Anxiety Disorders Flashcards
What are the different models of stress that can cause anxiety?
Psychological or transactional
Medicopsychological- fight or flight response
Biomechanical- environmental stressor on person which- if over limit can cause physical damage
What are the different ways of coping with stress?
Problem focussed
Emotion focussed
What kind of symptoms come with anxiety?
Psychological arousal e.g. fear & irritability
Autonomic arousal (symp) e.g. dry mouth, dizzy, sweats, tight chest etc
Muscle tension –> Tremor & headache
Hyperventilation –> SOB & numbness
Sleep Disturbances
Obviousbly anxiety disorders can be quite similar or overlap with MDD, schizophrenia, dementia etc. But what physical disorders can cause anxiety?
Thyrotoxicosis
Phaeochromocytoma
Hypoglycaemia
Asthma
What’s the difference between Generalised Anxiety Disorder (GAD) & Phobic Anxiety Disorders
GAD is persistant in all situations
Phobic anxiety disorders arise in specific situations
What are the most common anxiety disorders in order of prevalence?
GAD - 4.4% 1yr prevalence
OCD - 2% 1yr prevalence
PTSD - 1-4% 1yr prevalence
GAD can give you any of the symptoms described earlier. But what extra “symptoms” can come with Phobic anxiety disorders?
Anticipatory anxiety
This is where symptoms arise with a perceived threat of the feared situation arising
Phobic Avoidance - of those circumstances
What triggers GAD?
A stressor acting on a person who is already predisposed by genetic & environmental factors
How do we manage a case of GAD?
Counselling - Planning, education & advice re caffine, exercise etc
Relaxation training
Medication - Antidepressants (SSRI/TCA) or sedatives
CBT
What are the subtypes of phobic anxiety disorders?
Specific phobias e.g. uncircumcisedpenisphobia
Social Phobia
Agoraphobia
Define social vs agoraphobia?
Social - Anxiety in a situation where they feel observed or at risk of criticism e.g. public speaking
Agoraphobia is a fear of being unsafe/trapped/unable to escape e.g. in open spaces, crowds, restaurants etc
What symptoms of anxiety predominate in social phobia?
Blushing & tremor, but any anxiety symptoms can arise
How do we manage someone with Social Phobia?
CBT
Education & Advice
SSRIs
How does gender affect your risk of anxiety disorders?
GAD - F predominates
OCD is equal
PTSD - F predominates (prevalence also varies based on population exposure to disaster & culture)
OCD is a mixture of obsessional thoughts and compulsive repetitive acts. Describe the obsessive thoughts of someone with OCD?
They are not willed
Oft unpleasant or distressing
Recognised as their own thought (i.e. not psychotic)
The anxiety symptoms arise from the distressing nature or resistance to the thoughts
Describe the compulsive acts of someone with OCD
Repetitive
Not enjoyable or helpful for the individual
Viewed as either pointless or as preventing harm in some unrealistic way
Resistance/inability to perform the actions creates anxiety symptoms
How is OCD managed?
Education (include family/partner)
Seratonergic drugs e.g. SSRI (Fluoxetine) or TCA( Clomipramine)
CBT
Psychosurgery
Define PTSD?
Delayed or protracted reaction to a stressor of exceptional severity
Meaning its so bad it would upset/stress anyone
What kind of events can trigger ptsd?
combat Disasters Rape/assault Torture Etc
What are the major features of PTSD?
1) Hyperarousal - persistant anxiety, irritability, insomnia & poor conc
2) Re-experience phenomena - flashbacks or nightmares
3) Avoidance of reminders
What risk factors predispose you to PTSD?
- Mood disorders
- Previous trauma (Esp childhood)
- Low social support
- Female
- Genetics
- Life threatening stressor
- Greater exposure to stressor
What factors can protect against PTSD? aka protective factors!!
Higher educational/social group
Good paternal relationship
What do we do to prevent PTSD?
Screen disaster survivors at 1 month
IF they have mild symptoms we review them in another month
If they’re more severe we send straight to CBT
How do we treat PTSD?
CBT
EMDR (Eye movement desensitization & reprocessing)
SSRIs/TCAs
What are the common symptoms of psychological arousal?
- Irritablity
- Low concentration
- Sensitivity to noise
- Worrying thoughts
Give some examples of autonomic symptoms which may present
GI
- Nausea
- Motile stools
- Difficulty swallowing
CVS
- increased pulse
- Heart skips a beat
Resp
- Tight chest
GU
- frequency and urgency
- Amennorrhea/ dysmennorea
- Erectile failure
CNS
- Dizziness
- Sweating
what is the basis of psychological model of stress
depends on individuals ability to
- Analyse a problem
- Cope with a problem
What are hallucinations in PTSD called?
pseudohallucinations
