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Y3 - Psych > Anxiety Disorders > Flashcards

Anxiety Disorders Flashcards

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1
Q

What are the 2 brain systems involved in response to external stimuli?

A

Appetitive systems - seeking behaviours

Aversive systems - avoidant behaviours

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2
Q

What hormones are the 2 brain systems involved in response to external stimuli controlled by?

A

Appetitive system - dopamine

Aversive system - serotonin

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3
Q

What are schema?

A

Deep rooted, unconditional basic beliefs that stem from early childhood experiences that are pervasive, stable and shape our assumptions and automatic thoughts

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4
Q

When is anxiety classed as a disorder?

A

When symptoms are so marked in respect to severity or context that they impact a patient’s life
More extreme than is ‘normal’ or ‘necessary’, and in situations that are not ‘normally’ anxiety provoking

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5
Q

What are physical symptoms of anxiety?

A 
Tremor
Sweating
Palpitations
Chest pain
Difficulty breathing
Nausea
Hot flashes, cold chills
Dizziness or lightheadedness
Difficulty talking
Lump in throat, difficulty swallowing
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6
Q

What are cognitive symptoms of anxiety?

A 
Mind blanks
Racing thoughts
Feeling tense
Reduced concentration
Hyper-vigilance
Derealisation
Depersonalisation
Worrying about health and physical symptoms
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7
Q

What is derealisation?

A

Feeling that the world around you is unreal

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8
Q

What is depersonalisation?

A

Feeling that the self is distant or not really here

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9
Q

What are behavioural symptoms of anxiety?

A 
Restlessness
Agitation
Irritability
Avoidance of triggers
Exaggerated response to minor situations
Seeking reassurance
Use of drugs and alcohol to cope
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10
Q

What are the examples of anxiety disorders?

A

Generalised anxiety disorder
Panic disorder
Phobias: agoraphobia, social phobia and specific phobia
Obsessive compulsive disorder

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11
Q

What is the clinical course of generalised anxiety disorder?

A

Chronic, fluctuating

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12
Q

What is generalised anxiety disorder?

A

Excessive worry that is persistent and generalised, free-floating (not restricted to particular circumstances) and present for most days for at least 6 months

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13
Q

What are physical disorders that present similarly to anxiety?

A

Arrhythmia, asthma, hyperthyroidism, irritable bowel syndrome

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14
Q

What is the non-pharmacological management of generalised anxiety disorder?

A

Psychoeducation
Guided self-help (relaxation techniques, sleep hygiene, meditation, exercise)
CBT

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15
Q

How can CBT help in anxiety?

A

Based on identifying an individual’s automatic thoughts, cognitive biases and schemas
Help the individual identify thoughts, assumptions, misinterpretations and behaviours that reinforce and perpetuate the anxiety

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16
Q

What are the pharmacological options for management of generalised anxiety disorder?

A
  1. SSRI (sertraline)
  2. SNRI (venlafaxine)
  3. Pregabalin
  4. consider beta blockers for physical symptoms, consider short course of benzodiazepines
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17
Q

What is panic disorder?

A

Recurrent attacks of severe anxiety

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18
Q

What are the characteristics of panic attacks?

A

Not consistently associated with a specific situation
Not associated with exertion or exposure to dangerous situations
Discrete episode of fear or discomfort associated with multiple physical and psychological symptoms of anxiety
Onset is abrupt and symptoms crescendo in severity
Last a few minutes

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19
Q

Why does avoidance behaviour occur in panic disorder?

A

Individuals develop an anticipatory fear of having another attack which causes a lot of distress so they avoid things that could trigger an attack

20
Q

What disorder is seen in 2/3rds of patients with panic disorder?

A

Agorophobia

21
Q

What is the management for an acute panic attack?

A

Reassurance, encourage to slow breathing

Benzodiazepines

22
Q

What is the non-pharmacological treatment for panic disorder?

