Agarophobia (fear of leaving home and entering crowded places, travelling alone)

Anxiety Disorders Flashcards by Emilia Sykes

What are the 3 models of stress?

Biomechanical “engineering”
Medicophysiological
Psychological (transactional)
- Emphasises interaction between individual and environment
- Environment does not cause stress, but individual response to stressor does

How well did you know this?

Not at all

Perfectly

What are the different foccuses for coping mechanisms?

Problem focussed
- Where stressor is modified
- Such as preparation, studying or interview practice
Emotion focussed
- Modify emotional reaction
- Such as mental defence mechanisms (denial relaxation training) or taking sedative drugs

How well did you know this?

Not at all

Perfectly

What model describes how you need some stress to perform at best?

Yerkes Dodson curve

How well did you know this?

Not at all

Perfectly

What are human reactions to stress producing anxiety?

Psychological arousal
- Fearful anticipation
- Irritability
- Sensitivity to noise
- Poor concentration
- Worrying thoughts
Autonomic arousal
- Symptoms mediated by autonomic nervous system
  - GI
    - Dry mouth
    - Swallowing difficulties
    - Dyspepsia, nausea and wind
    - Frequent loose motions
  - Resp
    - Tight chest, difficulty inhaling
  - CVS
    - Palpitations/missed beats
    - Chest pain
  - Genitourinary
    - Frequency/urgency of micturition
    - Amenorrhoea/dysmenorrhoea
    - Erectile failure
  - CNS
    - Dizziness and sweating
Muscle tension
- Tremor
- Headache
- Muscle pain
Hyperventilation
- Hypocapnia
- Numbness and tingling in extremities due to carpopedal spasm
- Breathlessness
Sleep disturbance
- Initial insomnia
- Frequent waking
- Nightmares and night terrors

How well did you know this?

Not at all

Perfectly

What is seen in psychological arousal in response to stress?

Psychological arousal
- Fearful anticipation
- Irritability
- Sensitivity to noise
- Poor concentration
- Worrying thoughts

How well did you know this?

Not at all

Perfectly

What is seen in autonomic arousal in response to stress?

Autonomic arousal
- Symptoms mediated by autonomic nervous system
  - GI
    - Dry mouth
    - Swallowing difficulties
    - Dyspepsia, nausea and wind
    - Frequent loose motions
  - Resp
    - Tight chest, difficulty inhaling
  - CVS
    - Palpitations/missed beats
    - Chest pain
  - Genitourinary
    - Frequency/urgency of micturition
    - Amenorrhoea/dysmenorrhoea
    - Erectile failure
  - CNS
    - Dizziness and sweating

How well did you know this?

Not at all

Perfectly

What are signs of muscle tension in response to stress?

Muscle tension
- Tremor
- Headache
- Muscle pain

How well did you know this?

Not at all

Perfectly

What is seen in hyperventilation in response to stress?

Hyperventilation
- Hypocapnia
- Numbness and tingling in extremities due to carpopedal spasm
- Breathlessness

How well did you know this?

Not at all

Perfectly

What are signs of sleep disturbances in response to stress?

Sleep disturbance
- Initial insomnia
- Frequent waking
- Nightmares and night terrors

How well did you know this?

Not at all

Perfectly

What is the difference between phobic anxiety disorders and general anxiety disorders?

Both have same core anxiety symptoms but the either occur in particular circumstances:

Phobias
- Agarophobia (fear of leaving home and entering crowded places, travelling alone)
- Social phobia
- Specific (isolated) phobias
General anxiety disorder (GAD)
- Occurs persistently

How well did you know this?

Not at all

Perfectly

What does GAD stand for?

General anxiety disorder

How well did you know this?

Not at all

Perfectly

What are different kinds of phobias?

Agarophobia (fear of leaving home and entering crowded places, travelling alone)
Social phobia
Specific (isolated) phobias

How well did you know this?

Not at all

Perfectly

What is agarophobia?

Agarophobia (fear of leaving home and entering crowded places, travelling alone)

How well did you know this?

Not at all

Perfectly

Pathology - generalised anxiety disorders

Persistent (several months) and symptoms not confined to a situation or object

How well did you know this?

Not at all

Perfectly

Aetiology - generalised anxiety disorders

No clear line between “normal” anxiety and anxiety disorders
- Differ in extent of symptoms and durations
Stressor acting on personality predisposed to disorder
- Due to genetic factors and environmental influences since childhood

How well did you know this?

