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Block 3 > Anxiety & Stress > Flashcards

Anxiety & Stress Flashcards

1
Q

What is anxiety disorder?

A

An abnormal extreme, unnecessary and pathological fear and anxiety starts to take over individuals lives

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2
Q

What is general anxiety disorder (GAD)?

A

One of a range of anxiety disorders inc. panic disorder, PTSD, OCD, social phobia, specific phobias (e.g. of spiders) and acute stress disorder

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3
Q

What are some psychological symptoms of general anxiety disorder (GAD)?

A
  • Worry (difficult to control) leading to decreased occupational and social functioning
  • Interrupted sleep
  • Poor concentration
  • Increased sensitivity to noise
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4
Q

What are physical symptoms of general anxiety disorder (GAD) due to overactive ANS?

A
  • Sweating
  • Dry mouth
  • Urinary frequency
  • Hyperventilation (SOB + dizziness)
  • Palpitations
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5
Q

What is the DSM-IV diagnostic definition of general anxiety disorder (GAD)?

A

Excessive anxiety and worry that is difficult to control, occurring more days than not for at least 6 months, about a no. of events or activities (such as work or school performance)

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6
Q

Anxiety and worry are associated with three or more of the following 6 symptoms:

A
  1. Restlessness or feeling keyed up or on edge
  2. Being easily fatigued
  3. Difficulty concentrating or mind going blank/forgetfulness
  4. Irritability/sensitized to situations
  5. Muscle tension
  6. Sleep disturbance (difficulty falling or staying asleep or restless unsatisfying sleep)
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7
Q

What impacts can general anxiety disorder (GAD) have?

A
  • Chronic
  • Can occur with other physical conditions e.g. chronic pain
  • Daily living
  • Work
  • Social interactions
  • Relationships
  • Suicidal ideation and attempts are higher
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8
Q

What gives a person a predisposition to general anxiety disorder (GAD)?

A
  • Bio-psycho-social factors
  • Brain imaging studies show neural activity associated with abnormal cognitions e.g. increased attention to threat
  • Social environment (e.g. early childhood)
  • Perceived control (i.e. if lower than normal)
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9
Q

How can individuals cope with anxiety?

A
  1. Pharmacologically
  2. Relaxation/Mindfulness
  3. CBT
  4. Thought diary
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10
Q

What is Cognitive Behavioural Therapy (CBT)?

A

Helping patients to learn the link between physiological changes and the psychological response - teach them how there thoughts, emotions and behaviour interact giving them skills to adapt thoughts and helping them to gain back control

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11
Q

What are the 3 different types of anxiety-related thought patterns?

A
  1. Selective attention: seeing only the -ve features of an event
  2. Magnification: exaggerating the importance of undesirable events
  3. Overgeneralisation: drawing broad -ve conclusions on the basis of a single insignificant event
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12
Q

What are the 4 classes of effect of stress? Give a few examples of each.

A
  1. Affective: shock, distress, anxiety, fear, depression, anger
  2. Behavioural: smoking, alcohol, illicit drugs, sexual function
  3. Cognitive: poor attention, errors in decision-making, hypervigilance for threats, memory loss
  4. Physiological: activation of NS, hormone production, immune function, fatigue
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13
Q

Stress not only increases risk of illness amongst the healthy but also:

A

Impedes recovery/worsens prognosis among the ill

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14
Q

What are the results on the ward of a stress-in patient?

A
  • Slower wound healing
  • More post-surgery complications
  • Longer in-patient stay
  • More staff time per day
  • More analgesia use
  • Less satisfaction with treatment (associated with poor adherence)
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15
Q

What are the effects after discharge of a stressed in-patient?

A
  • Longer recovery (e.g. return to work)
  • More service use (e.g. related symptoms)
  • Less use of rehabilitation services
  • Increased risk of co-morbidity and early mortality
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16
Q

What are the 3 perspectives to understanding stress?

