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Psychiatry > Anxiety disorders > Flashcards

Anxiety disorders Flashcards

1
Q

are the three models of stress?

A

Biomechanical ‘engineering’
Medicophysiological
Physiological

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2
Q

What are the psychological models of stress?

A

Interactive

Coping

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3
Q

What are the two methods of coping with stress?

A

Problem focussed

Emotion focussed

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4
Q

What is problem focussed coping?

A

Where efforts are directed toward modifying stressor e.g. preparation, practice

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5
Q

What is emotion focussed coping?

A

Modify emotional response, mental defence mechanisms e.g. denial, relaxation training

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6
Q

What are symptom groups of anxiety?

A 
Psychological arousal
Autonomic arousal
Muscle tension
Hyperventilation
Sleep disturbance
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7
Q

What are symptoms of physiological arousal to stress?

A 
Fearful anticipation
Irritability
Sensitivity to noise
Poor concentration
Worrying thoughts
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8
Q

What are symptoms of autonomic arousal to stress?

A

GI: dry mouth, swallowing difficulties, dyspepsia, nausea, wind, frequent loose motions
Respiratory: tight chest, difficulty breathing
CVS: palpitations/missed beats, chest pain
Genitourinary: frequency/urgency, amenorrhoea, dysmenorrhoea, erectile feature
CNS: dizziness, sweating

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9
Q

What are symptoms associated with muscle tension in response to stress?

A

Tremor
Headache
Muscle pain

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10
Q

What are symptoms associated with hyperventilation in response to stress?

A

Causing CO2 deficit hypocapnia
Numbness tingling in extremities
Breathlessness

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11
Q

What are symptoms associated with sleep disturbance in response to stress?

A

Initial insomnia
Frequent waking
Nightmares and night terrors

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12
Q

What are the symptoms of generalised anxiety disorder (GAD)?

A 
Persistent (several months) symptoms not confined to a situation or object
All symptoms of human anxiety can occur:
- psychological arousal
- autonomic arousal
- muscle tension
- hyperventilation
- sleep disturbance
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13
Q

What are differential diagnoses of anxiety disorders?

A

Psychiatric conditions: depression, schizophrenia, dementia, substance misuse
Physical conditions: thyrotoxins, phaechromocytoma, hypoglycaemia, asthma or arrhythmias

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14
Q

Why is GAD usually caused?

A

A stressor acting on a personality predisposed to the disorder by a combination of genetic factors and environmental influences in childhood

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15
Q

What are the management options for GAD?

A

Counselling
Relaxation training
Medication
CBT

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16
Q

What are examples of GAD medication?

A

Sedatives

Antidepressants

17
Q

What are the risks of using sedatives in GAD?

A

High risk dependency

18
Q

What are the key features of phobic anxiety disorders?

A

Same core features as GAD
Only in specific circumstances
Person avoids phobia
Anticipatory anxiety

19
Q

What are 3 clinically important syndromes of phobic anxiety disorders?

A

Specific phobias
Social phobia
Agoraphobia

20
Q

What symptoms predominate in social phobia?

A

Blushing
Tremor
Any of anxiety cluster

21
Q

What is the management of social phobia?

A

CBT
Education and advice
Antidepressants (SSRI)

22
Q

What are the core features of OCD?

A

Recurrent obsessional thoughts and/or compulsive acts

23
Q

What are examples of obsessional thoughts?

A

Ideas, images, impulses
Occuring repeatedly not willed
Unpleasant and distressing
Recognised as the individuals own thoughts
Key anxiety symptoms arise because of distress of the thoughts or attempts to resist

24
Q

What are compulsive acts or rituals?

A

Stereotypical behaviours repeated again and again
Not enjoyable
Not helpful

25
Q

What is the management of OCD?

A

Education/explanation
Serotonergic drugs e.g. SSRI, clomipramine
CBT
Psychosurgery

26
Q

What is PTSD?

A

Delayed or protected reaction to a stressor of exceptional severity

27
Q

What are 3 key elements to a PTSD reaction?

A
  1. Hyperarousal
  2. Re-experiencing phenomena
  3. Avoidance of reminders
28
Q

What happens during hyperarousal stage of PTSD?

A

Persistent anxiety
Irritability
Insomnia
Poor concentration

29
Q

What happens during re-experiencing phenomena stage of PTSD?

A

Intense intrusive images: flashbacks/nightmares

30
Q

What happens during avoidance stage of PTSD?

A 
Emotional numbness
Cue avoidance
Recall difficulties
Diminishes interests
Anhedonia
Suicidal thoughts
31
Q

What are vulnerability factors in PTSD aetiology?

A

Mood disorder
Previous trauma (e.g. as a child)
Female
Lack social support

32
Q

What are protective factors in PTSD aetiology?

A

Higher education and social group

Good paternal relationship

33
Q

What is the management of PTSD?

A

Watchful waiting
Trauma-based CBT
Medication
Eye movement desensitisation and reprocessing

Psychiatry (15 decks)

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