Anxiety disorders Flashcards
what does an individuals reaction to stress depend on?
an individuals reaction to stress depends on a balance between their cognitive processing of any perceived threat and their perceived ability to cope
what are the 2 coping mechanisms?
problem focused i.e. revising for exams
emotion focussed i.e. relaxation therapy, sedatives
what are the psychological symptoms of anxiety?
fearful anticipation irritability sensitivity to noise poor concentration worrying thoughts
what are the autonomic symptoms of anxiety?
GI:
- dry mouth
- difficulty swallowing
- dyspepsia, nausea, wind
- frequent loose motions
respiratory;
- difficulty breathing
- hyperventillation
- tight chest
CV;
- palpitations
- chest pain
Genitourinary;
- increased frequency/ urgency of micturition
- amenorrhoea/ dysmenorrhoea
- erectile dysfunction
CNS;
- sweating
- dizziness
muscle tension;
- muscle pain
- tremor
- headache
hyperventillation;
- tingling in peripheries
- carpopedal spams (decrease in Ca)
- breathlessness
sleep disturbance;
- insomnia
- frequent wakening
- nightmares and terrors
what are the different anxiety disorders?
generalised anxiety disorder
phobia anxiety disorder
OCD
PTSD
what are differential diagnoses of an anxiety disorder?
depression
schizophrenia
substance misuse
dementia
thyrotoxicosis phaeochromocytoma hypoglycaemia asthma arrhythmia
how can you differentiate generalised anxiety disorder from phobic anxiety disorder?
GAD is persistant several months of anxiety symptoms not confined to a specific situation or object
phobic anxiety is only in specific circumstances or there is a perceived threat of encountering that feared object
what are the core symptoms of social phobia?
tremor
blushing
what is social phobia?
inapproate anxiety in a situation when you feel you are being observed or criticised
how is social phobia managed?
education and advice
CBT
medication i.e. SSRI
what are the management options for generalised anxiety disorder?
education and advice
relaxation training
CBT
medication - SSRI, benzodiazepine
what are the core features in CBT for generalised anxiety disorder?
identifying errors, reprocessing and reassessing responsibility
in what sex is GAD more common?
F > M
in what sex is PTSD more common?
F > M
what is the mechanism behind the aetiology of GAD?
GAD is caused by a stressor acting on a personality predisposed by a combination of genetic factors and environmental influences in childhood
what is OCD?
recurrent obsessional thoughts or compulsive acts
what is the genetic influence in the aetiology of OCD?
5 HT functional abnormalities
what are the management options for OCD?
antidepressants i.e. SSRI or clomipramine
CBT
psychosurgery
what are the features of obsessional thoughts in OCD?
ideas, images, impulses occurring repeatedly, unwilled unpleasant and distressing the individuals own thoughts anxiety arises because of the distress of the thought or attempts to resist it
what are the features of the compulsive acts or ritual associated with OCD?
behaviours repeated again and again
not a helpful act
not enjoyable
often viewed by the sufferers as preventing them from harm of self or from others
anxiety symptoms occur if they try and resist compulsions
what is PTSD?
prolonged or delayed response to a stressor of significant severity
what are the key elements to the reaction to a stressor of exceptional severity?
hyperarousal
re-experiencing phenomena
avoidance of reminders
what are the features of PTSD with regards to the key elements to the reaction of a stressor of significant severity?
hyperarousal;
- irritability
- persistant anxiety
- insomnia
- poor concentration
re-experiencing phenomena
- intense intrusive images
- flashbacks when awake
- nightmares
avoidance of reminders
- emotional numbness
- cue avoidance
- recall difficulties
- diminishes interests
what factors make some individuals more vulnerable to PTSD than others?
mood disorder
female
previous history of trauma esp child
lack of social support
what are the protective factors against PTSD?
higher education and social status
good paternal relationship
what is the management for mild PTSD?
watchful waiting and review in 1 month
what is the management for severe PTSD?
trauma focussed CBT
eye movement desensitisation and reprocessing
sedatives
SSRI
when are survivors of a disaster screened for PTSD?
after 1 month following disaster
