Anxiety and stress Flashcards
What is an anxiety disorder?
Abnormal and pathological fear and anxiety
What are the psychological features of Generalised Anxiety Disorder?
Difficult to control worry
Interrupted sleep
Poor concentration
Increased sensitivity to noise
What are the physiological features of Generalised Anxiety Disorder?
Sweating Dry mouth Urinary frequency Hyperventilation Palpitations
What features must be present for a diagnosis of GAD?
Excessive anxiety/ worry occurring more days than not for at least 6 months about a number of events/ activities
3+ symptoms including: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance
What impact can GAD have on daily living?
Co-morbidities with physical conditions (e.g. chronic pain)
Affects work, social interactions, relationships
Increased suicidal ideation
What factors can predispose an individual to GAD?
Combination of biological, psychological and social factors
Neural activity associated with abnormal cognitions and increased attention to threat
What treatments can be used to manage anxiety?
Pharmacological treatments
Mindfulness
CBT (establishing links between physiological and psychological changes)
Thought diary
What is selective attention?
Seeing only the negative features in events
What is magnification?
Exaggerating the importance of undesirable events
What is overgeneralisation?
Drawing broad negative conclusions on the basis of a single insignificant event
What behaviours do anxiety treatments aim to target?
Selective attention
Magnification
Overgeneralisation
What are the 4 classes of the effects of stress?
Affective
Behavioural
Cognitive
Physiological
What behaviours or emotions are affective effects of stress?
Shock Distress Anger Low self-esteem Guilt Depression Anxiety/ fear
What are the behavioural effects of anxiety?
Smoking Alcohol Help seeking delay Poor adherence Social withdrawal Illicit drugs Sexual function
What are the cognitive effects of anxiety?
Poor attention Poor decision making Hypervigilance to threats Memory loss Learning difficulties
What are the physiological effects of anxiety?
Nervous system activation Hormone production Metabolic function Immune function Fatigue Disease/ illness
How can the physiological effects of anxiety impact patients on the ward?
Poor wound healing Post-surgery complications Longer in-patient stays More staff time More analgesia use Poor adherence/ less satisfaction with treatment
How can the physiological effects of anxiety impact patients after discharge?
Longer recovery (e.g. return to work)
More service use
Less use of rehabilitation services
Increased risk of co-morbidity and early mortality
What 3 perspectives should be used to understand stress?
Stimulus (cause/ stressor)
Response (effect e.g. physiological)
Process (person-environment interaction)
What is stress?
A non-specific physiological response to a threat to one’s physical or emotional wellbeing
What are the 3 stages of a physiological response to stress?
- Alarm (fight or flight response - nervous, endocrine and immune systems activated for defence against threat)
- Resistance (conservation response initiated to return homeostasis) becomes counterproductive if alarm continues
- Exhaustion (depletion of physiological resources - collapse of adaptive responses, immune failures and disease outcomes)
What is the transactional model of stress?
A causal chain of influence involving a stimulus event and and outcome influenced by intervening processes:
- Primary appraisal (determines significance of event)
- Secondary appraisal (evaluation of available response options)
- Response (coping - cognitive and behavioural activities initiated in order to manage demands of event)
What does problem-focused coping involve?
Attempts to manage or change concrete aspects of the stressor
What does emotion-focused coping involve?
Attempts to remove or reduce the emotional distress
