Anxiety Disorders

Question 1

name 3 models of stress

Answer 1

> biomechanical
medico-physiological
psychological

Question 2

what is the psychological model of stress?

Answer 2

an individuals reaction to stress depends on a balance between their cognitive processing of any perceived threat and a perceived inability to cope

Question 3

what coping strategies are there to psychological stress?

Answer 3

> problem focused: effort directed towards modifying stressor
emotion focused: modifying emotional reaction to the stressor (denial or relaxation)

Question 4

describe the psychological arousal reaction to stress

Answer 4

> irritability
> fearful anticipation
> noise sensitivity
> poor concentration
> worrying thoughts

Question 5

what effect does muscle tension due to stress have?

Answer 5

> tremor
headache
pain

Question 6

how does stress affect the GI system?

Answer 6

> dysphagia
dry mouth
dyspepsia
loose motions

Question 7

how does stress affect the resp. system?

Answer 7

> tight chest

> difficulty inhaling

Question 8

how does stress affect the CVS system?

Answer 8

> chest pain

> palpations

Question 9

how does stress affect the urinary system?

Answer 9

> frequency
urgency
erectile dysfunction
amenorrhoea

Question 10

how does stress affect the CNS system?

Answer 10

> dizziness

> sweating

Question 11

how does stress affect sleep?

Answer 11

> night terrors
waking
initial insomnia

Question 12

what are the effects of hyperventilation?

Answer 12

> hypocapnia
numbness to extremities (carpopedal spasm)
breathless

Question 13

what is the presentation of generalised anxiety disorder?

Answer 13

persistent (months) of anxiety symptoms not confined to a situation or an object

Question 14

what is the differential diagnosis in generalised anxiety disorder?

Answer 14

> depression
> schizophrenia
> dementia
> substance misuse
> thyrotoxicosis
> pheochromocytoma
> hypoglycaemia
> asthma
> arrhythmias

Question 15

true or false

men are more effected by generalised anxiety disorder than women

Answer 15

false

Question 16

what management is there for generalised anxiety disorder?

Answer 16

> counselling
 - explanation
 - education
> relaxation training
> cognitive behaviour therapy
> SSRI's [SETRALINE]
(> sedation though this has high dependency)

Question 17

what are phobic anxiety disorders?

Answer 17

same features as GAD but confined to specific circumstances
> specific phobia
> social phobias
> agrophobia

Question 18

what management is available for phobic anxiety disordes?

Answer 18

> CBT
education and advice
SSRI’s [sertraline]

Question 19

how does OCD present?

Answer 19

experiencing recurrent obsessional thoughts and/or compulsive acts that
> will prevent harm
> pointless
> unpleasant
> individuals own thoughts

if there is an attempt to resist there is anxiety

Question 20

does OCD affect more men than women?

Answer 20

no it affects both men and women equally

Question 21

what management is available for OCD?

Answer 21

> psychosurgery
> CBT
> serotonergic drugs
 - SSRI's [sertraline]
 - TCA [clomipramine]
> involve family

Question 22

name some vulnerability factors of PTSD

Answer 22

> lack of social support
previous trauma
mood disorder
higher education

Question 23

what is PTSD?

Answer 23

delayed or protracted reaction to a stress of exceptional severity

Question 24

what are the 3 elements of PTSD?

Answer 24

> avoidance
 - numbness
 - diminished interest
 - avoidance
 - recall difficulties
> re-experience phenomena
 - intense intrusive images
 - on background of anhedonia
> hyperarousal 
 - persistent anxiety
 - irritability
 - insomnia
 - poor concentration

Question 25

what is the management for PTSD?

Answer 25

> screened at 1 month
> mild: watchful waiting
> severe: CBT
> eye movement desensitisation and reprocessing
> SSRI [fluoxetine]