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NSB > Anxiety and Stress Features > Flashcards

Anxiety and Stress Features Flashcards

1
Q

What are the three responses to stressors?

A
  • somatic = fight or flight
  • emotional = fear, anxiety,
    depression
  • psychological = means to cope
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2
Q

Emotional Responses to Stress:

A

anxiety is absence of stimulus
fear is presence of stimulus

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3
Q

Psychological Responses to Stress:

A
  • avoidance/denial of an acute
    stress can help short-term
  • finding a way to remove/work
    through problem
  • finding a way to come to terms
    with the problem

Maladaptive Responses:
- use of alcohol/drugs
- aggressive/exaggerated
behaviours
- deliberate self-harm

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4
Q

Acute Stress Reaction: Features:

A
  • response to exceptionally stressful
    events
  • severe symptoms of stress
    reaction
  • usually hours-few days after
    stressor
  • usually subside after a few days
    from removal of threat
  • lasts less than a week after a
    single event
  • lasts less than a month after an
    ongoing situation like a war
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5
Q

Acute Stress Reaction: Symptoms:

A
  • dissociative symptoms
  • insomnia
  • restlessness
  • poor concentration
  • ANS activated
  • anger/anxiety/depression
  • social withdrawal
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6
Q

Dissociative Symptoms:

A
  • emotional numbness
  • dazed
  • difficulty recalling the stressful
    event
  • depersonalisation = unreal,
    detached, separated from people
    by a pane of glass
  • derealisation - pane of glass
    separating from the environment
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7
Q

Adjustment Disorder: Features:

A
  • wide range of
    emotional/behavioural symptoms
  • stressor not necessarily life
    threatening
  • out of proportion to the stressor
  • more gradual and prolonged
    responses to stressful changes
  • lasts up to 6 months
  • arises as a direct consequence of
    acute stress or ongoing stressor
  • would not have arisen without the
    stressor
  • response to a more mild stressor
    than stressors in acute stress
    reaction
  • lasts longer than acute stress
    reaction
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8
Q

PTSD: Features:

A
  • response to exceptionally
    threatening or catastrophic event
  • threatened death/serious injury
  • symptoms last for at least a month
  • usually onset within days of event
    but not diagnosed till 1 month
  • 30% recover within 3 months
  • most recover within a year
  • 30% chronic
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9
Q

PTSD: Symptoms:

A
  • increased arousal
  • dissociative symptoms
  • hypervigilance/startle
  • re-experiencing event
    (flashbacks/nightmares)
  • avoiding reminders of stressful
    events
  • maladaptive coping strategies
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10
Q

PTSD: Increased Arousal:

A
  • tremor
  • palpitations
  • panic attacks
  • restlessness
  • insomnia
  • anger
  • poor concentration
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11
Q

Anxiety Flowchart:

A
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12
Q

5 general symptoms of anxiety disorders:

A
  • psychological arousal
  • autonomic arousal
  • muscle tension
  • hyperventilation
  • sleep disturbance
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13
Q

Anxiety: General Symptoms: Psychological:

A
  • fearful anticipation
  • irritability
  • restlessness
  • poor concentration
  • worry
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14
Q

Anxiety: General Symptoms: Autonomic Arousal:

A
  • chest constriction
  • difficulty inhaling
  • palpitations
  • chest discomfort
  • dry mouth
  • swallowing problems
  • epigastric pain
  • loose/frequent stool
  • frequent/urgent micturition
  • failure of erection
  • menstrual discomfort
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15
Q

Anxiety: General Symptoms: Muscle Tension:

A
  • tremor
  • headaches
  • aching muscles
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16
Q

Anxiety: General Symptoms: Hyperventilation:

A
  • dizziness
  • tingling hands and feet
  • feeling breathless
17
Q

Anxiety: General Symptoms: Sleep Disturbances:

A
  • insomnia
  • night terrors
18
Q

Epidemiology of Anxiety Disorders:

A
19
Q

Generalised Anxiety disorder: Overview:

A
  • symptoms of anxiety are always
    present and not restricted to a
    specific set of circumstances
  • present for more than 6 months
20
Q

Generalised Anxiety Disorders: Clinical Features:

A
  • worry
  • fearful apprehension
  • headache/motor tension
  • irritability
  • poor concentration
  • autonomic arousal
  • sleep disturbances
  • depersonalisatio
  • low mood
  • fixation with detail
  • comorbidities are common (70%)
    • depression, phobia, panic
21
Q

