WEEK 2:HEALTH AND ANXIETY

Question 1

What is anxiety?

Answer 1

A vague feeling of dread or apprehension in response to external or internal stimuli that can result in behavioral, emotional, cognitive, and physical symptoms

Question 2

Name the 4 main characteristics of anxiety

Answer 2

*Apprehension about a future threat
*Response mechanism to stress
*Not always bad
*Different from fear

Question 3

Distingush between anxiety and fear

Answer 3

FEAR
1.Feeling afraid due to a clearly identifiable threat
2.Triggers flight, fight, fright usually to save life
3.Tends to be short lived
4.Physiological arousal via SNS

ANXIETY
1.Feeling afraid due to a possible future threat
2.Increases preparedness for future event
3.Enhances performance if mild to moderate
4.Physiological arousal via SNS

Question 4

Describe the psychological nature of anxiety

Answer 4

1.Psychodynamic theories
*Defense mechanism
*Cognitive distortions
*Control mechanism

2.Learned behavioral response
Childhood

3.Biologic theories
*Possibility of inheritance
*Abnormalities in neuro-transmitters

.

Question 5

State the risk factors for anxiety disorders

Answer 5

*Gender male : female of 1:3
*Sociocultural factors -Japanese, Negative life events
*Genetic vulnerability -Twin studies especially panic *disorder and generalized anxiety disorder
*Neuro-biological- Neurotransmitters, Fear circuitry *hyperactivity
*Personality
*Cognitive -Pre-occupation with threats in the environment and Loss of control

Question 6

List adverse consequences of anxiety

Answer 6

*Physical illnesses (CAD, BP)
*Generalized anxiety disorder
*Social anxiety
*Phobias: excessive fear
*Panic attacks
*Behavioral disorders
*Obsessive compulsive disorder
*Post traumatic stress disorder
*Depression

Question 7

*Anxiety becomes chronic > 6 months
*Inability to control worry which becomes excessive
*Worry is about general issues e.g. health, work, finances, relationships
*Inability to cope
*Interferes with normal daily activities of living
WHAT DISORDER IS THIS?

Answer 7

Generalized anxiety disorder

Question 8

Outline symptoms associated with generalized anxiety disorder

Answer 8

1.Cognitive
Poor short-term memory, Poor concentration, forgetfulness

2.Behavioral
Comfort eating, Substance misuse

3.General
Fatigued easily, Insomnia, Irritability

4.Musculoskeletal

Question 9

What is OCD?

Answer 9

Obsessive thoughts, such as an irrational fear of contamination, accompanied by compulsive acts, such as repetitive hand washing, that are undertaken to alleviate the anxiety generated by the thoughts

Question 10

What does OCD stand for?

Answer 10

Obsessive compulsive disorder

Question 11

What is phobia?

Answer 11

Excessive fear of a particular object or situation

Question 12

Outline characteristics of Phobia

Answer 12

*Fear is DISPROPORTIONATE to actual or perceived threat
*Causes SEVERE DISTRESS and interferes with aspects of daily life or work
*Sufferer is AWARE that fear is excessive
*Sufferer uses AVOIDANCE as a coping mechanism

Question 13

Name the two types of phobia

Answer 13

1.Specific phobia
2. Social phobia

Question 14

What is specific phobia?

Answer 14

*Intense excess fear of specific objects or situations
*Cause extreme anxiety
*Avoidance is used as a coping mechanism

Question 15

Define the following phobias
Alliumphobia
Arachnophobia
Agoraphobia
neophobia

Answer 15

Fear of:
Garlic
Spiders
Open spaces
New things

Question 16

Name the phobias associated with the following fears.
Books
Dancing
Peanut butter sticking to roof of the mouth

Answer 16

Bibliophobia
Chorophobia
Arachybutyrophobia

Question 17

What is social phobia?

Answer 17

*Extreme version of social anxiety…extreme shyness
*Persistent, intense fear of social situations
*Generalized or specific
*Genetic vulnerability postulated
*Onset during adolescence

Question 18

State fears associated with social anxiety

Answer 18

Fear of
*Scrutiny
*Negative evaluation
*Humiliation
*Social embarrassment

Question 19

What is likely to happen to people with social phobia?

Answer 19

*Avoidant personality disorder
*Health seeking behavior
*Adverse coping mechanisms

Question 20

Define and describe panic attacks

Answer 20

*Sudden, intense episode of anxiety attack
*Characterized by feelings of impending doom and gloom
*Associated with severe apprehension and terror
*Intensity tends to peak within few minutes

Question 21

List symptoms of panic attacks

Answer 21

*Dizziness
*Palpitations
*Lightheadedness
*Profuse sweating, Hyperventilation
*Gastrointestinal upset

Other symptoms may include:
*Depersonalization, Derealization
*Fear of going crazy, losing control, or dying

Question 22

Reliving an intense physical or emotional threat or injury (for example, childhood abuse, combat, or an earthquake) in vivid dreams, flashbacks, or tormented memories.

Name this disorder

Answer 22

PTSD

Question 23

Outline signs and symptoms of PTSD

Answer 23

*difficulty sleeping
*difficulty in concentrating
*angry outbursts
*emotional withdrawal
*heightened startle response.

