Anxiety Disorders Flashcards
What are the models of stress?
Biomechanical engineering
Medicophysiological
Psychological (transitional)
What is psychological model of stress?
Interactive
An individuals reaction to stress depends on balance between cognitive processing of threat and ability to cope
Coping can be problem or emotion focussed
Describe problem focussed coping
Behavioural - attempts at control and problem solving
Cognitive - situational redefinition and restructuring
Describe emotion focussed coping
Behavioural - seeking social support and information seeking
Cognitive - emotional expression
What are some autonomic symptoms?
GI - dry mouth, swallowing difficulties, dyspepsia, nausea, wind and frequent loose stools
Resp. - tight chest and difficulty inhaling
Cardio - palpitations and chest pain
Frequency of urination, erectile failure and amenorrhoea
CNS - Dizziness and sweating
What are some psychological symptoms of anxiety?
Fearful anticipation, irritability, sensitivity to noise, poor concentration and worrying thoughts
How is anxiety disorders classified?
ICD 11
Contains anxiety or fear related disorders and OCD or related disorders
What are phobic and general anxiety disorders?
Have same core anxiety symptoms but either occur in particular circumstances or occur persistently
What is generalised anxiety disorder?
Persistent (several months) symptoms not confined to a situation or object
Psychological arousal, autonomic arousal, muscle tension, hyperventilation and sleep disturbance
What are differentials for anxiety disorders - psychiatric?
Depression, schizophrenia, dementia and substance misuse
What are differentials for anxiety disorder - physical conditions?
Thyrotoxicosis, pheochromocytoma, hypoglycaemia and asthma or arrhythmias
Describe the epidemiology of generalised anxiety disorder
Most common mental disorder
301 million people
More women affected
What is the aetiology of generalised anxiety disorder?
Is caused by a stressor acting on a personality predisposed to the disorder by combination of genetic factors and environmental influences in childhood
What is the management for generalised anxiety disorder?
Counselling
Relaxation therapy
Medication - sedatives (have high risk dependency) and SSRIs or TCA
Cognitive behavioural therapy
What are key features of phobic anxiety disorders?
Same core features as GAD
Only in specific circumstances
Person behaves to avoid these circumstances
What are types of phobias?
Agoraphobia - fear of going outside
Claustrophobia
Ophidiophobia
Arachnophobia
Trypophobia
Submechanophobia
What are 3 clinical important syndromes for phobic anxiety disorders?
Specific phobias
Social phobias
Agoraphobia
What is the cycle for social anxiety?
Anxiety - avoidance - short term relief - long term anxiety growth
What is obsessive compulsive disorder (OCD)?
Core features are experience of recurrent obsessional thoughts ad or compulsive acts
Thoughts occur repeatedly, unpleasant, distressing and recognised as individuals own thoughts
What is the epidemiology of OCD?
2% prevalence
Equally affects men and women
Can have genetic involvement - 5HT receptors
What is the management for OCD?
Education and explanation
Serotonergic drugs - SSRI (fluoxetine) and clomipramine
CBT
Psychosurgery
What is post traumatic stress disorder (PTSD)?
Delayed and/ or protracted reaction to a stressor of exceptional severity
Can be from combat, rape, natural disaster, assault, torture and witnessing these
What are the 3 key elements to a reaction in PTSD?
Hyperarousal, re-experiencing phenomena and avoidance of reminders
What is included in hyperarousal in PTSD?
Persistent anxiety, irritability, insomnia and poor concentration
What is included in re-experiencing phenomena?
Intense intrusive images - flashbacks when awake and nightmares during sleeping
What is included in avoidance in PTSD?
Emotional numbness, cue avoidance recall difficulties and diminishes interests
What is the epidemiology of PTSD?
1-4% one year prevalence
More women than males
What is the aetiology of PTSD?
Nature of stressor - vulnerability factors
Susceptibility partly genetic
Describe the management of PTSD
Mild symptoms - watchful waiting
Trauma focussed CBT if more severe
Eye movement desensitisation and reprocessing
Risk of dependence with sedatives but may prefer SSRI or TCA
