Anxiety Disorders Flashcards
What are three models of stress?
Biomechanical (engineering) - something about the patients environment has changed and is placing stress on them
Medicophysiological - any response to stress that triggers the flight or fight response in the patient
Psychological (transactional)
What are the three stages of the medicophysiological stress response?
Alarm response
Physiological adaptation to the stressor
Exhaustion (burnout)
Describe the psychological (transactional) stress model
The patient’s cognitive processive of an event determines whether or not they will find it stressful
If they find it stressful their ability to cope will determine whether or not the patient will become overwhelmed
Depends on the patients perception of threat and ability to cope with adversity
What are the two methods of coping that a patient can employ?
Problem focussed - coping based on modifying the stressor, preparation. (eg. studying for an exam)
Emotion focussed - coping based on modifying the mental reaction, mental defence mechanisms such as denial / relaxation training
Best to use both in tandem
Give some examples of autonomic physiological reactions to stress?
Gastrointestinal - dry mouth, swallowing difficulties, dyspepsia
Respiratory - tight chest, difficulty inhaling
Cardio - palpitations, chest pain
Genitourinary - frequency and urgeny of micturition, erectile failure, amenorrhoea
CNS - dizziness and sweating
What are some other important physiological responses to stress?
Muscle tension
- Tremor, headache, muscle pain
Hyperventilation
- CO2 deficit hypocapnia, numbness and tingling leading to carpopedal spasm, breathlessness
Sleep disturbance
- Initial insomnia, frequent waking, nightmares and night terrors
What’s the difference between phobic anxiety disorders and generalized anxiety disorders?
Phobic anxiety disorders tend to occur in specific situations whereas generalized anxiety disorders tend to occur in general
What is agoraphobia?
Phobia of being in situations like going into public places, shops, public transport
What is the approximate prevalence of generalized anxiety disorders? Which gender is more commonly affected?
4.4%
Women (although men may be underdiagnosed)
What is general anxiety disorder caused by?
A stressor acting on a personality that is predisposed to the disorder by a combination of genetic and environmental influences in childhood
How is general anxiety disorder managed?
Counselling: education, planning and advice
Relaxation training
Medication
- Antidepressants (sedatives usually avoided due to dependency risks)
Cognitive behavioural therapy
What do patients often do to manage their phobic anxiety?
Avoid the stressor completely (eg. avoid flying if they have a fear of flying)
Sufferer also experiences anticipatory anxiety if there is a percieved threat of encountering the stressor
What is social phobia?
A fear of scrutiny from other people that leads to a phobia of social situations
How are social phobias treated?
Cognitive behavioural therapy
Antidepressants - SSRI’s
What is OCD characterized by?
Obsessional thoughts - highly recurring thoughts that enter the patients mind
Compulsional behaviours - stereotypical behaviours that are not enjoyable or helpful but are repeated again and again
