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NSB Lectures > Anxiety & Stress-Related Disorders > Flashcards

Anxiety & Stress-Related Disorders Flashcards

1
Q

What are the two main literature books used for diagnoses in psychiatry?

A

ICD-11 (International Classification of Disease)

DSM-5 = (Diagnosis and Statistical Manual of Mental Disorders)

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2
Q

How has stress changed with evolution of mankind?

A

Has gone from being more acute fight / flight stresses to a more chronic stress on a daily basis

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3
Q

What is a stressor?

A

An event or situation that causes stress.

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4
Q

What did Holmes & Rahe develop?

A

The social readjustment rating scale - determines how stressful an event is deemed on a numeric scale.

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5
Q

What three types of response can you have to a stressor?

A

Somatic response
Emotional response
Psychological response

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6
Q

What is a somatic response?

A

A physical response (e.g. activation of fight / flight system) = Inc HR, BR, sweating

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7
Q

What is the difference between anxiety and fear?

A

Fear is what we experience when there is a real danger in front of us.

Anxiety = the experience we have when there is a threat of danger.

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8
Q

What is the emotional response to danger?

A

Fear

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9
Q

What is fear?

A

An emotional response to danger

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10
Q

What is anxiety?

A

An emotional response to threat of danger

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11
Q

What is depression?

A

An emotional response to separation / loss

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12
Q

Name three potentially helpful responses to stress.

A

Avoidance / denial (in the short term)

Working out how to remove / resole the problem

Coming to terms with the problem

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13
Q

Name three maladaptive ways Ps deal with stress

A

Alcohol / drug misuse

Aggressive / exaggerated behaviours

Deliberate self-harm

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14
Q

If someone undergoes an exceptionally stressful event - what is the immediate response to this known as?

A

Acute stress reaction

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15
Q

What is an acute stress reaction?

A

Severe symptoms of the normal stress reaction - that usually appear within a few hours to days after the stressor event

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16
Q

When does the acute stress reaction usually resolve?

A

Normally within a few days of the event / removal of threat.

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17
Q

How long can a patient be termed to be suffering from acute stress reaction? What does it become if it persists beyond this point?

A

Up to one month = ongoing acute stress reaction.

After one month = PTSD

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18
Q

What symptoms can indicate an acute stress reaction?

A

Dissociative symptoms
Insomina
Restlessness
Poor concentration
Autonomic arousal
Anger / anxiety / depression
Social withdrawal

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19
Q

What are dissociative symptoms?

A

Emotional numbness - feel like being in a daze, can cause inability to recall the stressful event

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20
Q

What are the two main types of dissociative symptoms?

A

Depersonalisation

Derealisation

Can have both at the same time

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21
Q

What is depersonalisation?

A

Feeling of disconnection within yourself & from other people - that you feel unreal and detected, and that your thoughts and feelings are of those of another person - feel separated via a pane of glass. Watching yourself from afar in 3rd person.

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22
Q

What is derealisation?

A

World around you is unreal.

This can feel as if reality is a dream, a TV show, or that it’s fake and could cease to exist at any moment. It can feel like you’re seeing the world from inside a glass bubble. You can feel a disconnection from the people around you, as if they’re actors or robots. Colours , objects, the whole world can look like it’s flat, 2D and unreal.

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23
Q

What is it called when the P has an out of proportion response to a stressor, with more gradual onset and prolonged response?

A

Adjustment disorder

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24
Q

What does adjustment disorder arise from?

A

As a direct consequence of acute stress or ongoing stress.

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25
Q

How can you differentiate between adjustment disorder and other behavioural disorders?

A

The adjustment disorder would not have arisen had it not been for the presence of the stressor in the P’s life.

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26
Q

What is PTSD?

A

A response to an exceptionally threatening or catastrophic event - with symptoms that last for at least a month.

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27
Q

What are PTSD symptoms?

A

Increased arousal
Dissociative symptoms
Hypervigilance / startle
Flashbacks / nightmares
Avoiding reminders of the stressful event
Maladaptive coping strategies

28
Q

What is the minimum period of time that has to pass from the stressor before a diagnosis of PTSD can be confirmed?

A

1 month

29
Q

What percentage of PTSD recover within 3 months and what percentage develop chronic PTSD?

A

30%

30%

30
Q

Give an example of an anxiety disorder in which the P feels anxious all the time.

A

Generalised anxiety disorder

31
Q

What is an anxiety disorder that is experience by a P only in a specific situation (e.g. spider runs over Hannah’s hand)?

A

Phobia

32
Q

Which anxiety disorder can be experienced by a P for intermittent periods of time but irrelevant of the situation the P is in?

A

Panic disorder

33
Q

What is OCD termed as?

A

An anxiety disorder

34
Q

What are the general symptoms of anxiety disorders?

A

Psychological arousal
Autonomic arousal (F or F)
Muscle tension
Hyperventilation
Sleep disturbance

35
Q

How can psychological arousal present in anxiety?