GAD :Differential Diagnoses:

A
  • other anxiety disorders
  • depressive illness
  • schizophrenia
  • dementia
  • substance misuse
  • physical illness
22
Q

Generalised Anxiety disorder: Risk Factors:

A
  • M:F = 1:2 (F»)
  • broad age of onset, usually
    adulthood
  • lower household income
  • unemployment
  • divorce and separation
23
Q

GAD: Aetiology:

A
  • stressful events
  • genetics
  • early experiences: adverse
    experiences, parenting styles like
    overprotection or lack of
    emotional warmth
  • cognitive theories
  • neurobiological mechanisms
24
Q

Panic disorder:

A
  • recurrent panic attacks
  • not in response to a phobic
    stimulus
  • fear of another attack and worry
    about implications like having a
    heart attack
25
Q

Panic Attack Features:

A
  • sudden onset
  • severe anxiety symptoms
  • catastrophising
  • hyperventilation
  • lasts a few minutes
  • palpitations
  • choking feeling
  • dizziness and faintness
  • dissociation
  • chest pain
  • fear of dying
  • fear of losing control
26
Q

Panic Attacks and Hyperventilation:

A
  • reduces CO2 in blood
  • dizziness, tingling extremities,
    tinnitus
  • weakness, faintness,
    breathlessness
27
Q

Panic Disorders: Aetiology:

A
  • genetics: 7 fold increased risk in
    first degree relatives
  • precipitating events
  • traumatic early life events
28
Q

Social Anxiety Disorder is a form of

A

phobia

29
Q

Specific Phobias: Features:

A
  • usually start in childhood
  • named by adding name of
    stimulus
  • avoid jargon

anticipatory anxiety if any chance of encountering

intense anxiety during encounter

avoidance of phobia

30
Q

Bi-phasic anxiety reaction:

A
  • initial short-lived sympathetic
    arousal
  • parasympathetic arousal
  • may result in vasovagal syncope
  • feeling of disgust and repulsion
    rather than pure apprehension
31
Q

Blood-Injury Phobia: Differences:

A
  • vaso-vagal syncope = parasymp
    arousal as well
  • feeling of disgust and repulse
    rather than apprehension

biphasic anxiety reaction

32
Q

Specific Phobias: Aetiology:

A
  • 1/3 = genetics
  • classical conditioning: with
    reinforcement of learned
    behaviour after adverse
    encounter, avoidance maintains
    the fear and makes it hard to shift
  • biological preparedness
    hypothesis: commonly feared
    stimuli are those that have
    historically threatened the survival
    of the species
33
Q

Social Anxiety Disorder: Features:

A
  • inappropriate anxiety
  • leads to avoidance of trigger
    situations or experience of
    intense anxiety
  • person concerned that they will
    act in a way or show anxiety
    symptoms that will be negatively
    evaluated by others
34
Q

Social Anxiety Disorder: Symptoms:

A
  • Anticipatory anxiety
  • Feeling anxious
  • Blushing
  • Trembling (observed writing is a
    problem)
  • Nausea
  • Relieved by alcohol in short term
    (potential for abuse)
35
Q

Agoraphobia:

A

intense fear and anxiety in situations when escape might be difficult and help may not be available

key themes: confinement, crowding, distance from home

  • often begins with a panic attack
    away from home
  • anxious cognitions about fainting
    and loss of control are common
  • avoidance is common and leads to
    maintenance
36
Q

OCD: Features:

A
  • obsessional thinking
  • compulsive behaviour
  • psychiatric: anxiety, depression,
    depersonalisation
  • includes: thoughts, doubts,
    impulses, ruminations
  • recognised as the patients own
  • intrude forcibly into the mind
  • unwanted; attempts are made to
    resist
  • usually unpleasant
37
Q

OCD: Obsessions vs Compulsions:

A
  • obsession themes: contamination,
    aggression, orderliness, illness,
    sex, religion
  • compulsions are repetitive,
    purposeful behaviours carried out
    in a stereotyped way and are in
    response to an obsession
38
Q

OCD: Aetiology:

A
  • Genetics: Monozygotic»dizygotic,
    first degree relatives
  • Evidence of Brain Disorder:
    encephalitis lethargica, associated
    with chorea which affects the
    caudate nucleus
  • neurobiological factors
  • psychoanalytic and cognitive
    theories

NSB (50 decks)

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