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Psychiatry > Anxiety Disorders > Flashcards

Anxiety Disorders Flashcards

1
Q

What makes an anxiety response abnormal?

A

Clinically significant distress or impairment in social or occupational functioning

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2
Q

What is a specific phobia and how long does it last?

A

Marked fear/anxiety about a specific object or situation leading to distress and avoidance, that lasts for longer than 6 months.

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3
Q

What are some aetiological factors of specific phobia?

A

Biological predisposition. May follow a traumatic event or unexplained panic attack, but many do not report this.

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4
Q

Treatment of specific phobia (3 approaches)

A

Behavioral - gradual exposure therapy
Cognitive - focus on irrational beliefs
Psychoanalytic - uncover repressed conflicts

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5
Q

What are the main clinical characteristics of a social phobia, including duration? (4)

A
  • Fear when exposed to scrutiny by others
  • Fear of being negatively evaluated by others
  • Social situations provoke fear/anxiety and are avoided if at all possible
  • Duration for >6 months
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6
Q

Median age of onset of social phobia

A

13 years

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7
Q

Treatment of social phobia

A

CBT (combined with social skills training)
Antidepressants
Anxiolytics such as BZDs should be avoided if possible

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8
Q

Definition of a panic attack

A

Sudden, unpredictable attack of intense fear/terror that lasts for about 10 minutes and is associated with a feeling of impending doom, fear of losing control/dying, and/or other somatisations of anxiety.

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9
Q

What is at the core of panic disorder?

A

Fear and catastrophic misinterpretation of the anxiety symptoms (e.g. heart attack)

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10
Q

To diagnose panic disorder, what are the panic attacks associated with?

A

At least one attack needs to be followed by at least 1 month of persistent worry about additional panic attacks and/or a maladaptive change in behaviour as a result of the attack

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11
Q

What does agoraphobia mean?

A

“fear of the market place”

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12
Q

Possible causal factors of panic disorder

A

Genetic predisposition
Hyperventilation
Exaggerated central response to arousal

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13
Q

Biological management of panic disorder

A

SSRIs
Tricyclics
Avoid BZDs if possible

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14
Q

Psychological management of panic disorder

A

Psychoeducation about panic symptoms and the cognitive theory of panic leading to a vicious cycle
Education that symptoms will always pass

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15
Q

Social management of panic disorder

A

Progressive desensitisation to triggers of anxiety

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16
Q

Criterion A of GAD

A

Excessive anxiety and worry for more than 6 months, about a number of different things

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17
Q

Criterion B of GAD

A

Finds it difficult to control the worry

18
Q

Criterion C of GAD (6)

A

Associated with 3+:

  • Restlessness
  • Fatigue
  • Concentration difficulties
  • Irritability
  • Muscle tension
  • Sleep disturbance
19
Q

Lifetime risk of GAD

A

9%

20
Q

Female:Male ratio of GAD

A

2:1

21
Q

Treatment of GAD (5)

A 
SSRIs
TCAs
BZDs tend to cause tolerance and dependence
CBT
Relaxation training
22
Q

Definition of obsessions

A

Recurrent and persistent thoughts, urges or images that are experienced as intrusive or unwanted

23
Q

What is the difference between an obsession and a delusion?

A

An obsession is a thought that is recognised as being internal, whereas a delusion is experienced as an external phenomenon.

24
Q

Definition of compulsions

A

Repetitive behaviours or mental acts that the individual feels driven to perform in response to an obsession or according to rules applied rigidly, in order to reduce anxiety or prevent a dreaded outcome.

25
Q

Criterion A of OCD

A

Presence of obsessions and/or compulsions

26
Q

Criterion B of OCD

A

O/C are time consuming (>1hr per day) or cause significant distress or impairment

27
Q

Lifetime prevalence of OCD

A

1%

28
Q

Examples of obsessions (5)

A 
Order or constancy
Concern about getting something wrong
Cleanliness
Forbidden sexual thoughts
Obsessional slowness
29
Q

Examples of compulsions (6)

A 
Hand washing
Checking
Collecting
Repeating behaviours
Arranging things
Cleaning
30
Q

Pharmacological tx of OCD

A

High dose SSRIs

31
Q

Psychological therapy for OCD

A

CBT with exposure response prevention (desensitisation by preventing them from carrying out their compulsions)

32
Q

Characteristics of PTSD

A 
TRAUMA
   Trauma
   Re-experiences
   Avoidance
   Unable to function
   at least 1 Month
   increased Arousal
33
Q

Criterion A of PTSD

A

Exposure to actual or threatened death, serious injury or sexual violence

34
Q

Criterion B of PTSD (5)

A

Intrusion symptoms:

  1. Recurrent, involuntary and intrusive distressing memories of the event
  2. Recurrent, distressing dreams in which the content of the dream is related to the event
  3. Dissociative reactions (e.g. flashbacks) where they feel that the event is recurring
  4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolise or resemble aspects of the event
  5. Marked physiological reactions to internal or external cues that resemble an aspect of the traumatic event
35
Q

Criterion C of PTSD

A

Avoidance of triggers

36
Q

Criterion D of PTSD (7)

A

Negative alterations in cognitions or mood:

  1. Amnesia of an important aspect of the traumatic event
  2. Persistent negative beliefs about one-self, others or the world
  3. Blaming oneself/others for event
  4. Persistent negative emotional state
  5. Decreased interest/participation in activities
  6. Feelings of detachment or estrangement
  7. Persistent inability to experience positive emotions
37
Q

Criterion E of PTSD (6)

A

Alterations in arousal and activity:

	1. Irritable behaviour and angry outbursts
	2. Reckless/self-destructive
	3. Hypervigilance
	4. Exaggerated startle response
	5. Problems concentrating
	6. Sleep disturbance
38
Q

Definition of Adjustment Disorder

A

Development of emotional/behavioural problems within 3 months of an identifiable stressor causing marked distress or impairment. These symptoms resolve within 6 months of removal of the stressor.

39
Q

Psychological therapy of PTSD

A

CBT with EMDR is best

40
Q

Therapy for PTSD in children and adolescents

A

Generally only use psychological therapy and avoid medications

41
Q

Pharmacological therapy for PTSD

A
  1. SSRIs

2. Atypical antipsyhotics

42
Q

Characteristics of acute stress disorder

A

Same as PTSD, but only lasts 3 days - 1 month

Psychiatry (7 decks)

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