Anxiety Disorders

Question 1

What are the models of stress?

Answer 1

Biomechanical engineering
Medicophysiological
Psychological

Question 2

Outline the Psychological (Transactional) model of stress?

Answer 2

Interactive

Balanced between cognitive processing of threat and ability to cope

Question 3

What are the mechanisms for coping?

Answer 3

Problem focussed - modify the stressor (preparation)

Emotion focussed - Modify the response (drugs, denial, relaxation)

Question 4

What are the symptoms groups of anxiety?

Answer 4

Psychological arousal
Autonomic arousal
Muscle tension
Hyperventilation
Sleep Disturbance

Question 5

What are the symptoms of psychological arousal?

Answer 5

Fearful anticipation
Irritability
Sensitivity to noise
Poor concentration
Worrying thoughts

Question 6

Autonomic arousal affects which systems?

Answer 6

GI (dry mouth, dyspepsia, diarrhoea)
Respiratory (hyperventilation)
Cardio (palpitations)
Urinary (dysmenorrhoea, erectile failure)
CNS (dizziness, sweating)

Question 7

How do Phobic Anxiety Disorders and General Anxiety Disorder differ?

Answer 7

Phobic - triggered by phobias, people calm when avoiding triggers
GAD - persistent

Question 8

How does General Anxiety Disorder present?

Answer 8

Persistent symptoms not confined to a situation
Psychological + Autonomic arousal
Muscle tension
Hyperventilation
Sleep disturbance

Question 9

DDx for anxiety disorders

Answer 9

Other psych disorders
Substance abuse
Thyrotoxicosis
Phaechromocytoma
Hypoglycaemia

Question 10

What is the management for Generalised Anxiety Disorders?

Answer 10

Counselling
Relaxation training
Medication 
 - Sedatives are addictive
 - SSRI, TCA
CBT

Question 11

How do Phobic Anxiety Disorders present?

Answer 11

Same as GAD but in certain circumstances
Phobic avoidance
Anxiety in perceived threat of encountering phobia

Question 12

What are the main clusters of phobias?

Answer 12

Social phobia
Agoraphobia
Specific phobias

Question 13

What is the management for social phobias?

Answer 13

CBT - address groundless fear of criticism
- Negative views of self
Education and advice
SSRIs

Question 14

How does OCD present?

Answer 14

Obsessional thoughts - repeatedly and unwilled
Unpleasant and distressing
Anxiety symptoms in attempts to resist
Compulsive acts/rituals - not enjoyable or helpful

Question 15

What is the aetiology of OCD?

Answer 15

5HT function abnormalities

Question 16

How is OCD managed?

Answer 16

Exclude depressive illness
Education + family
SSRI
Clomipramine
CBT
Psychosurgery (treatment resistant)

Question 17

PTSD is associated with what?

Answer 17

Combat
Disasters
Rape
Assault
Torture
Witnessing the above

Question 18

What are the key elements of PTSD reactions?

Answer 18

Hyperarousal
Re-experiencing phenomena
Avoidance of reminders

Question 19

What is Hyperarousal in PTSD?

Answer 19

Persistent anxiety
Irritability
Insomnia
Loss of concentration

Question 20

What is re-experiencing phenomena in PTSD?

Answer 20

Intense intrusive flashbacks/nightmares

Question 21

What is avoidance in PTSD?

Answer 21

Emotional numbness
Cue avoidance
Recall difficulties
Diminished interests

Question 22

What are the causes of PTSD?

Answer 22

Life threatening + degree of exposure
Genetic
Vulnerability factors
(lack of protective factors)

Question 23

Give 3 vulnerability factors for PTSD?

Answer 23

Female
Mood disorder
Previous trauma
Lack of social support

Question 24

Give 3 protective factors for PTSD?

Answer 24

Good paternal relationship
Higher education
Social group