Not at all

Perfectly

Epidemiology - generalised anxiety disorders

(sex, prevalence)

W>M
Prevalence 5%

Presentation - generalised anxiety disorders

Psychological arousal
Autonomic arousal
Muscle tension
Hyperventilation
Sleep disturbance

Differential diagnosis - generalised anxiety disorders

Psychiatric conditions
- Depression
- Schizophrenia
- Dementia
- Substance misuse
Physical conditions
- Thyrotoxocosis
- Phaeochromoctoma
- Hypoglycaemia
- Asthma

Management - generalised anxiety disorders

Counselling
- Clear plan of management
- Explanation and education
- Advice regarding caffeine, alcohol, exercise
Relaxation training
Medication
- Antideppresants
  - SSRI
  - TCA
- Not sedatives as high risk dependency
Cognitive behavioural therapy (CBT)

Classification - phobic anxiety disorders

3 clinically important syndromes
- Specific phobia
  - Common ones include: heights, blood, germs, dentist
- Social phobia
  - Anxiety in situations where person feels observed or could be criticised
  - Normal presentation combined with blushing and tremor
- Agorophobia

Presentation - phobic anxiety disorders

Same core features as general anxiety but occur only in specific circumstances

Complications - phobic anxiety disorders

Leads to people avoiding these circumstances
Could lead to panic attack

Management - social phobia

CBT
Education and advice
Medication
- SSRI antideppresants

What are the core features of OCD?

Core features are experience of recurrent obsessional thoughts and/or compulsive acts

What are obsessive thoughts?

* Ideas, images or impulse * Occurring repeatedly and not willed * Unpleasant and distressing * Recognised as individual’s own thoughts * Usual key anxiety symptoms arise because of distress of the thoughts or attempts to resist

What are compulsive acts of rituals?

* Behaviours that are repeated again and again * Not enjoyable * Not helpful * Viewed by sufferer as * Preventing some harm to self or others * Viewed as pointless and resisted with key anxiety symptoms accompanying resistance

What are the rituals during OCD viewed as by the patient?

* Viewed by sufferer as * Preventing some harm to self or others * Viewed as pointless and resisted with key anxiety symptoms accompanying resistance

Aetiology - OCD

* Genetic * Gene coding for 5HT receptors * 5HT function abnormalities

Epidemiology - OCD | (prevalence, sex)

* Prevalence 2% * M=F

Management - OCD

* General measures * Education and explanation * Involve partner/family * Serotonergic drugs * SSRI such as Fluoxetine * Clomipramine * CBT * Psychosurgery

Pathology - PTSD

Delayed and/or protracted reaction to a stressor of exceptional severity (would distress anyone), could be: * Combat * Natural or human0caused disaster * Rape * Assault * Torture * Witnessing any of the above

What are some things that could cause PTSD?

* Combat * Natural or human0caused disaster * Rape * Assault * Torture * Witnessing any of the above

Aetiology - OCD

* Stressful event which is of exceptional severity * Vulnerability factors * Mood disorder * Previous trauma – especially as child * Lack of social support * Female * Protective factors * Higher education and social group * Good paternal relationship

What are vulnerability and protective factors for OCD?

* Vulnerability factors * Mood disorder * Previous trauma – especially as child * Lack of social support * Female * Protective factors * Higher education and social group * Good paternal relationship

Epidemiology - OCD | (prevalence, sex)

* 1-4% 1 year prevalence * M:F 1:2

Presentation - OCD

* 3 key elements to reaction * Hyperarousal * Persistent anxiety * Irritability * Insomnia * Poor concentration * Re-experiencing phenomena * Intense intrusive images * Flashbacks when awake * Nightmares during sleep * Avoiding reminders * Emotional numbness * Cue avoidance * Recall difficulties * Can happen months/years after event

What are the 3 key elements to OCD reaction?

* Hyperarousal * Persistent anxiety * Irritability * Insomnia * Poor concentration * Re-experiencing phenomena * Intense intrusive images * Flashbacks when awake * Nightmares during sleep * Avoiding reminders * Emotional numbness * Cue avoidance * Recall difficulties

Management - OCD

* Survivors of disasters screened at 1 month * Mild symptoms * Watchful waiting and review 1 month on * More severe symptoms * CBT * Eye movement desensitisation and reprocessing * Medication * SSRI or TCA