Anxiety disorders

Question 1

What are the 3 models of stress?

Answer 1

Biomechanical engineering - straw that broke camel’s back
Medicophysiological
Psychological

Question 2

What is the psychological model of stress?

Answer 2

An individual’s stress will depend on a balance of perception of the perceived threat and perceived ability to cope

Question 3

What is problem focused coping?

Answer 3

Efforts are directed toward modifying the stressor

Question 4

What is emotion focused coping?

Answer 4

Modify emotional reaction - mental defence mechanisms

Question 5

What are symptom groups within fight or flight?

Answer 5

Psychological arousal
Autonomic arousal
Muscle tension
Hyperventilation
Sleep disturbance

Question 6

What symptoms are within psychological arousal?

Answer 6

Fearful anticipation
Irritability
Sensitivity to noise
Poor concentration
Worrying thoughts

Question 7

What symptoms are within autonomic arousal?

Answer 7

Dry mouth
Swallowing difficulty
Dyspepsia
Loose motions
Tight chest
Palpitations
Urinary frequency
Dizziness

Question 8

What symptoms are within muscle tension?

Answer 8

Tremor
Headache
Muscle pain

Question 9

What symptoms are within hyperventilation?

Answer 9

Hypocapnia

Breathlessness

Question 10

What symptoms are found within sleep disturbance?

Answer 10

Initial insomnia
Frequent waking
Nightmaress

Question 11

What are phobic anxiety disorders?

Answer 11

Anxiety symptoms occuring in specific circumstances

Question 12

What are examples of phobic anxiety disorders?

Answer 12

Agoraphobia
Social phobia
Specific isolated phobias

Question 13

What is generalised anxiety disorder?

Answer 13

Persistent anxiety symptoms

Question 14

What are differentials for anxiety disorders?

Answer 14

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

Question 15

Is generalised anxiety disorder more common in men or women?

Answer 15

Women

Question 16

What causes generalised anxiety disorder?

Answer 16

A stressor acting on a personality predisposed to the disorder by a combination of genetic factors and environmental influences in childhood

Question 17

What can be used to manage generalised anxiety disorders?

Answer 17

Counselling
Relaxation training
Medication
CBT

Question 18

What kind of scenarios can trigger agoraphobia?

Answer 18

Being on a plan/bus/public transport

Being somewhere they might not escape

Question 19

What is social phobia?

Answer 19

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

Question 20

How is social phobia managed?

Answer 20

CBT
Education and advice
Medication - SSRI

Question 21

What is OCD?

Answer 21

Experience of recurrent obsessional thoughts or compulsive acts

Question 22

What are obsessional thoughts?

Answer 22

Ideas, imagess or impulses occuring repeated unwillingly, unpleasant and distressing and recognised as their own thoughts

Question 23

What are compulsive acts?

Answer 23

Stereotypical behaviours repeated again and again, not enjoyable, not helpful, viewed by sufferer as preventing harm to self or others, and pointless

Question 24

What is the theorised aetiology for OCD?

Answer 24

5HT receptor abnormalities - serotonin

Question 25

How is OCD managed?

Answer 25

``` Good history and mental state examination to exclude depressive illness Education and explanation Involve family SSRI CBT - GRADE A Psychosurgery ```

Question 26

What is PTSD?

Answer 26

Delayed or protracted reaction to a stressor of exceptional severity

Question 27

What can cause PTSD?

Answer 27

``` Combat Natural or human caused disaster Rape Assault Torture Witnessing any of the above ```

Question 28

What are the 3 key elements to PTSD?

Answer 28

Hyperarousal Re-experiencing phenomena Avoidance of reminders

Question 29

What are features of hyperarousal?

Answer 29

Persistent anxiety Irritability Insomnia Poor concentration

Question 30

What are features of re-experiencing phenomena?

Answer 30

Intense intrusive images - flashbacks when awake, nightmares during sleep

Question 31

What are features of avoidance in PTSD?

Answer 31

Emotional numbness Cue avoidance Recall difficulties Diminishes interests

Question 32

What is aetiology of PTSD?

Answer 32

Nature of stressor - life threatening confers greater risk Vulnerability factors Partly genetic

Question 33

What are vulnerability factors for PTSD?

Answer 33

``` Mood disorder Previous trauma - especially as child Lack of social support Female Protective factors Higher education Good paternal relationship ```

Question 34

How is PTSD managed?

Answer 34

Survivors of disasters screened at 1 month | Trauma focused CBT if severe symptoms