Week 2 Flashcards
What is meant by anxiolytic?
Anti anxiety
What is stress?
Perceived imbalance between demands (pressure) and resources (ability to cope)
What is the difference between distress and eustress?
Distress - negative
Eustress - positive
In the transactional model of stress, what is primary appraisal?
Evaluation of potential threat e.g. Irrelevant, challenge, harm
In the transactional model of stress, what is secondary appraisal?
Evaluation of controllability and coping resources
What are some cognitive symptoms of distress?
Worry, apprehension, confusion, indivisible, irritable, agitation
What are some somatic symptoms of distress?
Raging heart, tense muscles, perspiration, nausea, loss of appetite
What are some behavioural symptoms of distress?
Nail biting, clumsiness, avoidance, substance use, tearfulness
What is the flight or fight response?
Linked to somatic stress - sense heightened to maximise success
Enables us to save ourselves from certain dangers
Comes from the autogenic nervous system
What is general adaptation syndrome?
Alarm stage
- arousal
- fight/flight
Resistance stage
- adaptation
- protection
Exhaustion stage
- overload
- stress related illness
What are psychological stressors?
Stress response frequently activated despite no physical danger
What is the impact of prolonged stress on the body - neck?
Sore throat
Mouth ulcers
What is the impact of prolonged stress on the body - arteries?
High BP
Cholesterol
Stroke
What is the impact of prolonged stress on the body - lungs?
Cough
Cold
Asthma
What is the impact of prolonged stress on the body - liver/pancreas?
Liver disease
Diabetes
What is the impact of prolonged stress on the body - sex glands?
Irregular periods
Low libido
Night sweats
What is the impact of prolonged stress on the body - hair?
Hair loss/thinning
What is the impact of prolonged stress on the body - muscles/joints?
Pain
Tension
Fluid retention
Fibromyalgia
What is the impact of prolonged stress on the body - heart?
Heart disease
Irregular heart beat
What is the impact of prolonged stress on the body - stomach?
Ulcers Malnutrition Anorexia IBS Constipation
What is the impact of prolonged stress on the body - brain?
Depression Anxiety Insomnia Low energy Migraines
What is the impact of prolonged stress on the body - skin?
Ageing
Acne
Eczema
Allergies
How is the 1998 football world cup used as an example of psychological stress and cardiovascular health?
Hospital admissions for myocardial infarctions on the day, and two days after England lost penalty shoot out
Admissions rate 25% higher than in previous month and on the same date in 1997 and 1999
What is the role of exercise in managing stress?
Stress response occurs in anticipation of physical action but mobilised energy unused
Regular exercise is a natural way of counteracting this metabolic disturbance to prevent harmful effects
Temporary distraction from stressful stimuli
Physical fitness leads to reduced stress activity
What did a meta analysis of 34 studies of the effect of aerobic fitness on resistance to psychological stressors in the lab show?
Higher effect size (greater reduction) for HR, BP, muscle tension, skin responses, self report
Protective/inoculation mechanism - reduced physiological response to stressors
Recovery/coping mechanisms - faster recovery of nervous system
What is anxiety?
Feelings of fear, worry, apprehension, accompanied by somatic symptoms and behavioural responses.
State - situational
Trait - predispositional
Clinical - functional impairment
What is generalised anxiety disorder?
Non specific persistent anxiety
What is panic disorder?
Recurrent brief attacks of intense anxiety
What is agoraphobia?
Anxiety in situations where you feel escape is hard
What is social phobia?
Anxiety regarding social situations
What are specific phobias?
Intense irrational fear of specific objects/situations
What are the defining features of generalised anxiety?
Excessive worry about many things Difficulty controlling the worry Restlessness Fatigue Concentration problems Irritability Muscle tension
What is the diagnostic criteria (DSM-V) for generalised anxiety disorder?
Excessive worry that is difficult to control for 6 or more months most days and 3 or more symptoms
What is panic disorder?
Recurrent panic attacks along with fear of consequences and/or avoidance behaviour for 1 or more months.
What are the symptoms of panic attacks?
Palpitations Nausea Sweating Dizziness Shaking/trembling Shortness of breath Choking sensation Chest pain Numbness Fear of losing control
What was the effect of clomipramine in an exercise intervention for panic disorder?
First few weeks steep drop in anxiety, for med, exercise group and placebo group
Placebo then increases again, clomipramine decreases more rapidly than exercise effect but both approx the same at 10 weeks
What is exposure therapy?
Exposure to feared symptoms helps to reattribute to recognisable cause (desensitisation)
Exercise vs cognitive behavioural therapy on panic related distress
Randomised trial for 12 week intervention and 12 month follow up
Both CBT and exercise bring a significant reduction in panic related distress, at 6 month follow up approx the same, at 12 months exercise effects increased again slightly but still lower than base levels.
What are the NICE recommendations in management in primary, secondary and community care?
Self help
Offer bibliotherapy based on CBT principles
Offer info about support groups
Discuss the benefits of exercise
