Anxiety disorders Flashcards
3 models of stress
biomechanical “engineering”
medicophysiological
transactional/psychological
Psychological model of stress
interactive
individuals reaction to stress depends on perceived threat and perceived ability to cope
2 coping methods
problem focussed
emotion focussed
5 anxiety symptoms group
psychological arousal ANS arousal muscle tension sleep disturbance hyperventilate
Stress vs performance curve
Yerkes dodson
psychological arousal
fearful anticipation sensitive to noise irritable decreased concentration worrying thoughts
ANS arousal examples
palpitations, diarrhoea, SOB, chest pain, amenorrhoea, dizziness and sweating
Muscle tension
headache
muscle pain
tremor
hyperventilate
leads to hypocapnia
carpopedal spasm
SOB
Sleep disturbance
initial insomnia
frequent wakening
nightmares and night terrors
Phobic anxiety and GAD similarity and differences
same core anxiety symptoms
particular circumstance - phobias
occur persistently = GAD
3 phobic anxieties
agoraphobia
social phobia
specific phobias
GAD
persistent (several months) symptoms not confined to situation or object
GAD diff diagnosis
psych = depression, schizophrenia, dementia, substance misuse physical = phaeochromocytoma, thyrotoxicosis, asthma
GAD epidemiology
1 year prevalence 4%
more women diagnosed
GAD aetiology
stressor acting on personality predisposed by combo of genetic and environmental factors in childhood
Management of GAD
counselling - explain, education, coffee, alcohol, exercise
relaxation training
CBT
SSRI or TCA
phobic avoidance
person behaves to avoid phobias
Anticipatory anxiety
experience anxiety if perceived threat of encountering object or situation
Specific phobias
spiders, heights, blood etc
Social phobia
inappropriate anxiety in situation where person feels observed or could be criticised
predominant symptoms in social phobia
tremor and blushing
Managing social phobia
CBT
education and avice
SSRI
OCD
experience of recurrent obsessional thoughts and/or compulsive acts
OCD - obsessional thoughts
key anxiety symptoms - distress of attempts to resist
ideas, impulses, unpleasant
recognises individuals own thoughts
OCD - compulsive acts
unhelpful and not enjoyable
stereotypical acts over and over again
Epidemiology of OCD
2% 1yr prevalence
M=F
genetic: 5HT - serotonin
managing OCD
good history and MSE to discount treatable depressive illness education, explain, involve family CBT SSRI or clomipramine (serotonergic) psychosurgery
PTSD
delayed and/or protracted reaction to stressor of exceptional severity eg rape, assault, combat
3 key elements of PTSD
ANS arousal, re-experience and avoidance of reminders
PTSD epidemiology
variable culture and exposure to disaster
1-4% 1yr prevalence
more women diagnosed
aetiology PTSD
nature of stressor eg life threatening, proximity
genetics susceptibility
vulnerable = mood disorder, female, prev trauma
protective = high education, good parent relationship
Managing PTSD
screen at 1 month watchful waiting CBT SSRI/TCA eye movement desensitisation
