Anxiety

Question 1

What is anxiety?

Answer 1

-Anxiety is a feeling of unease, worry or fear. We all feel anxious at times, but anxiety may be a mental health problem if your feelings are very strong or last a long time.

Question 2

What is one form of anxiety?

Answer 2

-Phobias

Question 3

Can anxiety be healthy?

Answer 3

• When being put into threatening situations
• Survival mechanisms
• Increases heart rate, blood rate increases
• Primes body for fight or flight
• Pupils dilate

Question 4

What is yerkes-dobson curve?

Answer 4

-Shows relationship between stress and productivity

Question 5

What are the different types of anxiety disorders?

Answer 5

• Pain disorder
• OCD
• Acute stress Disorder - receives. bad news
• PTSD - war veterans
• Social phobia - fear being around people
• simple phobia- fear of clowns and dogs

Question 6

What is generalised anxiety disorder?

Answer 6

• Free-floating anxiety

- anything can trigger anxiety

Question 7

What is anxiety often seen inconjunction with?

Answer 7

• Depression

- Schizophrenia

Question 8

What is ICD-10 criteria for anxiety?

Answer 8

• At least 6 months of prominent tension, worry, and feelings of apprehension about everyday events and problems
• At least four of the following 22 symptoms must be present, at least one of which must be from the autonomic arousal cluster

Question 9

What are examples of autonomic arousal symptoms?

Answer 9

-palpitations or pounding heart or accelerated heart rate; sweating; trembling or shaking; dry mouth (not due to medication or dehydration)

Question 10

What are anxiety symptoms involving the chest and abdomen?

Answer 10

• difficulty in breathing; feeling of choking; chest pain or discomfort; nausea or abdominal distress

Question 11

What are the symptoms involving mental state?

Answer 11

• feeling dizzy, unsteady, faint or lightheaded; derealization or depersonalization; fear of losing control, ‘going crazy’, or passing out; fear of dying

Question 12

What are general symptoms for anxiety?

Answer 12

• hot flushes or cold chills; numbness or tingling sensations

Question 13

What are the symptoms of tension?

Answer 13

• muscle tension or aches and pains; restlessness and inability to relax; feeling keyed up, or on edge, or mentally tense; a sensation of a lump in the throat, or difficulty in swallowing

Question 14

What are the clinical features of anxiety?

Answer 14

• Free floating
• Not a feature of another disorder
• Co morbidity with depression and other psychiatric disorder

Question 15

What is epidemiology?

Answer 15

• Life-time prevalence 5.7%
• Increased risk
  Female
  Middle-aged
  Low income
• Decreased risk
  African American, Asian, Hispanic

Question 16

What is issue with anxiety diagnosis?

Answer 16

-Can be difficult to separate out from other disorders

Question 17

What is the unique profile of GAD?

Answer 17

• High negative affect and anxiety

- Low physiological arousal and depression

Question 18

What is aetiology of anxiety disorders?

Answer 18

• Genetic
• Five times more prevalent in first-degree relatives
• No difference in twin studies
• Modest role,
• genetic more linked to depression
• Neurobiological mechanisms
• Noradrenergic systems
• HPA axis

Question 19

Describe noradrenergic nervous system in people with anxiety?

Answer 19

• Resting catecholamine levels are normal
• Subnormal response to stimulation and blockade
• Implication is down-regulation of receptors

Question 20

Describe HPA axis

Answer 20

• Cortisol released in response to stress, with negative feedback on pituitary and hippocampus
• In rats, chronic exposure to stress or steroids, downregulates the negative feedback
• Reduced dexamethasone suppression seen in 1/3 of GAD
• Unable to bring cortisol levels

Question 21

What part of the brain is involved in brain?

Answer 21

-amygdala

Question 22

What does MRI of children amygdala show?

Answer 22

• MRI of children and adolescents with GAD showed volume increases
• maybe change in amygdala is linked to anxiety conditions

Question 23

What is psychology aetiology of anxiety?

Answer 23

• Diminished sense of control over themselves and over their life
• trauma and insecure attachment to primary caregivers
• parenting style
• giving child attention
• encouragement of the child to explore and manipulate the environment
• Life stress
• 52% of GAD suffers have experience a PTSD like event c/f to 21% of non GAD sufferers

Question 24

What is prognosis of anxiety?

Answer 24

• remission rate 38% at 5 years
• relapse rate 27% at 3 years
• poor prognosis
• poor life satisfaction
• poor relationship with spouse and anxiety
• Cluster C personality (anxious, fearfulcluster. It includes the Avoidant, Dependent, and Obsessive-CompulsivePersonalityDisorders)

Question 25

What are Pharmacological treatment for anxiety?

Answer 25

-Benzodiazepines - addictive -Buspirone - serotonin -Anti-depressants - SSRI and SNRI -Pregabalin - Voltage gated pre-synaptic calcium channel Reduces glutamate release

Question 26

What are psychological treatments or anxiety?

Answer 26

- CBT - Psychoeducation - Relaxation - Exposure