Anxiety Disorders Flashcards
What are the three models of stress?
- Biomechanical engineering (stimulus is tolerated up to a point but then it becomes too much)
- Medicophysiological (fight or flight response)
- Psychological (response depends on the balance between their cognitive processing of any perceived threat and perceived ability to cope
What is the difference between problem focused and emotion focused coping ?
- Problem focused: where efforts are directed towards the modifying stressor
- Emotion focused: modify emotional reaction and create mental defence mechanisms
What are the symptom groups of anxiety?
- Psychological arousal
- Autonomic arousal
- Muscle tension
- Hyperventilation
- Sleep disturbance
List the symptoms that are classed as psychological arousal
- Fearful anticipation
- Irritability
- Sensitivity
- Poor concentration
- Worrying thoughts
List the symptoms that come under autonomic arousal
- GI: dry mouth, swallowing difficulties, dyspepsia, nausea, wind and frequent loose motions
- Resp: tight chest and difficulty breathing
- Cardio: palpitations, mixed beats and chest pain
- Genitourinary: frequency/urgency of micturition, amenorrhoea/dysmenorrhoea and erectile failure
- CNS: dizziness and sweating
What are the common anxiety disorders?
- Phobic anxiety disorders
- General anxiety disorder
What are the features of generalised anxiety disorder?
- Persistent symptoms not confined to a situation or object
- All the symptoms of anxiety can occur
What are the differential diagnoses for anxiety?
- Depression
- Schizophrenia
- Dementia
- Substance misuse
- Thyrotoxicosis
- Phaeochromoctoma
- Hypoglycaemia
- Asthma and/or arrhythmias
How can generalised anxiety disorders be managed?
- Counselling
- Relaxation of training
- Medications: sedatives (have high risk of dependency), SSRIs or TCAs
- CBT
What are the features of phobic anxiety disorders?
- Same core features as GAD
- Only in specific circumstances
- Person behaves to avoid these circumstances
- Also experiences anxiety if there is a perceived threat of encountering the feared object or situation
What are the three clinically important phobia anxiety disorders?
- Specific phobias
- Social phobia
- Agrophobia
How can social phobia be managed?
- CBT
- Education and advice
- SSRI antidepressants
What are the key features of OCD?
- Obsessional thoughts: ideas, images or impulses
- Anxiety symptoms arise because of distress of the thoughts or attempts to resist
- Stereotypical behaviours repeated again and again
How can OCD be managed?
- Good history and MSE to exclude treatable depressive illness
- Education and explanation
- Serotonergic drugs: SSRI and clomipramine
- CBT
- Psychosurgery
Give the three key elements to reaction in PTSD
- Hyperarousal: persistent anxiety, irritability, insomnia and poor concentration
- Re-experiencing phenomena: flashbacks when awake and nightmares during sleep
- Avoidance of reminders: emotional numbness, cue avoidance, recall difficulties and diminished interests
