Anxiety Disorders

Question 1

What is the biomechanical “engineering” model of stress?

Answer 1

External source of stress is put onto an individual

Question 2

What is the medicophysiological model of stress?

Answer 2

Fight or flight response

Question 3

What is the psychological “transactional” model of stress?

Answer 3

Interactive model where a persons response to a stressor will depend on ability to cope

Question 4

What is problem focussed coping?

Answer 4

Where people modify the stressor (e.g. studying for exams)

Question 5

What is emotion focussed coping?

Answer 5

Modifying emotional reaction to stressor

Question 6

Symptoms of anxiety?

Answer 6

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

Question 7

What is psychological arousal?

Answer 7

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

Question 8

What is autonomic arousal?

Answer 8

• GI (dry mouth, nausea, wind ect)
• Resp (difficulty breathing)
• CV (palpitations, chest pain)
• Genitourinary (frequency/urgency, erectile failure ect)
• CNS (dizziness and sweating)

Question 9

What does muscle tension cause?

Answer 9

Tremor
Headache
Muscle pain

Question 10

Similarities and difference between phobic anxiety disorder and general anxiety disorder?

Answer 10

Both have the same symptoms but with phobia disorder the symptoms occur in particular circumstances, general they occur all the time

Question 11

Differential diagnosis for anxiety disorder?

Answer 11

• Depression, schizophrenia, dementia, substance misuse

- Thyrotoxicosis, phaeochromocytoma, hypoglycaemia, asthma or arrhythmias

Question 12

Management of general anxiety disorder?

Answer 12

• Counselling
• Relaxation training
• Medication
• CBT

Question 13

Three syndromes in phobic anxiety disorder that are important?

Answer 13

• Specific phobias
• Social phobia
• Agoraphobia

Question 14

Examples of specific phobias?

Answer 14

• Spiders, heights, dentist, blood ect

Question 15

What is social phobia?

Answer 15

Inappropriate anxiety in situation where person feels observed or could be criticized (restraunts, shops or any queues, public speaking)

Question 16

Symptoms of social phobia?

Answer 16

Same as GAD but blushing and tremor predominate

Question 17

How is social phobia managed?

Answer 17

• CBT
• Education and advice
• SSRI antidepressants

Question 18

What are the core features of obsessive compulsive disorder?

Answer 18

• Obsessional thoughts

- Compulsive acts (stereotypical behaviours repeated again and again)

Question 19

Does OCD affect men or women more and what is the genetic abnormality?

Answer 19

M = W

5HT (serotonin) receptor function abnormalities

Question 20

Management of OCD?

Answer 20

• Education and explanation
• SSRI (fluoxetine)
• Clomipramine
• CBT
• Psychosurgery (rare)

Question 21

What is PTSD?

Answer 21

Delayed and or protracted reaction to a stressor of exceptional severity

Question 22

Key elements of PTSD?

Answer 22

Hyperarousal
Re-experiencing phenomena
   - Flashbacks when awake 
   - Nightmares during sleep 
Avoidance of reminders
   - Emotional numbness 
   - Cue avoidance 
   - Recall difficulties

Question 23

Management of PTSD?

Answer 23

• Survivors of disasters screened at one month
• Mild symptoms > watchful waiting and review in a month
• Trauma-focused CBT if more severe symptoms
• Eye movement desensitisation and reprocesing
• Risk of dependance with sedatives but patient may prefer medication so SSRI or TCA