Anxiety disorders

Question 1

3 models of stress

Answer 1

biomechanical “engineering”
medicophysiological
transactional/psychological

Question 2

Psychological model of stress

Answer 2

interactive

individuals reaction to stress depends on perceived threat and perceived ability to cope

Question 3

2 coping methods

Answer 3

problem focussed

emotion focussed

Question 4

5 anxiety symptoms group

Answer 4

psychological arousal 
ANS arousal 
muscle tension 
sleep disturbance 
hyperventilate

Question 5

Stress vs performance curve

Answer 5

Yerkes dodson

Question 6

psychological arousal

Answer 6

fearful anticipation 
sensitive to noise 
irritable 
decreased concentration 
worrying thoughts

Question 7

ANS arousal examples

Answer 7

palpitations, diarrhoea, SOB, chest pain, amenorrhoea, dizziness and sweating

Question 8

Muscle tension

Answer 8

headache
muscle pain
tremor

Question 9

hyperventilate

Answer 9

leads to hypocapnia
carpopedal spasm
SOB

Question 10

Sleep disturbance

Answer 10

initial insomnia
frequent wakening
nightmares and night terrors

Question 11

Phobic anxiety and GAD similarity and differences

Answer 11

same core anxiety symptoms
particular circumstance - phobias
occur persistently = GAD

Question 12

3 phobic anxieties

Answer 12

agoraphobia
social phobia
specific phobias

Question 13

GAD

Answer 13

persistent (several months) symptoms not confined to situation or object

Question 14

GAD diff diagnosis

Answer 14

psych = depression, schizophrenia, dementia, substance misuse 
physical = phaeochromocytoma, thyrotoxicosis, asthma

Question 15

GAD epidemiology

Answer 15

1 year prevalence 4%

more women diagnosed

Question 16

GAD aetiology

Answer 16

stressor acting on personality predisposed by combo of genetic and environmental factors in childhood

Question 17

Management of GAD

Answer 17

counselling - explain, education, coffee, alcohol, exercise
relaxation training
CBT
SSRI or TCA

Question 18

phobic avoidance

Answer 18

person behaves to avoid phobias

Question 19

Anticipatory anxiety

Answer 19

experience anxiety if perceived threat of encountering object or situation

Question 20

Specific phobias

Answer 20

spiders, heights, blood etc

Question 21

Social phobia

Answer 21

inappropriate anxiety in situation where person feels observed or could be criticised

Question 22

predominant symptoms in social phobia

Answer 22

tremor and blushing

Question 23

Managing social phobia

Answer 23

CBT
education and avice
SSRI

Question 24

OCD

Answer 24

experience of recurrent obsessional thoughts and/or compulsive acts

Question 25

OCD - obsessional thoughts

Answer 25

key anxiety symptoms - distress of attempts to resist
ideas, impulses, unpleasant
recognises individuals own thoughts

Question 26

OCD - compulsive acts

Answer 26

unhelpful and not enjoyable

stereotypical acts over and over again

Question 27

Epidemiology of OCD

Answer 27

2% 1yr prevalence
M=F
genetic: 5HT - serotonin

Question 28

managing OCD

Answer 28

good history and MSE to discount treatable depressive illness 
education, explain, involve family 
CBT 
SSRI or clomipramine (serotonergic) 
psychosurgery

Question 29

PTSD

Answer 29

delayed and/or protracted reaction to stressor of exceptional severity eg rape, assault, combat

Question 30

3 key elements of PTSD

Answer 30

ANS arousal, re-experience and avoidance of reminders

Question 31

PTSD epidemiology

Answer 31

variable culture and exposure to disaster
1-4% 1yr prevalence
more women diagnosed

Question 32

aetiology PTSD

Answer 32

nature of stressor eg life threatening, proximity
genetics susceptibility
vulnerable = mood disorder, female, prev trauma
protective = high education, good parent relationship

Question 33

Managing PTSD

Answer 33

screen at 1 month 
watchful waiting 
CBT 
SSRI/TCA 
eye movement desensitisation