A
  1. Stimulus: focus on cause (stressor)
  2. Response
    (physiological) : focus on effect

BUT cannot look at these individually as everyone responds differently to stress so look at:

  1. Process: focus on person-environment interaction (transaction)
17
Q

What is the fight or flight response?

A
  1. CNS activates SNS acute stress response
  2. Increased HR, BP, RR, glycogenolysis, peripheral diversion of blood + cortisol
  3. Decreased immune surveillance, gut function, kidney function, fat stores + sex steroids
18
Q

What is the rest and digest response?

A
  1. CNS activates the PNS conservation response
  2. Decreased HR, BP, RR, glycogenolysis, peripheral diversion of blood + cortisol
  3. Increased immune surveillance, gut function, kidney function, fat stores + sex steroids
19
Q

Why do we get physiological symptoms of stress?

A

As stress will naturally activate our SNS acute stress response when it is not needed

20
Q

What is stress?

A

Non-specific physiological response to a threat to one’s physical or emotional well-being

21
Q

What are the 3 stages of physiological response to stress?

A
  1. Alarm: fight or flight response - nervous, endocrine + immune systems activated for defence against threat initially
  2. Resistance: conservation response initiated to return homeostasis but becomes counterproductive if alarm continues
  3. Exhaustion: depletion of physiological resources - collapse of adaptive responses, immune failures + disease outcomes
22
Q

What is the direct and indirect subjective process of stress?

A
  1. Direct: stimulus event causes stress response
  2. Indirect: stimulus events causes appraisal + coping and then the stress response happens (changes reaction to stress to a healthy one)
23
Q

What is the transactional model of stress?

A

Causal chain of influence where the stimulus events are indirectly related to stress experience as there are processes of appraisal and coping intervene in the stressor-stress relationship and stress then comes about as a subjective post-appraisal outcome

24
Q

What are the steps of the transactional model of stress?

A
  1. Stimulus event (potential stressor)
  2. Primary appraisal (event demands)
  3. Secondary appraisal (oneself)
  4. Response (coping)
  5. Health-related outcome (stress)
25
Q

Describe the steps in the intervening process in the transactional model of stress.

A
  1. Primary appraisal: determines adaptational significance of event i.e. is event relevant to me, what are its demands and if so, is it a challenge, harm or threat?
  2. Secondary appraisal: evaluates available response options + opportunities i.e. am I able to copy adequately with the events adaptational demands? Do I need help to do so?
  3. Coping: cognitive + behavioural activities initiated in response to the appraisal process in order to manage the adaptational demands of the event and evaluation of coping
26
Q

What is problem-focused coping and when is it effective?

A

Attempt to manage or change concrete aspects of the stressor - most effective when stressor is amenable to change e.g. medical school stress as students can revise and get help from students/staff to help

27
Q

What is emotion-focused coping and when is it effective?

A

Attempt to remove or reduce the emotional distress of a situation (e.g. mindfulness/relavation) - most effective when stressor cannot be changed e.g. chronic pain

28
Q

What are the sources of stress and anxiety in the medical profession?

A
  1. Job: workload, time pressure, admin duties, sleep deprivation, no regular meals + threat of malpractice suits
  2. Organisation: career structure, career uncertainties, lack or resources + support, culture + climate of the organisation
  3. Individual: personality, high demands on self/others, dealing with death/dying
  4. Relationship with others: staff conflicts, bullying, professional isolation, patient expectations/demands
  5. Work-life balance: stress over-spill from work to home life + vice versa, lack of free time/exercise + leisure activities, home demands + disruption to social life
29
Q

Why did medical students felt stress impact on their patient care?

A 
Tiredness
Pressured by overwork
Depression/anxiety
Alcohol effects
Irritability/anger
30
Q

What are good techniques for stress and anxiety management?

A
  1. Relaxation (visualisation/imagery, progressive or passive muscles relaxation + autogenic relaxation)
  2. Mindfulness
  3. CBT
  4. Counselling
  5. Pharmacotherapy
  6. Self-help

Block 3 (40 decks)

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