Question 24

State disorders and behaviors that one can adopt to due to anxiety disorders

Answer 24

1.Substance misuse

2.Poor health seeking behavior
*Avoidance of health care facilities
*Lack of adherence to treatment
*Excess use of health care facilities

3.Poor interpersonal relationships
*Relationship breakdown
*Unemployment
*Social exclusion

Question 25

Describe the Cognitive Brain Theory as a method of treatment of anxiety disorders

Answer 25

*Challenges negative thoughts and expectations about adverse outcomes

*Individual empowerment to cope with triggers through changing maladaptive behaviors

*Worry only during scheduled times

*Focus on the present rather than unknown future
GAD, agoraphobia

Question 26

Outline ways of performing relaxation techniques as ways of dealing with anxiety disorders

Answer 26

1.Breath focus – eating disorders
2. Body scan
3. Guided imagery- memory lane
4. Mindfulness meditation- anxiety, depression, pain
5. Yoga, tai chi – flexibility and distraction
6. Repetitive prayer

Question 27

Describe the treatments Of Anxiety Disorders

Answer 27

*Depends on cause and type
*Patient education
*Medication- Anxiolytics, Benzodiazepines, antidepressants
*Psychological therapies
*Combination of drugs and therapy
*Exposure Incremental approach
Good for phobias

*Relaxation training
Breathing techniques, yoga

*Panic control therapy
Exposure to panic inducing sensations in a controlled setting

Question 28

Describe the economic impact of anxiety

Answer 28

*Commonest psychiatric disorder

*Most anxiety disorders begin in childhood, adolescence, and early adulthood

*Social phobia is the most common anxiety disorder; it has an early age of onset—by age 11 years in about 50% and by age 20 years in about 80% of individuals

*Anxiety disorders have high rates of comorbidity with major depression and alcohol and drug abuse.

*Chronic anxiety may be associated with increased risk for cardiovascular morbidity and mortality.
over three-quarters were attributable to lost or reduced productivity.

*Most of these indirect costs were associated with morbidity, as mortality accounted for just 2.7% of the total-

Question 29

Describe the following examples of anxiety disorders.

*Separating anxiety disorder
*Selective mutism
*Specific phobia
*Social anxiety disorder
*Panic disorder
*Generalized anxiety disorder
*Substance/ medication induced anxiety disorder
*Anxiety disorder due to another medical condition

Answer 29

*Separating anxiety disorder

It involves excessive fear or worry about being separated from a loved one or a familiar environment.

Resulting in distressing symptoms such as constant worry, fear of harm or abandonment, physical symptoms like headaches or stomachaches, and avoidance of separation situations.

*Selective mutism

Selective mutism is a severe anxiety disorder where a person is unable to speak in certain social situations, such as with classmates at school or to relatives they don’t see very often.

*Specific phobia

Specific phobia is an anxiety disorder, characterized by an extreme, unreasonable, and irrational fear associated with a specific object, situation, or concept which poses little or no actual danger.

*Social anxiety disorder

It is when you feel nervous or afraid of being in social situations or performing in front of others

*Panic disorder

is a type of anxiety disorder that is characterized by intense, recurrent, and unexpected panic attacks

*Generalized anxiety disorder
Anxiety becomes chronic > 6 months
Inability to control worry which becomes excessive
Worry is about general issues e.g. health, work, finances, relationships
Inability to cope
Interferes with normal daily activities of living

*Substance/ medication induced anxiety disorder
*Anxiety disorder due to another medical condition

Question 30

Usually episodic, with symptoms that last from months to years and equally long quiet periods

These individuals use medical care at high rates, making frequent visits to the emergency departments, clinics, and other health care providers

They tend to undergo frequent physical examinations, laboratory testing, and other costly, invasive, and potentially dangerous procedures
illness anxiety disorder appears to occur equally in men and women.

The disorder can begin at any age, but the most common age of onset is early adulthood.

A good prognosis appears to be associated with high socioeconomic status, treatment-responsive anxiety or depression, the absence of a personality disorder, and the absence of a related non-psychiatric medical condition.

WHAT EXAMPLE OF ANXIETY DISORDER IS THIS?

Answer 30

Illness anxiety disorder (Hypochondriasis)

Question 31

Describe the cycle that maintains the hypochondriacal disorder.

Answer 31

*Perceived threats
*Develops apprehension
*Preoccupation with illness and disease
*Sees illness everywhere
*Feeds back to feeling of being under threat
*Cycle continues

Question 32

Describe an example of etiology of panic disorder

Answer 32

1.watching Tv
2.feel dizzy
3.Worry there is something wrong
4.Feel anxious
5.Sweating, increased temperature, heart rate and respiratory rate
6.Thinking you are going to collapse and die
7.Adds on anxiety and cycle continues

Question 33

Describe an example of etiology of panic disorder

Answer 33

1.watching Tv
2.feel dizzy
3.Worry there is something wrong
4.Feel anxious
5.Sweating, increased temperature, heart rate and respiratory rate
6.Thinking you are going to collapse and die
7.Adds on anxiety and cycle continues