Anxiety Disorders Flashcards
What does the term neurosis mean?
Distress without delusions or hallucinations (synonymous with anxiety disorders)
What type of illness are anxiety disorders?
Functional
How does fear feed anxiety?
Fear leads to arousal and avoidance by initiating a cycle of thoughts affecting feelings which in turn affects behaviours and vice versa.
What happens when danger is perceived by the brain?
The autonomic (sympathetic) nervous system is activated
What response does the sympathetic nervous system have in response to perceived danger?
Releases adrenaline and noradrenaline to prime the body for action
What is the primary function of anxiety?
To protect us from threats via fight/flight system
When is anxiety a problem?
When the perceived danger does not exist (i.e. a psychological threat).
The brain cannot separate the psychological threats from physical ones.
What effects does anxiety have?
Physiological arousal
Racing thoughts
Inability to concentrate
Cognitive bias (focused attention on certain things)
What is Padesky’s anxiety equation?
Anxiety = Estimate of danger/estimate of coping
What does Padesky’s equation hypothesise?
Severity of anxiety is related to how dangerous a situation seems in relation to how well the person believes they can cope with that situation
How do people with anxiety disorders try to reduce their anxiety?
By employing safety behaviours to increase their estimated coping
What are the anxiety disorders? (7 answers)
Panic disorder (with/without agoraphobia)
Social anxiety disorder (social phobia)
Specific phobias
Health anxiety (hypochondriasis)
Obsessive compulsive disorder (OCD)/Body dysmorphic disorder (BDD)
Post-traumatic stress disorder (PTSD)
Generalised anxiety disorder (GAD)
What are specific phobias?
A marked fear of specific object or situation (e.g. dogs, spiders, snakes, balloons, etc.)
How do people with specific phobias normal act?
By markedly avoiding the object or situation causing their phobias
What is a panic disorder?
A fear of ones own physiological and psychological reactions
What do people with panic disorder often view bodily/psychological changes as?
Signs of impending collapse, insanity or death
What does a patient with panic disorder have if they avoid the situations which may trigger physiological/psychological reactions?
Accompanying agoraphobia
Describe a cognitive model of panic disorder
Internal/external triggers lead to the perception of a threat
This the leads to anxiety
Anxiety leads to physical/cognitive symptoms (e.g. heart racing)
The patient will then misinterpret these symptoms as something sinister and panic
Patients may then employ safety behaviours or avoid these situations in the future (agoraphobia)
What is generalised anxiety disorder?
Essentially a worry problem
What types of worries make up generalise anxiety disorder?
Type 1 worries
Types 2 worries
What are type 1 worries?
Worries with specific content which can change/vary
What are type 2 worries?
‘Worries about worries’
What is gernalised anxiety disorder usually accompanied by?
Low level physical symptoms e.g. insomnia, muscle tension, GI problems, headache
What often maintains generalised anxiety disorder?
The belief that worry is useful e.g. motivates, shows responsibility etc.
What is social anxiety disorder?
Essentially a social phobia
What lies at the core of social anxiety disorder?
A fear of negative evaluation by others
What can the fear of negative evaluation by others associated with social anxiety disorder lead to?
Avoidance of feared situations
(Counter-productive) use of safety behaviours
Anticipatory anxiety
Unhelpful ‘post-mortems’ following social encounters
What two characteristics define obsessive compulsive disorder (OCD)?
Obsessions
Compulsion
What are obsessions in terms of OCD?
Unwanted, recurring and distressing intrusive thoughts or images
What are some examples of obsessions experienced in OCD?
The thought of being contaminated
The thought of wanting to cause harm
The thought of behaving inappropriately
How do the obsessions experience in OCD relate to the patient’s ego?
They are ego-dystonic
What is meant by ego-dystonic?
They aren’t what the patient wants to be/do?
i.e. a patient thinking of hurting someone will not actually want to hurt someone
What is meant by compulsions in relation to OCD?
Neutralising behaviours conducted by a patient to manage the distress (primarily anxiety) caused by the intrusive obsessions
What are some examples of overt neutralising behaviours seen in OCD?
Washing
Checking
Ordering/aligning
What are some examples of covert neutralising behaviours seen in patients with OCD?
Praying
Counting
Repeating words
What is body dysmorphic disorder characterised by?
An imagined defect in appearance
What does body dysmorphic disorder often lead to?
Time consuming behaviours aiming to correct imagined defect
What is post traumatic stress disorder (PTSD)?
An anxiety disorder caused by exposure to an event or situation of exceptionally threatening or catastrophic nature which would be likely to cause pervasive distress in almost anyone
Where did the definition of PTSD first appear?
DSM-III (1980)
Where did PTSD as a recognised condition originate?
The US anti-war movement
What are the 3 main features of PTSD?
Re-experiencing
Avoidance
Hyperarousal
What are common co-morbidities seen in PTSD?
Other anxiety disorders
Depression
Substance misuse
What problems can be associated with anxiety disorders (9 answers)?
Increased autonomic arousal
Avoidance
Time consuming anxiety reducing behaviours
Worry
Procrastination/inability to make decisions
Reduced concentration
Impact on functioning - work, social, health, etc.
Impaired sleep pattern
Alcohol and drug dependence
What are some differential diagnoses for anxiety?
Adjustment disorders or bereavement
Other functional psychiatric illnesses
Organic disorders
What are some organic disorders that could be a differential diagnosis for anxiety?
Endocrine diseases
Dementia
MS
Drug induced anxiety
Alcohol/drug abuse
Infection
