Anxiety disorders Flashcards
What is anxiety?
natural and normal human response to threat designed to keep us safe
Anxiety vs anxiety disorder
anxiety:
- temporary/contextual
- normal emotion
- sense of threat
- apprehension
- increased heart rate/breathing
- changes in digestive system
- increased sweating
anxiety disorder:
- pervasive/outside typical anxiety-provoking context
- over-estimated sense of threat
- hypervigilance
- rumination
- fear of loss of control
- palpitations
- dizziness/derealisation
- nausea
- bladder/bowel urgency
- excessive sweating
Physiological features of anxiety
dizziness
increased resp rate
heart rate increased/palpitations
tremor/shaking
gastro issues/nausea
tension
headache
sleep disturbance
fatigue
pins and needles
Cognitive features of anxiety
overestimation of threat
intrusive thoughts
hypervigilance to threat
thoughts seen as facts
negative appraisals
attentional difficulties
Behavioural features of anxiety
avoidance of feared situations
safety behaviours
reassurance seeking
Examples of predisposing factors to anxiety
traumatic events
health/development
bullying/shaming
adverse childhood experiences
loss
significant transitions/changes
Name some common obsessions in OCD
contamination ears
fear of harm or injury to self or others
‘forbidden’ thoughts
symmetry/exactness/’just so’
What are compulsions in OCD?
repetitive behaviours or mental acts that the person feels compelled to perform in response to an obsession
What are obsessions in OCD?
intrusive and unwanted
repetitive + persistent thoughts/images/urges
recognised as own thoughts
threating/requires action
Common compulsions in OCD
excessive washing
rituals
reassurance
checking
‘slowness’
touching/tapping/rubbing
counting
ordering/arranging
hoarding
praying
Describe the cycle of OCD
obsessions
emotions
anxious physical sensations
compulsions
short term relief
What is generalised anxiety disorder (GAD)?
excessive worry and tension about every day events and problems, on most days, for at least 6 months, to the point where the person experiences distress or has marked difficulty in performing day-to-day tasks
Key cognitive indicators of GAD
pervasive worry
feels dangerous/uncontrollable
attempting to suppress/control worry
worries are diverse
threat posed by worries overestimated
intolerance of uncertainty
metacognitive worries (‘worry about worry’)
Key behavioural indicators of GAD
avoidance
reassurance seeking
rumination
procrastination
attention to potential threat
sleep disturbance
What is social anxiety disorder (SAD)?
marked and excessive fear/anxiety that consistently occurs in one or more social situations
individual is concerned that they will act in a way that is negatively evaluated by others
Key cognitive indicators of social anxiety disorder
misinterpretation of social situations as others are negatively evaluating them
fear of showing anxiety in social situations
self-conscious
thoughts and images around previous/predicted social embarrassment
selective memory bias for negative situations/past failures
Key behavioural indicators of social anxiety disorder
avoidance of social situations
escaping feared situations
self-monitoring
rehearsal
avoiding eye contact
putting on a ‘front’
What is panic disorder?
recurrent and unexpected panic attacks with a month or more of a persistent concern about additional attacks, worry about the implications of the attack, or significant behaviour change due to the attacks
Key cognitive indicators of panic disorder
catastrophic misinterpretation of anxiety related bodily sensations as imminent danger
intrusive imagery/memory of panic attacks
hypervigilance for bodily sensations
worry about when it may happen again
fears around response of others
Key behavioural indicators of panic disorder
avoidance of anxiety-provoking situations
safety behaviours - holding onto things, attempting to control breathing, distraction, medication
What is PTSD?
post-traumatic stress disorder
exposure to an extremely stressful or terrifying event
either being part of it or witnessing it
symptoms include intrusions, avoidance, negative alterations in mood/cognition and increased arousal
Key cognitive indicators of PTSD
continued idea of threat
intrusions/flashbacks
negative appraisals about self, others and the world
fragmented or incomplete memory of the trauma
hypervigilance
attentional difficulties
Key affective indicators of PTSD
mood low
continued fear
irritability/anger
Key behavioural indicators of PTSD
avoidance of triggers
suppression - avoidance of thinking or talking about the trauma
rumination
sleep disturbance
substance use/reckless behaviour
diminished interest
relational issues
What is illness anxiety disorder?
preoccupation with and fear of having or acquiring a serious disorder
diagnosis is confirmed when gears and symptoms (if any) persist for >6 months despite reassurance after a thorough medical evaluation
Key cognitive indicators of illness anxiety disorder
misinterpretation of bodily sensations
strong obsessional features and intrusions about illness
preoccupation with bodily function (eg. HR)
Key behavioural indicators of illness anxiety disorder
reassurance seeking
bodily checking
frequent investigations/referrals/GP visits
frequent illness info seeking
What are specific phobias?
marked fear or anxiety about a specific object or situation, and is actively avoided or endured with significant anxiety, and the fear is out of proportion to the actual threat posed by the object or situation
What medical conditions can mimic anxiety disorders?
hyperthyroidism
phaeochromocytoma
hyperparathyroidism
hypercalcaemia
cardiac arrhythmias
resp conditions eg. COPD
temporal lobe epilepsy
What medications/substances can mimic anxiety symptoms?
caffeine
corticosteroids
withdrawal from benzodiazepines
