Anxiety disorders Flashcards
are the three models of stress?
Biomechanical ‘engineering’
Medicophysiological
Physiological
What are the psychological models of stress?
Interactive
Coping
What are the two methods of coping with stress?
Problem focussed
Emotion focussed
What is problem focussed coping?
Where efforts are directed toward modifying stressor e.g. preparation, practice
What is emotion focussed coping?
Modify emotional response, mental defence mechanisms e.g. denial, relaxation training
What are symptom groups of anxiety?
Psychological arousal Autonomic arousal Muscle tension Hyperventilation Sleep disturbance
What are symptoms of physiological arousal to stress?
Fearful anticipation Irritability Sensitivity to noise Poor concentration Worrying thoughts
What are symptoms of autonomic arousal to stress?
GI: dry mouth, swallowing difficulties, dyspepsia, nausea, wind, frequent loose motions
Respiratory: tight chest, difficulty breathing
CVS: palpitations/missed beats, chest pain
Genitourinary: frequency/urgency, amenorrhoea, dysmenorrhoea, erectile feature
CNS: dizziness, sweating
What are symptoms associated with muscle tension in response to stress?
Tremor
Headache
Muscle pain
What are symptoms associated with hyperventilation in response to stress?
Causing CO2 deficit hypocapnia
Numbness tingling in extremities
Breathlessness
What are symptoms associated with sleep disturbance in response to stress?
Initial insomnia
Frequent waking
Nightmares and night terrors
What are the symptoms of generalised anxiety disorder (GAD)?
Persistent (several months) symptoms not confined to a situation or object All symptoms of human anxiety can occur: - psychological arousal - autonomic arousal - muscle tension - hyperventilation - sleep disturbance
What are differential diagnoses of anxiety disorders?
Psychiatric conditions: depression, schizophrenia, dementia, substance misuse
Physical conditions: thyrotoxins, phaechromocytoma, hypoglycaemia, asthma or arrhythmias
Why is GAD usually caused?
A stressor acting on a personality predisposed to the disorder by a combination of genetic factors and environmental influences in childhood
What are the management options for GAD?
Counselling
Relaxation training
Medication
CBT
What are examples of GAD medication?
Sedatives
Antidepressants
What are the risks of using sedatives in GAD?
High risk dependency
What are the key features of phobic anxiety disorders?
Same core features as GAD
Only in specific circumstances
Person avoids phobia
Anticipatory anxiety
What are 3 clinically important syndromes of phobic anxiety disorders?
Specific phobias
Social phobia
Agoraphobia
What symptoms predominate in social phobia?
Blushing
Tremor
Any of anxiety cluster
What is the management of social phobia?
CBT
Education and advice
Antidepressants (SSRI)
What are the core features of OCD?
Recurrent obsessional thoughts and/or compulsive acts
What are examples of obsessional thoughts?
Ideas, images, impulses
Occuring repeatedly not willed
Unpleasant and distressing
Recognised as the individuals own thoughts
Key anxiety symptoms arise because of distress of the thoughts or attempts to resist
What are compulsive acts or rituals?
Stereotypical behaviours repeated again and again
Not enjoyable
Not helpful
