Anxiety Disorders

Question 1

List psychological symptoms of anxiety disorders

Answer 1

Worry/panic
Fear of going mad/dying
Concentration problems
Racing thoughts
Hypervigilance
Inability to relax
Derealization and depersonalisation

Question 2

Anxiety is a normal state. True/False?

Answer 2

True

Causes issues when daily living is affected, however

Question 3

List physical symptoms of anxiety disorders

Answer 3

Palpitations
Sweating, dry mouth
Tremor
Dizziness
Muscle tension
Numbness/tingling
Lump in throat (globus hystericus), dysphagia
Chest pain/tightness
Nausea, vomiting, butterflies
Difficulty breathing

Question 4

How does the amygdala aid in our aversive/defensive psychosystem?

Answer 4

Acts as an emotional filter of brain for assessing whether sensory material via thalamus requires a stressor fear response

Question 5

Describe generalised anxiety disorder

Answer 5

Excessive persistent worrying that is not restricted to particular circumstances
Lasting most days for at least 6 months

Question 6

Describe panic disorder

Answer 6

Recurrent “panic attacks” not restricted to particular situations (episodes of severe, unpredictable anxiety)

Question 7

How long does a panic attack last to be classified as a panic attack?

Answer 7

Peaks within 10 minutes

Lasts up to 45 mins

Question 8

Describe social phobia

Answer 8

Social anxiety disorder
Persistent unreasonable fear of being observed or judged negatively by other people
Fear of personal humiliation/ embarrassment

Question 9

Describe agoraphobia

Answer 9

Fear of leaving home, shops, crowds, public places, travelling alone
Open places

Question 10

Describe specific phobia

Answer 10

Fear cued by presence or anticipation of specific object or situation e.g. flying, heights, animals, injection, blood

Question 11

If someone predominately suffers from a traumatic past with flashbacks, what is the condition to look for?

Answer 11

PTSD

Question 12

If someone predominately suffers from compulsions and persistent ideas, what is the condition to look for?

Answer 12

Obsessive compulsive disorder

Question 13

If someone predominately suffers from uncontrollable worry about several things at once, what is the condition to look for?

Answer 13

Generalised anxiety disorder

Question 14

If someone predominately suffers from fear of social scrutiny, what is the condition to look for?

Answer 14

Social phobia

Question 15

What is the main aim of psychological/behavioural therapy when tackling anxiety disorders?

Answer 15

To understand conditioning and attempt to undo previous learning

Question 16

What is the difference between graded exposure/sensitisation and flooding approach in psychological therapy for anxiety?

Answer 16

Graded: slow counter-conditioning involving build-up of coping mechanisms against feared stimuli
Flooding: full exposure to feared stimulus + staying with it until fear reduces

Question 17

List the medication used for OCD

Answer 17

SSRIs

Clomipramine

Question 18

List psychological therapy used for OCD

Answer 18

CBT

Exposure and response prevention

Question 19

What is the first line treatment for OCD?

Answer 19

Exposure and response prevention

Question 20

The obsessions in OCD are usually desired and associated with relief. True/False?

Answer 20

False
Usually unwanted, recurrent and intrusive
Distressing and associated with anxiety

Question 21

The compulsions in OCD usually lead to reduced anxiety. True/False?

Answer 21

True

Resistance to compulsion leads to heightened anxiety

Question 22

OCD is familial. True/False?

Answer 22

True

Question 23

What is the mean age of onset of OCD?

Answer 23

20 years old

Question 24

List some clinical features of OCD

Answer 24

Preoccupied with rules, lists, schedules
Perfectionism
Inflexibility of thought
Controlling

Question 25

List 5 screening questions you may ask to probe about OCD

Answer 25

Do you wash/clean a lot? Do you check things a lot? Is there any thought that persistently bothers you? Does it take you a long time to finish things? Are you concerned with orderliness/symmetry?

Question 26

List behavioural symptoms of anxiety disorders

Answer 26

``` Avoid certain situations Exaggerated response to minor suprises Difficulty getting to sleep Excessive use of alcohol/ drugs Persistant irritability Seek reassurance ```

Question 27

When does anxiety become pathological?

Answer 27

Anxiety more extreme than normal Anxiety in situation that is not normally anxiety provoking Impairment of social/ occupation function

Question 28

List symptoms of generalised anxiety disorder

Answer 28

``` Persistent nervousness Trembling Muscle tensions Sweating Lightheadedness Palpitations Dizziness Epigastric discomfort ```

Question 29

List management options for generalised anxiety disorder

Answer 29

CBT SSRIs/ SNRIs Pregabalin Benzodiazepines (short-term)

Question 30

List symptoms of panic disorder

Answer 30

``` Sudden onset of: Palpitations Chest pain Choking sensation Dizziness Feelings of unreality Fear of dying/ going mad ```

Question 31

Panic disorder is strongly associated with which type of phobia?

Answer 31

Agoraphobia

Question 32

Which imaging tool can be used to diagnose panic disorder?

Answer 32

PET scan | Increased metabolism in anterior pole of temporal lobe

Question 33

List management options for panic disorder

Answer 33

CBT SSRIs/ SNRIs TCADs Benzodiazepines (short-term)

Question 34

List the three main types of phobias and features common to all of these

Answer 34

``` Agoraphobia Social phobia Specific phobia Fear recognised as irrational Typified by avoidance or anticipatory anxiety ```

Question 35

List symptoms of social phobia

Answer 35

Blushing, shaking Fear of vomiting, micturation, defecation Poor school/ occupational performance

Question 36

List management options for phobia

Answer 36

CBT SSRIs/ SNRIs Benzodiazepines (short-term)

Question 37

What are the two main components of OCD

Answer 37

Recurrent obsessional thoughts - ideas, images, impulses | Recurrent compulsive acts - repeated, stereotyped rituals or behaviours

Question 38

List diagnostic criteria for OCD

Answer 38

Must be present for at least 2 weeks and be a source of distress or occur with activities Obsessions must be individuals own thoughts and must be repetitive Resistance must be present

Question 39

OCD is strongly associated with which other mental health disorder?

Answer 39

Depression

Question 40

What is the maximum amount of time benzodiazepines should be used for? List some side effects

Answer 40

``` 2 weeks Sedation and psychomotor impairment DIscontinuation/ withdrawal problems Dependency and abuse Alcohol interaction Worsen depression ```

Question 41

List differential diagnosis for anxiety

Answer 41

``` Thyroid function Menopause Cortical-secreting tumours Depression Gambling, addiction ```