Anxiety Disorder Flashcards
What are the models of stress?
Biomechanical engineering - env.
Medicophysiological - non-specific physiological reaction
Psychological - demands vs ability to cope
What are the symptom groups of fight or flight?
- Psychological arousal
- Autonomic arousal
- Muscle tension
- Hyperventilation
- Sleep disturbance
What constitutes psychological arousal?
- Fearful anticipation
- Irritability
- Sensitivity to noise
- Poor concentration
- Worrying thoughts
What constitutes autonomic arousal?
CNS Resp CVS GI GU
What constitutes muscle tension?
Tremor
Headache
Muscle pain
What constitutes hyperventilation?
- CO2 hypocapnia
- Numbness tingling in extremities may lead to carpopedal spasm
- Breathlessness
What constitutes sleep disturbance?
- Initial insomnia
- Frequent waking
- Nightmares and night terrors
What is generalised anxiety disorder?
Anxiety that is persistent and not associated with specific events.
What are the psychiatric differentials for GAD?
Depression
Schizo
Dementia
Substance misuse
What are the physical differentials for GAD?
Thyrotoxicosis
Phaechromocytoma
Hypoglycaemia
Asthma or arrhythmia
What are the treatments for GAD?
- Counselling
- Relaxation training
- Medication
- CBT
What are the medications for GAD?
Sedatives: although high risk of dependency
Antidepressants
SSRI or TCA
What is phobic anxiety disorder?
Triggered in specific circumstances where the person avoids these circumstances of phobic avoidance.
Sufferer experiences anxiety if there is a perceived threat of encountering the feared object or situation.
What kinds of phobias are there?
Social phobias
Specific phobias
Agoraphobia
What is OCD?
Obsessional thoughts with ideas, images or impulses. These occur repeatedly, are not willed and are unpleasant and distressing.
What are the symptoms of OCD?
- Compulsive acts or rituals
- Stereotypical behaviours repeated
- Not enjoyable or useful
- Often viewed as preventing some harm to others
- Viewed as pointless and resisted with key anxiety symptoms
What are the treatments for OCD?
General measures
- Education and explanation
- Involve partner and family
Medication
CBT
Psychosurgery
What are the medications for OCD?
Serotonergic drugs
- SSRI
- Clomipramine
What kind of CBTs are there for OCD?
- Exposure and response prevention
- Examination of evidence to weaken convictions
What is PTSD?
Delayed or protracted reaction to a stressor of exceptional severity
What are the three key elements to a reaction?
Hyperarousal
Re-experiencing phenomena
Avoidance
What constitutes hyperarousal?
- Persistent anxiety
- Irritability
- Insomnia
- Poor concentration
What constitutes re-experiencing phenomena?
- Intensive intrusive images
- Flashbacks
- Nightmares
What constitutes avoidance?
- Emotional numbness
- Cue avoidance
- Recall difficulties
- Diminished interests
What are the vulnerability factors for PTSD?
Mood disorders, previous trauma esp childhood, lack of social support, female, partly genetic
What are the protective factors for PTSD?
Higher education and social group, good paternal relationship
What are the treatments for PTSD?
Watchful waiting
Trauma focused CBT
EMD (eye movement desensitization) and reprocessing
Medication
What are the medications for PTSD?
Risk of dependence with sedatives, patient may prefer SSRI or TCA
