Anxiety and related disorders Flashcards
When is anxiety abnormal?
It’s the fight or flight response.
Abnormal when out of proportion to the stressful situation, persists when stressful situation has gone.
Appears for no apparent reason when there are no stressors.
What does the Yerkes-Dodson curve suggest?
That there is an optimal arousal of stress which results in optimal performance but any less and and any more will impair performance.
What is the physiology of stress?
- HPA AXIS -> cortisol
- Direct sympathetic system
- Pro-inflammatory (cytokines)
- Reduced neurotrophin (BDNF)
How does reduced neurotrophin (BDNF) link with anxiety?
- Reduced neurotrophin (BDNF)
- Smaller hippocampus
- Reduced neuro-genesis
- Hippocampus linked with memory, emotion etc.
3 Ps
What’s important when taking a history for anxiety?
- Predisposing factors (family, personal)
- Precipitating factors (triggers)
- Perpetuating factors (what happened, response)
What are the mental symptoms of anxiety?
- Restlessness, inner tension and worry
- Fear of dread, losing control or dying
- Rumination + unable to concentrate
- Fatigue, irritable
- Derealisation + depersonalisation
Autonomic + chest/GI
What are the physical symptoms of anxiety?
AUTONOMIC: Palpations, sweating, shaking, hot flushed, dry mouth and muscular tension.
CHEST/GI: Hyperventilaton, numbness, choking, chest/abdo pain and nausea.
What criteria constitutes a diagnosis of Generalised Anxiety Disorder?
- Excessive anxiety and worry, occurring more days than not, for 6 months - worry that is difficult to control.
- Associated with 3 or more:
- > restlessness/’keyed up’/on edge
- > easily fatigued
- > difficulty concentrating or ‘mind going blank’
- > irritability
- > muscle tension
- > sleep disturbance
What are the risk factors associated with GAD?
- Low socio-economic status
- Childhood maltreatment + conduct problems
What is a phobia?
Excessive unreasonable fear, by presence or anticipation of a specific object/situation.
With/without panic attacks -> can interfere with life.
3 stages
What is classical conditioning?
Classical conditioning basically involves forming an association between two stimuli resulting in a learned response.
-
Before conditioning:
unconditioned stimulus -> unconditioned response
neutral stimulus -> no conditioned response -
During conditioning:
neutral + unconditioned stimulus -> unconditioned response -
After conditioning:
conditioned (prev neutral) stimulus -> conditioned response
What is operant conditioning?
Operant conditioning focuses on using either reinforcement or punishment to increase or decrease a behavior.
Through this process, an association is formed between the behavior and the consequences for that behavior.
In what main way are classical and operant conditioning different to each other?
Involuntary vs voluntary
Classical conditioning involves associating between an involuntary response and a stimulus, while operant conditioning is about associating between a voluntary behavior and a consequence
What is agoraphobia?
The fear of open spaces - associated with fears of dying and losing control. Fear of being alone at places where escape is difficult.
This leads to avoidance, over-dependency and bad temper/agitation.
Can be with or without panic disorder.
What is a panic attack?
Intense axiety peaking within 10 mins:
- Shortness of breath / choking
- Palpitations or chest pain
- Fear - dying, “going crazy”
- Other anxiety symptoms:
- > dizziness or faintness
- > derealisation + depersonalisation
- > hot flashes or chills, nausea or stomach distress; numbness, tingling, sweating, trembling…
