Anxiety disorders

Question 1

What is anxiety?

Answer 1

natural and normal human response to threat designed to keep us safe

Question 2

Anxiety vs anxiety disorder

Answer 2

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

Question 3

Physiological features of anxiety

Answer 3

dizziness
increased resp rate
heart rate increased/palpitations
tremor/shaking
gastro issues/nausea
tension
headache
sleep disturbance
fatigue
pins and needles

Question 4

Cognitive features of anxiety

Answer 4

overestimation of threat
intrusive thoughts
hypervigilance to threat
thoughts seen as facts
negative appraisals
attentional difficulties

Question 5

Behavioural features of anxiety

Answer 5

avoidance of feared situations
safety behaviours
reassurance seeking

Question 6

Examples of predisposing factors to anxiety

Answer 6

traumatic events
health/development
bullying/shaming
adverse childhood experiences
loss
significant transitions/changes

Question 7

Name some common obsessions in OCD

Answer 7

contamination ears
fear of harm or injury to self or others
‘forbidden’ thoughts
symmetry/exactness/’just so’

Question 8

What are compulsions in OCD?

Answer 8

repetitive behaviours or mental acts that the person feels compelled to perform in response to an obsession

Question 9

What are obsessions in OCD?

Answer 9

intrusive and unwanted
repetitive + persistent thoughts/images/urges
recognised as own thoughts
threating/requires action

Question 10

Common compulsions in OCD

Answer 10

excessive washing
rituals
reassurance
checking
‘slowness’
touching/tapping/rubbing
counting
ordering/arranging
hoarding
praying

Question 11

Describe the cycle of OCD

Answer 11

obsessions
emotions
anxious physical sensations
compulsions
short term relief

Question 12

What is generalised anxiety disorder (GAD)?

Answer 12

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

Question 13

Key cognitive indicators of GAD

Answer 13

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’)

Question 14

Key behavioural indicators of GAD

Answer 14

avoidance
reassurance seeking
rumination
procrastination
attention to potential threat
sleep disturbance

Question 15

What is social anxiety disorder (SAD)?

Answer 15

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

Question 16

Key cognitive indicators of social anxiety disorder

Answer 16

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

Question 17

Key behavioural indicators of social anxiety disorder

Answer 17

avoidance of social situations
escaping feared situations
self-monitoring
rehearsal
avoiding eye contact
putting on a ‘front’

Question 18

What is panic disorder?

Answer 18

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

Question 19

Key cognitive indicators of panic disorder

Answer 19

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

Question 20

Key behavioural indicators of panic disorder

Answer 20

avoidance of anxiety-provoking situations
safety behaviours - holding onto things, attempting to control breathing, distraction, medication

Question 21

What is PTSD?

Answer 21

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

Question 22

Key cognitive indicators of PTSD

Answer 22

continued idea of threat
intrusions/flashbacks
negative appraisals about self, others and the world
fragmented or incomplete memory of the trauma
hypervigilance
attentional difficulties

Question 23

Key affective indicators of PTSD

Answer 23

mood low
continued fear
irritability/anger

Question 24

Key behavioural indicators of PTSD

Answer 24

avoidance of triggers
suppression - avoidance of thinking or talking about the trauma
rumination
sleep disturbance
substance use/reckless behaviour
diminished interest
relational issues

Question 25

What is illness anxiety disorder?

Answer 25

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

Question 26

Key cognitive indicators of illness anxiety disorder

Answer 26

misinterpretation of bodily sensations
strong obsessional features and intrusions about illness
preoccupation with bodily function (eg. HR)

Question 27

Key behavioural indicators of illness anxiety disorder

Answer 27

reassurance seeking
bodily checking
frequent investigations/referrals/GP visits
frequent illness info seeking

Question 28

What are specific phobias?

Answer 28

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

Question 29

What medical conditions can mimic anxiety disorders?

Answer 29

hyperthyroidism
phaeochromocytoma
hyperparathyroidism
hypercalcaemia
cardiac arrhythmias
resp conditions eg. COPD
temporal lobe epilepsy

Question 30

What medications/substances can mimic anxiety symptoms?

Answer 30

caffeine
corticosteroids
withdrawal from benzodiazepines