anxiety disorders Flashcards
What are the 3 models of stress?
- Biomechanical “Engineering”
- Medicophysiological
- Psychological (Transactional)
What is the psychological model of stress?
An individual’s reaction will depend on a balance between their cognitive processing of the threat and perceived ability to cope
What are the types of coping?
- Problem focussed
- Emotion focussed
What is problem focussed coping?
where efforts are directed toward modifying stressor
- preparation, studying or interview practice
What is emotion focussed coping?
where efforts focussed on modifying emotional reaction
- mental defence mechanisms (eg denial)
- relaxation training
- sedative drug
How are our physiological and psychological reactions to stress elicited?
stressor leads to release of corticotropin releasing hormone:
- adrenal gland: adrenocorticotropic released –> glucocorticoid, noradrenaline and adrenaline
- peripheral blood: prolactin & growth hormone released –> cytokines
- lymph node: hardwiring sympathetic innervation
What are the symptoms groups of the fight or flight response?
- psychological arousal
- autonomic arousal
- muscle tension
- hyperventilation
- sleep disturbance
What is the Yerkes Dodson curve of stress performance connection?
As stress increases so too does performance until stress becomes too much and performance declines
What psychological arousal can be produced by stress?
anxiety symptoms
- fearful anticipation
- irritability
- sensitivity to noise
- poor concentration
- worrying thoughts
what autonomic arousal can be produced by stress?
GI: dry mouth, swallowing difficulties, dyspepsia, nausea and wind, frequent loose motions
resp: chest tightness, difficulty inhaling
cardio: palpitations, chest pain
urinary: frequency/urgency of micturition, amernorrhoea/dysmenorrhoea, erectile failure
CNS: dizziness, sweating
How can muscle tension associated with stress manifest?
- tremor
- headache
- muscle pain
How can hyperventilation associated with stress manifest?
- causing CO2 deficit hypocapnia
- numbness tingling in extremeities may lead to carpopedal spasm
- breathlessness
How can sleep disturbance associated with stress manifest?
- Initial insomnia
- Frequent waking
- Nightmares and night terrors
How are anxiety disorders characterised?
ICD10 F40-F48
how do phobias and GAD differ?
same core anxiety symptoms
- phobias occur in particular circumstances
- GAD occurs persistently
what symptoms are associated with GAD?
symptoms of human anxiety
- psychological arousal
- autonomic arousal
- muscle tension
- hyperventilation
- sleep disturbance
persistent; not confined to a situation or object
What is the differential diagnosis for anxiety disorder?
psychiatric conditions
- depression
- schizophrenia
- dementia
- substance misuse
physical conditions
- thyrotoxicosis
- phaeochromoctoma
- hypoglycaemia
- asthma
- arrhythmias
What is the epidemiology of GAD?
- one year prevalence around 4.4% in England
- W>M
what is the difference between anxiety and GAD
- no clear line
- differ in extent and duration of symptoms
What is the aetiology of GAD?
stressor acting on a personality predisposed to the disorder by a combination of childhood:
- genetic factors
- environmental influences
how are GAD managed?
- counselling
- relaxation training
- medication
- cognitive behavioural therapy
how is CBT used in anxiety disorders?
our emotional response to a situation will depend on our cognitive processing of it
- identifying errors, reprocessing and reassessing responsibility
- maintaining remission appears superior to drug therapy
what symptoms are associated with phobic anxiety disorders?
symptoms of human anxiety
- psychological arousal
- autonomic arousal
- muscle tension
- hyperventilation
- sleep disturbance
occur in specific circumstances only
What are the 3 clinically important phobic anxiety syndromes?
- specific phobias
- social phobia
- agoraphobia
