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
2
Q
Emotional Responses to Stress:
A
anxiety is absence of stimulus
fear is presence of stimulus
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
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
5
Q
Acute Stress Reaction: Symptoms:
A
- dissociative symptoms
- insomnia
- restlessness
- poor concentration
- ANS activated
- anger/anxiety/depression
- social withdrawal
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
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
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
9
Q
PTSD: Symptoms:
A
- increased arousal
- dissociative symptoms
- hypervigilance/startle
- re-experiencing event
(flashbacks/nightmares) - avoiding reminders of stressful
events - maladaptive coping strategies
10
Q
PTSD: Increased Arousal:
A
- tremor
- palpitations
- panic attacks
- restlessness
- insomnia
- anger
- poor concentration
11
Q
Anxiety Flowchart:
A
12
Q
5 general symptoms of anxiety disorders:
A
- psychological arousal
- autonomic arousal
- muscle tension
- hyperventilation
- sleep disturbance
13
Q
Anxiety: General Symptoms: Psychological:
A
- fearful anticipation
- irritability
- restlessness
- poor concentration
- worry
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
15
Q
Anxiety: General Symptoms: Muscle Tension:
A
- tremor
- headaches
- aching muscles
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
Panic Attack Features:
- 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
Panic Attacks and Hyperventilation:
- reduces CO2 in blood
- dizziness, tingling extremities,
tinnitus
- weakness, faintness,
breathlessness
27
Panic Disorders: Aetiology:
- genetics: 7 fold increased risk in
first degree relatives
- precipitating events
- traumatic early life events
28
Social Anxiety Disorder is a form of
phobia
29
Specific Phobias: Features:
- 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
Bi-phasic anxiety reaction:
- initial short-lived sympathetic
arousal
- parasympathetic arousal
- may result in vasovagal syncope
- feeling of disgust and repulsion
rather than pure apprehension
31
Blood-Injury Phobia: Differences:
- vaso-vagal syncope = parasymp
arousal as well
- feeling of disgust and repulse
rather than apprehension
biphasic anxiety reaction
32
Specific Phobias: Aetiology:
- 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
Social Anxiety Disorder: Features:
- 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
Social Anxiety Disorder: Symptoms:
- Anticipatory anxiety
- Feeling anxious
- Blushing
- Trembling (observed writing is a
problem)
- Nausea
- Relieved by alcohol in short term
(potential for abuse)
35
Agoraphobia:
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
OCD: Features:
- 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
OCD: Obsessions vs Compulsions:
- 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
OCD: Aetiology:
- 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
