Anxiety disorders Flashcards
What are the 3 models of stress?
Biomechanical engineering - straw that broke camel’s back
Medicophysiological
Psychological
What is the psychological model of stress?
An individual’s stress will depend on a balance of perception of the perceived threat and perceived ability to cope
What is problem focused coping?
Efforts are directed toward modifying the stressor
What is emotion focused coping?
Modify emotional reaction - mental defence mechanisms
What are symptom groups within fight or flight?
Psychological arousal Autonomic arousal Muscle tension Hyperventilation Sleep disturbance
What symptoms are within psychological arousal?
Fearful anticipation Irritability Sensitivity to noise Poor concentration Worrying thoughts
What symptoms are within autonomic arousal?
Dry mouth Swallowing difficulty Dyspepsia Loose motions Tight chest Palpitations Urinary frequency Dizziness
What symptoms are within muscle tension?
Tremor
Headache
Muscle pain
What symptoms are within hyperventilation?
Hypocapnia
Breathlessness
What symptoms are found within sleep disturbance?
Initial insomnia
Frequent waking
Nightmaress
What are phobic anxiety disorders?
Anxiety symptoms occuring in specific circumstances
What are examples of phobic anxiety disorders?
Agoraphobia
Social phobia
Specific isolated phobias
What is generalised anxiety disorder?
Persistent anxiety symptoms
What are differentials for anxiety disorders?
Psychiatric - depression, schizophrenia, dementia, substance misuse
Physical - thyrotoxicosis, hypoglycaemia, phaeochromocytoma, asthma
Is generalised anxiety disorder more common in men or women?
Women
What causes generalised anxiety disorder?
A stressor acting on a personality predisposed to the disorder by a combination of genetic factors and environmental influences in childhood
What can be used to manage generalised anxiety disorders?
Counselling
Relaxation training
Medication
CBT
What kind of scenarios can trigger agoraphobia?
Being on a plan/bus/public transport
Being somewhere they might not escape
What is social phobia?
Inappropriate anxiety in situation where person feels observed or could be criticised
How is social phobia managed?
CBT
Education and advice
Medication - SSRI
What is OCD?
Experience of recurrent obsessional thoughts or compulsive acts
What are obsessional thoughts?
Ideas, imagess or impulses occuring repeated unwillingly, unpleasant and distressing and recognised as their own thoughts
What are compulsive acts?
Stereotypical behaviours repeated again and again, not enjoyable, not helpful, viewed by sufferer as preventing harm to self or others, and pointless
What is the theorised aetiology for OCD?
5HT receptor abnormalities - serotonin
How is OCD managed?
Good history and mental state examination to exclude depressive illness Education and explanation Involve family SSRI CBT - GRADE A Psychosurgery
What is PTSD?
Delayed or protracted reaction to a stressor of exceptional severity
What can cause PTSD?
Combat Natural or human caused disaster Rape Assault Torture Witnessing any of the above
What are the 3 key elements to PTSD?
Hyperarousal
Re-experiencing phenomena
Avoidance of reminders
What are features of hyperarousal?
Persistent anxiety
Irritability
Insomnia
Poor concentration
What are features of re-experiencing phenomena?
Intense intrusive images - flashbacks when awake, nightmares during sleep
What are features of avoidance in PTSD?
Emotional numbness
Cue avoidance
Recall difficulties
Diminishes interests
What is aetiology of PTSD?
Nature of stressor - life threatening confers greater risk
Vulnerability factors
Partly genetic
What are vulnerability factors for PTSD?
Mood disorder Previous trauma - especially as child Lack of social support Female Protective factors Higher education Good paternal relationship
How is PTSD managed?
Survivors of disasters screened at 1 month
Trauma focused CBT if severe symptoms
