Anxiety Disorder

Question 1

What are the models of stress?

Answer 1

Biomechanical engineering - env.
Medicophysiological - non-specific physiological reaction
Psychological - demands vs ability to cope

Question 2

What are the symptom groups of fight or flight?

Answer 2

• Psychological arousal
• Autonomic arousal
• Muscle tension
• Hyperventilation
• Sleep disturbance

Question 3

What constitutes psychological arousal?

Answer 3

• Fearful anticipation
• Irritability
• Sensitivity to noise
• Poor concentration
• Worrying thoughts

Question 4

What constitutes autonomic arousal?

Answer 4

CNS
Resp
CVS
GI
GU

Question 5

What constitutes muscle tension?

Answer 5

Tremor
Headache
Muscle pain

Question 6

What constitutes hyperventilation?

Answer 6

• CO2 hypocapnia
• Numbness tingling in extremities may lead to carpopedal spasm
• Breathlessness

Question 7

What constitutes sleep disturbance?

Answer 7

• Initial insomnia
• Frequent waking
• Nightmares and night terrors

Question 8

What is generalised anxiety disorder?

Answer 8

Anxiety that is persistent and not associated with specific events.

Question 9

What are the psychiatric differentials for GAD?

Answer 9

Depression
Schizo
Dementia
Substance misuse

Question 10

What are the physical differentials for GAD?

Answer 10

Thyrotoxicosis
Phaechromocytoma
Hypoglycaemia
Asthma or arrhythmia

Question 11

What are the treatments for GAD?

Answer 11

• Counselling
• Relaxation training
• Medication
• CBT

Question 12

What are the medications for GAD?

Answer 12

Sedatives: although high risk of dependency
Antidepressants
SSRI or TCA

Question 13

What is phobic anxiety disorder?

Answer 13

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.

Question 14

What kinds of phobias are there?

Answer 14

Social phobias
Specific phobias
Agoraphobia

Question 15

What is OCD?

Answer 15

Obsessional thoughts with ideas, images or impulses. These occur repeatedly, are not willed and are unpleasant and distressing.

Question 16

What are the symptoms of OCD?

Answer 16

• 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

Question 17

What are the treatments for OCD?

Answer 17

General measures

• Education and explanation
• Involve partner and family

Medication
CBT
Psychosurgery

Question 18

What are the medications for OCD?

Answer 18

Serotonergic drugs

• SSRI
• Clomipramine

Question 19

What kind of CBTs are there for OCD?

Answer 19

• Exposure and response prevention

- Examination of evidence to weaken convictions

Question 20

What is PTSD?

Answer 20

Delayed or protracted reaction to a stressor of exceptional severity

Question 21

What are the three key elements to a reaction?

Answer 21

Hyperarousal
Re-experiencing phenomena
Avoidance

Question 22

What constitutes hyperarousal?

Answer 22

• Persistent anxiety
• Irritability
• Insomnia
• Poor concentration

Question 23

What constitutes re-experiencing phenomena?

Answer 23

• Intensive intrusive images
• Flashbacks
• Nightmares

Question 24

What constitutes avoidance?

Answer 24

• Emotional numbness
• Cue avoidance
• Recall difficulties
• Diminished interests

Question 25

What are the vulnerability factors for PTSD?

Answer 25

Mood disorders, previous trauma esp childhood, lack of social support, female, partly genetic

Question 26

What are the protective factors for PTSD?

Answer 26

Higher education and social group, good paternal relationship

Question 27

What are the treatments for PTSD?

Answer 27

Watchful waiting
Trauma focused CBT
EMD (eye movement desensitization) and reprocessing
Medication

Question 28

What are the medications for PTSD?

Answer 28

Risk of dependence with sedatives, patient may prefer SSRI or TCA