Q

Describe normal fear/anxiety.

A

Response to objectively dangerous/life threatening situations.
Protects from harm, constructive action

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3
Q

What are the domains of anxiety?

A

Physiological
Cognitive
Affective
Behavioural

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4
Q

Describe the physiological domain.

A

Physiological response - what the body does when in fear (e.g. fight/flight response)

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5
Q

Describe the cognitive domain of anxiety.

A

Perception of danger, threat, loss (thoughts in moment of initial fear)
Changes in cognition - sharp/clear or confused/foggy

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6
Q

Explain the affective domain of anxiety.

A

What we feel - nervous, fear/scared, anxious, uneasy, terror/dread

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7
Q

What is the behavioural domain of anxiety?

A

What we do - fight/flight/avoid/safety behaviours

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8
Q

What is abnormal anxiety?

A

Degree of fear or anxiety is greatly disproportionate to the risk or severity of possible danger.
Inaccurate appraisal of threat to wellbeing.

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9
Q

What causes abnormal anxiety?

A

Overestimating the danger

Overestimate the probabilty

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10
Q

How long does abnormal anxiety occur?

A

Occurs or continues to occur even though no objective danger exists. Anticipation of future threat.

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11
Q

List the anxiety disorders we will study.

A 
Panic Disorder
Agoraphobia 
Specific Phobia 
Separation Anxiety 
Social Phobia 
Generalized Anxiety Disorder
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12
Q

What are anxiety related disorders?

A

OCD, PTSD, Acute stress disorder

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13
Q

Define a panic attack (remember this is a CRITERIA for PANIC DISORDER)

A

Intense abrupt surge of fear that includes 4 or more of the following symptoms & peaks within 10 minutes:

  • Palpitations, pounding heart, accelerated HR
  • Sweating
  • Trembling or shaking
  • Shortness of breath/smothering
  • Feelings of choking
  • Chest pain/discomfort
  • Nausea/abdominal distress
  • Dizzy, unsteady, lightheaded, faint
  • Chills or heat sensations
  • Numbness or tingling sensations
  • Derealization or depersonalization
  • Fear of losing control/going crazy
  • Fear of dying
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14
Q

Describe the criteria needed to diagnose Panic Disorder.

A

A - recurrent unexpected panic attacks
B - at least one of the attacks has been followed by 1 month (or more) of one or both of the following:
1 - persistent concern or worry about having additional attacks or their consequences (heart attack, going crazy)
2 - significant maladaptive change in behaviour related to the attacks

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15
Q

What is the prevalence and median age for Panic Disorder?

A

Lifetime prevalence: 4.7%

Median age: 20-24 years

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16
Q

Things to note about Panic Disorder

A

Panic attack - full symptoms vs limited symptoms attacks
May be expected or unexpected
Criteria is recurrent (more than one) panic attacks
Frequently comorbidity = with agoraphobia

17
Q

What conditions and substances produce panic like symptoms?

A

Anameia, angina, COPD, epilepsy, parathyroid disorders
Marijuana, caffeine, general anesthetics
Withdrawal from substance use

18
Q

List the criteria of Agoraphobia.

A

A - Marked fear/anxiety about two or more of the following
1 - using public transport
2 - being in open spaces
3 - being in enclosed spaces
4 - standing in line/being in a crowd
5 - being outside of home alone
B - Individual fears/avoids these situations due to concerns not able to escape or help not available or embarrassing symptoms
C - almost always provoke fear/anxiety
D - avoided/need a companion/endured with intense fear
E - out of proportion to the actual danger posed
F - persistent (typically 6 months or more)
Causes significant distress or impairment in functioning

19
Q

What is the lifetime prevalence of agoraphobia?

A

1.4%

20
Q

Describe the symptoms of Specific Phobia.

A

Marked fear/anxiety about a specific object or situation.
Almost always provokes fear/anxiety.
Avoided/endured with intense anxiety.
Fear is recognized as excessive/unavoidable.
Persistent, (6 months or more)
Avoidance, fear or anxiety significant distress impairs functioning.

21
Q

What is the lifetime prevalence of specific phobia?

A

7.2% - 11.3%

22
Q

What are some key clues for children suffering from Specific Phobia?

A

May not always identify physiology or thoughts
Avoidance often key identifier
Somatic symptoms (feel sick, sore tummy)
Crying, tantrums, clinging

23
Q

Describe the criteria for Separation Anxiety Disorder.

A

Developmentally inappropriate & excessive fear concerning separation from those to whom the individual is attached, 3 or more of the following:
1 - recurrent excessive distress when anticipating or experiencing separation from home/attachment figures
2 - persistent/excessive worry about losing attachment figure or possible harm to them
3 - persistent worry about an event that causes separation
4 - reluctance or refusal to go out due to fear of separation
5 - reluctance to be alone or without attachment figures in home or other settings
6 - reluctance or refusal to sleep away from home or without the attachment person there
7 - nightmares involving separation
8 - physical symptoms when separated (headaches, stomach ache, nausea, vomiting)
Persistent (4 weeks for child/adolescent, 6 months for adult)
Causes significant distress or impairment in functioning

24
Q

What are the symptoms of the domains associated with separation anxiety?

A

Physiological - breathless, sore tummy, nausea, sick
Cognitive - I can’t, vivid nightmares about separation
Affective - nervous
Behaviour - avoidant, refusing to be separated, crying, clinging

25
Q

Name some typical presentations of separation anxiety.

A 
Avoidance of school/going to friend's houses/staying away from home 
Somatic symptoms 
Extreme reaction to forced separation 
Middle childhood most common (6-9yrs) 
Check for other factors (bullying etc.)
26
Q

Describe the criteria for Social Phobia.

A

Marked fear or anxiety about one or more social situations in which individual is exposed to possible scrutiny of others.
Fears that he/she will act in a way to show anxiety symptoms that will be negatively evaluated.
Social situations almost always provoke fear/anxiety.
Avoided/endured with intense anxiety
Fear is excessive/unreasonable
Persistent (6 months or more)
Avoidance, fear or anxiety significant distress or impairs functioning.

27
Q

What is the paradox of Social Anxiety?

A

The actual fear of being nervous, inhibited, looking anxious = reasonable probability of being recognized.
Overestimates the threat = hypervigilant to cues from others about their acceptability.

28
Q

What is the prevalence and normal age of social phobia?

A

Lifetime prevalence 3% -13%

Develops in late childhood and adolescence

29
Q

Describe the criteria of Generalized Anxiety Disorder (GAD).

A

Excessive anxiety or worry occurring more days than not for at least 6 months about a number of events or activities.
Individual finds it difficult to control the worry.
3 or more of the following:
- on edge, restless, keyed up
- easily fatigued
- can’t concentrate/mind going blank
- irritability
- muscle tension
- sleep disturbance
Anxiety or worry causes clinically significant distress or impairment.

30
Q

What features in life are common causes for GAD?

A 
School/work performance
Finances
Family/relationships
Health
Community/world affairs 
Minor matters
31
Q

How does GAD differ from non-pathological worry?

A

Excessive vs not excessive
More pervasive, distressing & longer duration vs perceived as manageable
Frequently without a precipitant vs can be put off when more pressing matters arise
Impairs functioning vs less likely to be accompanied by physical symptoms

32
Q

Describe the two different types of GAD.

A

Type 1 worry (positive elements) = worries about external events
Type 2 worry - worry about the worry (negative) = my worry is uncontrollable, I could go crazy with worrying, my worries will take over and control me

Psychological Medicine Block (Unsorted) (15 decks)

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