Week Two - Anxiety Flashcards
Two main features on an anxiety disorder
- Fear = The emotional response to real/perceived threat
- Anxiety= The anticipation of a future threat (eg. Muscle tension)
DSM-5 Criteria for General Anxiety Disorder (GAD)
- Worrying for at least 6m , more often than not
- Accompanied by 3+ physical/cognitive symptoms (1+ in children)
NHS Features of GAD
- Sense of dread, decreased self esteem
- Shortness of breath, stomach ache, pins and needles
Explain the concept of the anxiety cycle
- Often maintained through avoidance behaviours
- Anxiety Causing Situation = Thinking/planning self in situation = Pre-situational anxiety = Avoidance = Feeling better (but maintained anxiety)
Explain the role of Adrenalin in anxiety
- ANS activation resulting in physical symptoms
- Prioritises short term resources, rather than maintenance of LT
Epidemiology of anxiety
- Most prevalent MH disorder
- Up to 33.7% of population affected
- [Reme et al] systematic review : higher prevalence in chronic physical illness/ vulnerable stigma/ cog impairments
Co-Morbidity of anxiety
- High overlap with other disorders, particularly within anxiety diagnosis (eg. GAD with separation anxiety)
- 63% of those with anxiety have depressive disorder
How can medication help with anxiety
- Anxiolytic Drug Therapy (eg. Clonzaepam)
- Medication best used alongside therapy
How is CBT useful in easing anxiety?
- Based on a situation having more of an impact on reaction
- Helps evaluate distorted perceptions
- SITUATION= AUTOMATIC THOUGHT = REACTION= EMOTION/BEHAVIOUR/PSYCHOLOGICAL RESPONSE
Explain the features of REMBT and how it works in relation to anxiety
- Evidence focused CBT
- Goal = change irrational thoughts to rational ones
- Challenge false beliefs though reality testing
How can mindfulness ease anxiety?
- Focused on attention at present moment
- Aware of thoughts, feelings, and bodily sensations
- eg. Meditation, yoga, breathing
Describe the features of separation anxiety disorder
- Persistent anxiety beyond development level in relation to separation of attachment figure
- Associated with panic attacks , diagnostic criteria of nightmares/repeated physical symptoms/ sleepover refusal
- Accompanied with distress when separated, persistent worry around death or loss, and worry about experiencing event itself
Physiology of Separation Anxiety
- Early exposure to traumatic events (altering caregiver bond = altered functioning of oxytocin receptors)
- Risk of internalising symptoms in neonatal period
Aetiology of separation anxiety
- Family history of depression/anxiety (first degree relatives)
- Traumatic seperation
- Early separation
General treatment of Separation Anxiety
- CBT / Low intensity CBT
- Some effectiveness of pharmacological treatments
What is the criteria for PTSD
(Not an anxiety disorder)
- Alteration of arousal and reactivity
- History of exposure to traumatic event
- Intrusion
-Avoidance of stimuli
- Negative Thoughts
- Affects PFC / Amygdala/ Hippocampus
Treatment for PTSD
- Psychological debriefing (research shows may be worse / not helpful)
- EMDR : follow a pencil whilst reprocessing trauma
4 types of phobias
- Situational
- Natural Environmental Type
- Blood Injury-Injection Type
- Animal
(Other Type)
[Persistent for at least 6m + impact functioning)
How can phobias be treated?
- CBT / REMBT (address cognitive distortions)
- Behavioural Exposure Therapy (in vivo / imagination)
- Creation of a fear hierarchy
- Habituation occurs overtime
What are the 5Ps of assessment?
- Presenting Problem(s)
- Predisposing Factors
- Precipitating Factors
- Perpetuating Factors
- Protective Factors