A

Fearful Ps
Irritability
Restlessness
Poor concentration
Worry

36
Q

How does autonomic arousal present in anxious patients?

A

Respiratory - tightness & SOB

GI - dry mouth, swallowing inhibition, epigastric pain & diarrhoea

CVS - palpitations & discomfort

GUI - need to wee, failure of erection, menstrual discomfort

37
Q

What are the muscle symptoms of anxiety?

A

Tremor
Headaches
Aching muscles

38
Q

What are the symptoms of hyperventilation?

A

Dizziness
Tingling hands & feet
Feeling breathless

39
Q

What sleep disturbances can you have with anxiety?

A

Insomnia
Night terrors

40
Q

What is the disorder when symptoms of anxiety persist all the time and are not restricted to a specific set of circumstances?

A

Generalised anxiety disorder

41
Q

What symptoms are often found with generalised anxiety disorder?

A

Worry
Fearful apprehension
Headache
Irritability
Poor concentration
Autonomic arousal
Sleep disturbances

42
Q

What symptoms can also be found in conjunction with generalised anxiety disorder?

A

Depersonalisation
Low mood
Fixation with detail

43
Q

What other differentials can there be for generalised anxiety disorder?

A

Other anxiety disorders
Depressive illnesses
Schizophrenia
Dementia
Substance misuse
Physical illness

44
Q

Who is more likely to be affected by generalised anxiety disorder?

A

Females more than males (2:1)

Also associated with
- Lower income, unemployment, divorced/separated Ps

45
Q

What are the possible causes of generalised anxiety disorder?

A

Not really known for sure - but combination of

  • Stressful events
  • Genetic
  • Early adverse experiences

Are also cognitive theories and neurobiological mechanisms which can account for a diagnosis of GAD.

46
Q

Which disorder means the P has recurrent panic attacks that are not in response to a phobic stimulus?

A

Panic disorder

47
Q

How long do panic attacks last?

A

2-3 minutes

48
Q

What are the symptoms of a panic attack?

A

Sudden onset of severe anxiety symptoms
Palpitations
Sensation of being unable to breathe / choking
Dizziness and faintness
Dissociation
Chest pain
Fear of dying
Fear of losing control / sanity

49
Q

What does hyperventilation cause?

A

Reduced CO2 in blood -> dizziness, tingling, tinnitus, weakness, faintness, SOB

50
Q

What are the risk factors for panic disorder?

A

Genetics (x7 if first degree relative)

Precipitating events (stressful life events)

Traumatic early life events

51
Q

What can phobias be divided into?

A

Specific phobias
Agoraphobia
Social anxiety disorders

52
Q

When do most specific phobias begin?

A

Childhood

53
Q

What are the symptoms of a specific phobia?

A

Phobia regarding specific circumstances - with anticipatory anxiety + intense anxiety + avoidance

54
Q

Why do some patients faint with phobias?

A

There is a biphasic anxiety reaction - initial short SS arousal followed by PSS arousal = vasovagal syncope

55
Q

What are the causes of specific phobias?

A

Genetics

Classical conditioning

Biological preparedness hypothesis

56
Q

What is the biological preparedness hypothesis?

A

That today’s commonly feared stimuli are those historically linked to threatening the survival of the species - and that we are genetically more prepared to learn to fear these stimuli.

57
Q

Which disorder affects a P by giving inappropriate anxiety regarding social interactions / being observed by others?

A

Social anxiety disoder

58
Q

What are the symptoms of social anxiety disorder?

A

Anticipatory anxiety
Anxiety
Blushing
Trembling
Nausea

59
Q

What can social anxiety disorder be relieved by in the short term?

A

Alcohol

60
Q

Which disorder means Ps have intense fear and anxiety in situations which might make escape difficult and/or fear that help may not be available?

A

Agoraphobia

61
Q

What do Ps with agoraphobia fear?

A

Confinement

Crowding

Distance from home (especially when alone)

62
Q

What are the clinical features of agoraphobia?

A

Anxiety symptoms and panic attacks about loss of control - leading to extreme avoidance of these situations.

63
Q

Which disorder means the P suffers with obsessional thinking and compulsive behaviour?

A

Obsessive Compulsive Disorder

64
Q

What other psychiatric symptoms can present with OCD?

A

Anxiety
Depression
Depersonalisation

65
Q

What are obsessional thoughts?

A

Thoughts / doubts / impulses which intrude forcibly into the mind. They cannot be resisted, usually unpleasant and are unwanted intrusions.

66
Q

What are compulsive behaviours?

A

Repetitive, purposeful behaviours carried out in a stereotyped way in response to an obsession.

67
Q

What are thought to be the risk factors for OCD?

A

Genetic link

Brain disorder evidence (encephalitis & Sydenham’s chorea)

Neurobiological factors

Also are psychoanalytic and cognitive theories

NSB Lectures (48 decks)

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