Anxiety Disorders Flashcards
What are the symptoms groups of anxiety?
- psychosocial arousal
- autonomic arousal
- muscle tension
- hyperventilation
- sleep disturbance
What are psychological arousal symptoms of anxiety?
- fearful anticipation
- irritability
- sensitivity to noise
- poor concentration
- worrying thoughts
What are autonomic arousal symptoms of anxiety?
- GI
- dry mouth, swallowing difficulties, dyspepsia, nausea, wind, frequent loose motions
- respiratory
- tight chest, difficulty inhaling
- CVS
- palpitations, missed beats, chest pain
- genitourinary
- frequency/urgency of micturation, ammenorrhoea/dysmenorrhoea, erectile failure
- CNS
- dizziness, sweating
What are muscle tension symptoms of anxiety?
- tremor
- headache
- muscle pain
What are hyperventilation symptoms of anxiety?
- CO2 deficit hypocapnia
- numbness, tingling in extremities- may lead to carpopedal spasm
- breathlessness
What are sleep disturbance symptoms of anxiety?
- initial insomnia
- frequent waking
- nightmares + night terrors
What is the difference between phobic anxiety disorders and generalised anxiety disorder?
- same core anxiety symptoms
- occur in particular circumstances
- phobias
- agoraphobia
- social phobia
- specific (isolated) phobias
- GAD
- occur persistantly (several months)
- not confined to situation/object
What are differential diagnoses for anxiety disorders?
Psychiatric:
- depression
- schizophrenia
- dementia
- substance misuse
Physical:
- thyrotoxicosis
- paeochromoctoma
- hypoglycaemia
- asthma
- arrhythmias
What is the aetiology for generalised anxiety disorders?
- stressor
- acting on a personality predisposed
- by genetics factors + environmental influences in childhood
What is the management for generalised anxiety disorder?
- counselling
- clear plan of management
- explanation + education
- lifestyle advice
- relaxation training
- group/individual
- DVDs, tapes, clinical lead
- medication
- sedatives
- antidepressants
- CBT
What are features of social phobia?
- inappropriate anxiety in a situation where a person would feel observed or criticised
- restaurants
- shops, queues
- public speaking
- blushing + tremor most predominant symptoms
What is the management for social phobia?
- CBT
- negative views of self
- “safety barriers”
- unrealistically high standards
- excessive self monitoring
- education + advice
- SSRI antidepressants
What are features of obsessive compulsive disorder (OCD)?
- experience of recurrent obsessional thoughts + or compulsive acts
What are obsessional thoughts?
- ideas, images, impulses
- occuring repeatedly not willed
- unpleasant + distressing (often opposite of personality type, e.g. obscene, violent)
- recognised as the individuals own thoughts
- key anxiety symptoms from distress of own thoughts or or attempts to resist
What are compulsive acts or rituals?
- stereotypical behaviours repeated again + again
- not enjoyable
- not helpful
- often viewed by sufferer as;
- preventing some harm to self or others
- pointless and resisted with key anxiety symtpoms accompanying resistance
What is the aetiological theory for OCD?
- genetic
- 5HT function abnormalities
What is the management for OCD?
- general
- education + explanation
- involve partner/family
- serotogenic drugs
- SSRI
- clomipramine
- CBT
- exposure + response prevention
- exam evidence to weaken convictions
- psychosurgery
What is post traumatic stress disorder (PTSD)?
- delayed or protracted reaction to a stressor of exceptional severity
- combat
- natural or human caused disaster
- rape
- assault
- torture
- witnessing any of the above
What are the element to reaction of PTSD?
- hyperarousal
- persistant anxiety
- irritability
- insomnia
- poor concentration
- re-experiencing phenomena
- intense intrusive images (flashbacks when awake, nightmares during sleep)
- avoidance
- emotional numbness
- cue avoidance
- recall difficulties
- diminishes interests
What is the aetiology of PTSD?
- nature of stressor
- life threatening + degree of exposure generally confers greater risk
- vulnerability factors (mood disorder, previous trauma esp. as child, lack of social support, female)
- protective factors (higher education and social groups, good paternal relationship)
- susceptibility partly genetic
What is the management for PTSD?
- survivors of disasters screened at 1 month
- mild- watchful waiting
- severe- trauma-focused CBT
- Eye Movement Desensitisation + Reprocessing
- sedatives, antidepressants