A

Psychoeducation
Guided self-help
CBT

23
Q

What is the pharmacological treatment for panic disorder?

A
  1. any SSRI
  2. tricyclic - clomipramine, imipramine
  3. venlafaxine
24
Q

What are phobias?

A

Disorders where anxiety occurs only in particular circumstances
Anticipatory anxiety at the prospect of encountering the circumstance
Avoidance behaviour to prevent exposure
Recognised as irrational by the patient

25
Q

What are the disorders included in ‘phobias’?

A

Specific phobia
Agoraphobia
Social phobia

26
Q

What are specific phobias?

A

A marked and persistent fear caused by a specific situation or object
Exposure to the stimulus provokes an immediate anxiety response

27
Q

What are the management options for specific phobias?

A

CBT - graded exposure

Short term benzodiazepines

28
Q

What is agoraphobia?

A

Phobia associated with fear of being in unfamiliar places in which they cannot easily escape from - crowds, public places, travelling alone or away from home

29
Q

What are management options for agoraphobia?

A

Psychoeducation and relaxation techniques
CBT - graded exposure
SSRI (fluoxetine)

30
Q

What is social phobia?

A

A marked, persistent and unreasonable fear of being observed or evaluated negatively by other people in social or performance situations - e.g. public speaking, classes, parties
The fear results in severe avoidance of triggering circumstances

31
Q

What are management options in social phobia?

A 
Psychoeducation
CBT
Social skills training
SSRI
Alternatives: SNRI, clonazepam, gabapentin
32
Q

What is OCD?

A

Recurrent obsessive ruminations, images or impulses, and/or recurrent physical or mental compulsive acts

33
Q

What are obsessions?

A

Recurrent, intrusive and distressing thoughts or ideas that are unwanted and out of the patient’s control
Ego-dystonic

34
Q

What does ego-dystonic mean?

A

Cause distress, not what they agree with or want to be thinking about

35
Q

What are compulsions?

A

Repetitive behaviours that the individual is driven to carry in order to reduce anxiety
Not enjoyable
Recognised as irrational by patient but need to reduce anxiety overcomes rational thought
Resisting causes distress and ability to do so diminishes over time

36
Q

What is needed for a diagnosis of OCD?

A

Obsessional symptoms or compulsive acts must be present most days for at least 2 weeks
Must be a source of distress and interfere with activities

37
Q

What is the non-pharmacological treatment of OCD?

A

Psychoeducation and self-help
Response prevention - after preparing them, get them to do something that would trigger a compulsion and tell them to resist it for increasing amounts of time

38
Q

What is the pharmacological treatment of OCD?

A
  1. SSRI
  2. tricyclic - clomipramine
    Augmentation: risperidone, lamotrigine
39
Q

What is done if there are significant anxiety related symptoms and impaired function AND moderate/severe depression?

A

Treat depression

40
Q

What is the diagnosis if there are significant anxiety related symptoms and impaired function AND trauma history and flashbacks?

A

PTSD

41
Q

What is the diagnosis if there are significant anxiety related symptoms and impaired function AND obsessions +/- compulsions?

A

OCD

42
Q

What is the diagnosis if there are significant anxiety related symptoms and impaired function AND uncontrollable worry about several areas?

A

Generalised anxiety disorder

43
Q

What is the diagnosis if there are significant anxiety related symptoms and impaired function AND intermittent panic/anxiety attacks and avoidance AND fear of social scrutiny?

A

Social phobia

44
Q

What is the diagnosis if there are significant anxiety related symptoms and impaired function AND intermittent panic/anxiety attacks and avoidance caused by a discrete object/situation?

A

Specific phobia

45
Q

What is the diagnosis if there are significant anxiety related symptoms and impaired function AND intermittent panic/anxiety attacks and avoidance AND some uncued/spontaneous attacks?

A

Panic disorder

Y3 - Psych (12 decks)

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