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Psychiatry > Anxiety Disorders > Flashcards

Anxiety Disorders Flashcards

1
Q

What does an individual’s response to stress depend on?

A

Cognitive processing of any perceived threat and perceived ability to cope with threat

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2
Q

What are the two kinds of coping and how do they differ?

A

Problem focussed - dealing modifying with the stressor

Emotion focussed - modifying emotions towards the stressor, e.g. denial or relaxation therapy

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3
Q

What are the groups of symptoms in anxiety disorders?

A 
Muscle tension - MORE
Sleep disturbance - SAD 
Psychological arousal - PEOPLE
Hyperventilation - HAVE 
Autonomic arousal - ANXIETY
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4
Q

What is the model describing that the right amount of stress is helpful?

A

Yerkes-Dodson Curve

Too little stress leads to sleep, low alertness etc., too much leads to anxiety and disorganisation

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5
Q

What symptoms are included within the psychological arousal symptom group?

A 
Irritability
Sensitivity to noise
Poor concentration 
Fearful anticipation 
Worrying thoughts
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6
Q

What symptoms are included within the autonomic arousal symptom group?

A

GI - nausea/loose stools/wind/dyspepsia/dry mouth/difficulty swallowing
Resp - tight chest, difficulty inhaling
CV - palpitations/missed beats/chest pain
GU - urinary frequency/urgency/erectile dysfunction/a/dysmenorrhoea
CNS - dizziness, sweating

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7
Q

What symptoms are included within the muscle tension symptom group?

A

Tremor
Muscle cramps
Headache

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8
Q

What symptoms are included within the hyperventilation symptom group?

A

Hypocapnia
Tingling fingers (may lead to carpopedal spasm (intense muscle pain in hands/feet)
Breathlessness

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9
Q

What symptoms are included within the sleep disturbance symptom group?

A

Initial insomnia
Frequent waking
Night terrors/nightmares

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10
Q

What is the differences between phobic and generalised anxiety?

A

Same symptoms that occur but GAD occurs persistently and anxiety is not confined to a particular object/situation, whereas phobic anxiety is

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11
Q

What are the three most clinically relevant phobic anxieties?

A

Agoraphobia
Social phobia
Specific phobias

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12
Q

What is agoraphobia?

A

Fear of being in situations where escape/seeking help would be difficult

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13
Q

What is social phobia?

A

Inappropriate anxiety in a situation where the person feels observed/criticised

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14
Q

What are specific phobias?

A

Intense, persistent fear of a particular object/situation

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15
Q

How do you diagnose GAD?

A

Persistent (>6m) anxiety symptoms not confined to a situation/object

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16
Q

What are differential diagnoses for anxiety conditions?

A

Psychiatric - depression, schizophrenia, substance misuse, dementia
Physical - phaeochromocytoma, thyrotoxicosis, asthma/arrhythmias, hypoglycaemia

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17
Q

What is the 1 year prevalence of GAD?

A

4.4%

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18
Q

Which gender is most affected by GAD?

A

Woman

19
Q

What causes GAD?

A

Caused by a stressor acting on a personality predisposed to the disorder by genetic and environmental influences in childhood

20
Q

How do you manage GAD?

A

Counselling - advice (re caffeine, alcohol, exercise), education, planning management
Relaxation training
Medication - sedatives/SSRIs/TCAs
CBT

21
Q

What are the key features of phobic anxiety?

A

Same features as GAD but only in specific circumstances
Avoidance of these circumstances = phobic avoidance
Anxiety in perceived threat of encountering object/situation = anticipatory anxiety

22
Q

What are the main symptoms of social phobia?

A

Blushing and tremor

23
Q

How do you manage social phobia?

A

CBT addressing fear of criticism, challenging negative view of self, safety barriers, unrealistic exceptions, excessive self-monitoring
Education and advice
SSRIs

24
Q

What are the core features of OCD?

A

Recurrent obsessional thoughts and compulsive acts

25
Q

What are the obsessional thoughts in OCD?

A

Ideas, images, impulses
Not willed, repeated
Unpleasant/intrusive/violent/obscene

RECOGNISED AS INDIVIDUALS OWN THOUGHTS

26
Q

What causes anxiety in OCD?

A

Distress of thoughts or attempting to resist compulsions

27
Q

What are the compulsions like in OCD?

A

Stereotypical behaviours repeated over and over

Not enjoyable/helpful

28
Q

How does the sufferer tend to view their compulsions in OCD?

A

As a way of preventing harm to self or others

As pointless and they get symptoms of anxiety when trying to resist them

29
Q

What is the prevalence of OCD?

A

2%

30
Q

Which gender is OCD affect more?

A

Equally

31
Q

What is the aetiology of OCD?

A

Genetic abnormality in gene coding from 5HT receptor –> 5HT function abnormality

32
Q

How do you manage OCD?

A

Rule out depression
Education, advice, involve family
Serotonergic drugs, e.g. fluoxetine, clomperamine
CBT (graded exposure, response prevention, weakening convictions)

33
Q

What is PTSD?

A

Delayed/protracted reaction to stressor of exceptional severity

34
Q

What may be stressors causing PTSD?

A 
Combat
Assault 
Rape 
Natural/human caused disasters
Torturing 
Witnessing the above
35
Q

What are the three key elements of PTSD?

A

Hyperarousal
Avoidance of reminders
Re-experiencing phenomena

36
Q

What is included in hyperarousal in PTSD?

A

Irritability
Poor concentration
Persistent anxiety
Insomnia

37
Q

What is included in re-experiencing phenomena in PTSD?

A

Nightmares/flashbacks

38
Q

What is involved in avoidance of reminders in PTSD?

A

Emotional numbness
Cue avoidance
Difficulty recalling
Diminished interests

39
Q

Which gender does PTSD affect more?

A

2x more woman

40
Q

What is the aetiology of PTSD?

A

Nature of stressor - more lifethreatening/more exposure –> greater risk
(vulnerability/protective factors)
Some genetic susceptibility

41
Q

What are the vulnerability factors for PTSD?

A

Mood disorder
Prev trauma, esp in childhood
Lack of social support
Female

42
Q

What are the protective factors for PTSD?

A

Higher educational attainment/social group

Good paternal relationship

43
Q

How do you manage PTSD?

A

Trauma focused CBT
Eye movement desensitisation and reprocessing
SSRI/TCA

44
Q

How is it made sure that we catch PTSD in at risk populations?

A

Survivors of disasters screened monthly

If mild symptoms - watch and review next month

Psychiatry (26 decks)

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