Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatry > Management of Anxiety Disorders > Flashcards

Management of Anxiety Disorders Flashcards

1
Q

Before management of any anxiety disorder what first needs to be ruled out?

A
  • medical condition
  • medication
  • toxin
  • alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When working to change beliefs in the management of anxiety disorder what are three levels of belief that exist?

A
  • Automatic thoughts (thoughts pop into mind automatically e.g. sensations/feelings/images)
  • assumptions
  • early maladaptive schema (deeprooted unconditional basic beliefs that stem from childhood and are less accessable - they shape and colour assumptions/automatic thoughts, they are more resistant to change as are pervasive and stable)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

describe how early maladaptive schemas develop into automatic thoughts

A

early life experiences > early maladaptive schema > dysfunctional assumptions > activating event ? automatic -ve thoughts > mood/behavior/physiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the resonance phenomena?

A

Tend to tune into frequencies we’re familiar with which is directly influenced by our underlying beliefs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

describe 5 psychological methods used to manage anxiety disorders

A
  • thought record sheet
  • considering alternatives
  • developing a wise mind concept
  • increasing the window of tolerance
  • CBT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is involved when creating a thought record sheet when managing anxiety disorders? what is the aim?

A

To help rationalise thoughts

  • situation
  • symptom
  • beliefs (AT)
  • evidence for
  • evidence against
  • balanced thought
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is involved in ‘considering alternatives’ when managing anxiety disorders?

A
  • Disorder e.g. PTSD
  • existing belief e.g. I am in danger
  • alternative belief e.g. it is in the past, i am ok now
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When managing anxiety disorders, what is ‘developing a wise mind concept’?

A

a wise mind is an overlap of the emotional mind and the rational mind

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When managing anxiety disorders what does it mean to increase the window of tolerance? what is the window of tolerance?

A

In between the hyper-aroused state and the hypo-aroused state there is a window of tolerance - aim to stay in here.
-window of tolerance is e.g. comfort zone/ability to self soothe/ability to be emotionally regulated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe what a hyper aroused state is in anxiety disorders?

A

flight/fight response

e. g:
- anxiety
- overwhelmed
- chaotic responses
- outbursts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe what a hypo aroused state is in anxiety disorders?

A

Freeze response

e. g.
- memory loss
- shut down
- dissociation
- auto pilot
- no display of emotion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe some methods used to stay in or widen the window of tolerance

A
  • mindfulness
  • deep slow breathing
  • recognise limiting beliefs and counter these with positive statements
  • techniques for self soothing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When managing anxiety disorders what is the difference between top down processing and down up processing?

A

top down - working on cognitions/adaptive behavior

down up - working with physiological reactions/emotions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the 6 different types of anxiolytic drugs? (one type is not recommended)

A 
1 - barbiturates (not recommended)
2 - Benzodiazepines
3 - antidepressant drugs
4 - Buspirone
5 - Pregabalin
6 - B-Blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give examples of benzodiazepines and list their 6 pharmacological effects

A

Diazepam/Lorazepam/Nitrazepam…etc

  • reduce anxiety
  • reduce aggression
  • hypnosis/sedation
  • muscle relaxant
  • anticonvulsant effect
  • anteretrograde amnesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do benzodiazepines work?

A

bind to GABA receptors and allow more Cl- in than if just GABA binds

17
Q

What is GABA? What is the effect of GABA?

A

Gamma Amino Butyric Acid
-main inhibitory neurotransmitter in brain (Glycine is another inhibitory neurotransmitter restricted to the brain and spinal cord)
-widespread distribution
Causes hyperpolarisation of target cells by allowing CL- in.

18
Q

Describe the role of GABA in anxiety

A
  • all receptor modulators GABA exhibit anxiolytic properties
  • inverse BDZ agonists have anxiogenic properties
  • GABA antagonist (Flumazenil - antedote for BZD’s) can increase anxiety
19
Q

What is the antidote for benzodiazepines?

A

flumazenil

20
Q

List the 8 uses of benzodiazepines?

A
  • Acute treatment of extreme anxiety
  • hypnosis
  • Alcohol withdrawal
  • Mania
  • Delirium
  • Rapid tranquilisation
  • status epilepticus
  • premedication before sugery or during minor procedures
21
Q

Are benzodiazepines safe in overdose

A
  • Fairly safe
  • can cause respiratory depression (unlikely)
  • can give flumazenil
22
Q

What are the main adverse effects of benzodiazepines?

A
  • anteretrograde amnesia and impaired co-ordination (rohypnol is a benzo)
  • paradoxical depression
  • Causes tolerance and dependence: rebound anxiet on withdrawal +/- physical symptoms
23
Q

Describe what happens in benzodiazepine withdrawal, what can happen in rapid withdrawal?

A

Rapid withdrawal may = confusion/toxic psychosis and even convulsions
-insomnia/appetite loss/anxiety/wt loss/tremor/perspiration/tinnitus/perceptual disturbance

24
Q

What can happen to the body’s response to GABA with chronic benzodiazepine use? how could this be explained?

A
  • decrease in the body’s response to GABA

- withdrawal symptoms may be due to decrease in the number of GABA receptor receptors.

25
Q

What are the 4 steps involved in withdrawal from benzodiazepines?

A

1 - transfer patient to daily dose of diazepam/chlordiazepam (preferably taken at night)
2 - decrease dose every 2-3 weeks in steps of 2 to 2.5 mg (if symptoms occur maintain dose until improvement)
3 - decrease dose further and in smaller steps if necessary (too slow is better than too quick)
4 - stop completely, this may take 4 weeks to a year or more.

26
Q

Which antidepressants are used in anxiety? (4)

A

1 - SSRIs: panic disorder/OCD/PTSD/Phobias/GAD
(for GAD use escitalopram/fluoxetine)
2 - Tricyclic: 2nd line for panic disorder (unlicensed)/OCD
3 - Venlafaxine: GAD
4 - Moclobemide: social anxiety disorder (this is a new MAOI with no food/drug interactions)

27
Q

What is the effect of MAOI on anxiety?

A

anxiogenic stimuli cause:

  • an increase in noradrenaline release from neurons projecting to hippocampus and prefrontal cortex
  • an increase in serotonin release from neurons projecting to dorsal raphe nucleus
  • MAOI can block this increase (as can BDZ’s)
28
Q

Describe the role of SSRI’s in anxiety management

A

Acutely they cause an increase in serotonin and have anxiogenic properties however chronically they have an anxiolytic effect (mechanism not understood)
=will cause and increase in anxiety first before working anxiolytically.

29
Q

What is buspirone? What is it’s role in anxiety management?

A

5-HT1a agonist

-relatively weak anxiolytic in animals and humans and shows slow onset

30
Q

What is pregabalins role in anxiety management?

A

‘new’ BZD licensed for chronic pain.
calcium channel blocker and GABA enhancer.
Only considered if unresponsive to other treatments

31
Q

What are B-blockers role in anxiety?

A

-best for somatic symptoms e.g. palpitations

unlikely to work as primary treatment.

Psychiatry (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions