WEEK 2:HEALTH AND ANXIETY Flashcards by Oratile Ramosweu

What is anxiety?

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

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Name the 4 main characteristics of anxiety

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

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Distingush between anxiety and fear

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

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Describe the psychological nature of anxiety

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

2.Learned behavioral response
Childhood

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

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State the risk factors for anxiety disorders

*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

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List adverse consequences of anxiety

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

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*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?

Generalized anxiety disorder

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Outline symptoms associated with generalized anxiety disorder

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

2.Behavioral
Comfort eating, Substance misuse

3.General
Fatigued easily, Insomnia, Irritability

4.Musculoskeletal

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What is OCD?

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

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What does OCD stand for?

Obsessive compulsive disorder

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What is phobia?

Excessive fear of a particular object or situation

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Outline characteristics of Phobia

*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

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Name the two types of phobia

1.Specific phobia
2. Social phobia

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What is specific phobia?

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

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Define the following phobias
Alliumphobia
Arachnophobia
Agoraphobia
neophobia

Fear of:
Garlic
Spiders
Open spaces
New things

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

Bibliophobia
Chorophobia
Arachybutyrophobia

What is social phobia?

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

State fears associated with social anxiety

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

What is likely to happen to people with social phobia?

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

Define and describe panic attacks

*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

List symptoms of panic attacks

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

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

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

PTSD

Outline signs and symptoms of PTSD

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

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

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

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

*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

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

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

Describe the treatments Of Anxiety Disorders

*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

Describe the economic impact of anxiety

*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-

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

*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

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?

Illness anxiety disorder (Hypochondriasis)

Describe the cycle that maintains the hypochondriacal disorder.

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

Describe an example of etiology of panic disorder

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

Describe an example of etiology of panic disorder