Anxiety & Stress

Question 1

Describe the psychological symptoms of GAD

Answer 1

• Worry (difficult to control) - could lead to decreased occupational and social functioning
• interrupted sleep
• poor concentration
• increased sensitivity to noise

Question 2

Describe the physical symptoms of GAD

Answer 2

overactive autonomic nervous system

• sweating
• dry mouth
• urinary frequency
• hyperventilation (SOB + dizziness)
• Palpitations

Question 3

Describe the different methods of treating/coping with anxiety

Answer 3

• Pharmacology
• Relaxation - Mindfulness
• CBT: learning the link between physiological changes and the psychological responses
• Thought diary - emotions associated with physical symptoms

Question 4

What are selective attention, magnification and overgeneralisation?

Answer 4

Selective attention: seeing only the negative features of an event

Magnification: Exaggerating the importance of undesirable events

Overgeneralisation: Drawing broad negative conclusions on the basis of a single insignificant event

Question 5

What are the 4 classes of effect of stress?

Answer 5

1. Affective: shock, distress, anxiety, fear, depression, anger, frustration, lowered self-esteem, guilt
2. Behavioural: Smoking, alcohol, help seeking delat, poor adherence, relapse, social withdrawal, illicit drugs, sexual function
3. Cognitive: Poor attention, errors in decision making, hypervigilence for threats, bias to interpret ambiguous events as threatening, memory loss and learning is difficult
4. Psychological: Activation of nervous system, hormone production, metabolic function, immune function, fatigue, disease and illness

Question 6

What effect does stress have on patients on the ward and after discharge?

Answer 6

On the ward:

• Slower wound healing
• More post-surgery complications
• longer in-patient stay
• more staff time per day
• more analgesia use
• less satisfaction with treatment - assoc with poor adherence

After discharge:

• 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

Stress not only increases risk of illness among the healthy but also impedes recovery and worsens prognosis in the ill.

Question 7

Describe the physiological response to stress: