Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 3 Clinical > Generalised Anxiety, Panics, Phobias, OCD > Flashcards

Generalised Anxiety, Panics, Phobias, OCD Flashcards

(58 cards)

Start Studying
1
Q

Model of emotional disorders?

A

Cognition, behaviour, biology and emotions are all affected by environmental input

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Physical symptoms of anxiety?

A

Occur due to sympathetic over-activity:
• Sweating, hot flushes or cold chills
• Trembling or shaking
• Muscle tensions, aches and pains
• Numbness and tingling
• Dizziness, unsteady, faint, light-headed
• Dry mouth that is not due to drugs or dehydration
• Feeling of choking
• Sensation of a throat lump or sensation of dysphagia
• Difficulty breathing
• Palpitations, pounding and accelerated HR
• Nausea or abdominal distress (churning in stomach)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cognitive symptoms of anxiety?

A

Feeling of losing control, keyed up, on edge or mentally tense

Difficulty in concentrating

Hypervigilance (internal and external)

Racing thoughts

Meta-worry (about everything, inc. anxiety itself)

Hypochondriasis

Preference for order and routine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Behavioural symptoms of anxiety?

A

Avoidance of certain situations

Exaggerated response to minor surprises of being startled

Difficulty sleeping

Excessive alcohol consumption or drug use

Restlessness or an inability to relax

Persistent irritability

Seek reassurance from family / GP

Checking behaviours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the stress response

A

Exposure to stress results in instantaneous and concurrent biological responses:
• To assess danger
• To organise and appropriate response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Role of the amygdala in the stress response?

A

Acts as the emotional filter of the brain, to assess whether than sensory material via the thalamus require a stress/fear response (takes milliseconds)

NOTE - this is modified by a cortically processed signal that is received later (‘act first, think later)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which hormones are released due to acute stress?

A

Dose-dependent increased in:
• Catecholamines
• Cortisol (acts to mediate and shutdown the stress response; via -ve feedback, it acts on the pituitary, hypothalamus, hippocampus and amygdala, which are responsible for stimulation of cortisol release)

i.e: acute stress increases cortisol levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How to differentiate anxiety from anxiety disorder?

A

Anxiety is pathology, i.e: a disorder, when it is more extreme than ‘normal’ (in extent) and in situations that are not ‘normally’ anxiety-provoking (in context)

It causes significant distress and impairment of social / occupational / other functions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Types of anxiety disorders?

A

Generalised anxiety disorder

Panic disorder

Agoraphobia

Social phobia

Specific phobia (not always assoc. with anxiety)

OCD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is generalised anxiety disorder?

A

Anxiety that is GENERALISED and PERSISTENT but is not restricted to, or even strongly dominant in, any part. environmental circumstances

It is not due to substance misuse or another medical conditions, e.g: hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dominant symptoms in generalised anxiety disorder?

A

Persistent nervousness

Trembling

Muscular tensions

Sweating

Light-headedness and dizziness

Palpitations

Epigastric discomfort

Often, patients express fear that they or a relative will shortly become ill or have an accident

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

3 general requirements for how severe generalised anxiety disorder must be?

A

Needs to be severe enough to be:
• Long lasting (most days in a 6 month period)
• Uncontrollable
• Causing significant distress / impairment in function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What signs is generalised anxiety disorder typically assoc. with?

A

Restlessness or feeling of being keyed up or on edge

Being easily fatigued

Difficult conc. or mind going blank

Irritability

Muscle tension

Sleep disturbance (difficulty falling or staying asleep and restless / unsatisfying sleep)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Occurrence of generalised anxiety disorder?

A

Typical age of onset if 20-40 years

More common in females

Has a chronic, fluctuating course, i.e: better sometimes and worse at others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clues that a patient may have GAD?

A

Assoc. with disability, MUS and over-utilisation of health care services

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Cormorbidities with GAD?

A

90% of patients have comorbidities with other psychiatric disorders, e.g: depression, substance abuse, other anxiety disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment of GAD?

A

CBT is the main and preferred choice

SSRIs / SNRIs or pregabalin may be used

Benzodiazepines are very effective but are only ever used SHORT-TERM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is CBT?

A

Evidence-based psychological treatment

It is based on identifying a patient’s automatic thoughts, cognitive biases and schemas; this helps the patient identify their thoughts, assumptions, misinterpretations and behaviours that reinforce and perpertuate anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is panic disorder?

A

Essential feature is recurrent attacks of sudden, severe anxiety (i.e: panic); this is not restricted to any part. situation or set of circumstances and so they are UNPREDICTABLE

It is not due to direct physiological effects of a drug or general medical conditions, e.g: hyperthyroidism, caffeine intoxication

It is also not better accounted for by another mental disorder, e.g: depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Dominant symptoms of panic disorder?

A

Sudden onset of palpitations, chest pain, choking sensations, dizziness and feelings of unreality (depersonalisation and derealisation)

Often, there is a fear of dying, losing control or going mad that occurs secondary to the symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Features assoc. with panic disorder?

A

May occur with / without agoraphobia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Occurrence of panic disorder?

A

Typical onset is late adolescence to mid-30s

Many of these patients have agoraphobia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Typical course of panic disorder?

A

Chronic (waxing and waning)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Co-morbidities with panic disorder?

Study These Flashcards
A

Other anxiety disorders, depression, drug and alcohol misuse

25
PET scan signs in panic attacks?
Increased metabolism in the anterior pole of the temporal lobe to the parahippocampal gyrus
26
How can susceptible individuals be triggered, biologically, to have a panic attack?
By infusion of lactate, which is a by-product of muscle activity; it can also trigger panic attacks in relatives of susceptible individuals OR By re-breathing air (increased CO2)
27
Treatment of panic disorder?
CBT SSRIs / SNRIs / TCAs Benzodiazepines are only used short-term
28
3 types of phobia?
Agoraphobia Social phobia Specific phobia
29
Occurrence of phobias?
Typically they have early onset: • Agoraphobia - most present by early 30s and half present by the age of 20 • Social and specific phobias - most present by early adolescence and 20s, repectively
30
Features of phobias?
Fear is recognised as irrational Typified by avoidance and anticipatory anxiety, which may in itself trigger a panic attack
31
What is agoraphobia?
Well-defined cluster of phobias of embracing fear of leaving home alone, entering shops, CROWDS and public places, travelling ALONE in trains/buses/planes Often, patients avoid the phobic situation and some patients experience little anxiety because they do this
32
Types of agoraphobia?
May be a primary disorder More often, it is SECONDARY to other pathology, e.g: panic disorder, depression
33
Techniques employed by individuals with agoraphobia to avoid anxiety?
Often have other people do their shopping OR internet shopping OR visit 24 hour stores at quiet times, in order to avoid crowds Drink alcohol to overcome fear
34
What is a specific phobia?
AKA simple phobia ``` Marked and persistent fear, that is excessive / unreasonable, cued by the presence / anticipation of a SPECIFIC OBJECT / SITUATION, e.g: • Flying • Heights • Animals / insects • Receiving an injection • Blood ``` Exposure, almost invariably, provokes an immediate anxious response, akin to a panic attack
35
Features of specific phobias?
Person recognises that fear is excessive Avoidance of phobic situation OR endured with intense anxiety Normal functioning is impaired
36
Treatment of specific phobias?
Behavioural therapy - graded exposure and systematic desensitisation Add CBT, if necessary If required, SSRIs / SNRIs
37
What is a social phobia?
AKA social anxiety disorder Persistent fear on 1 / more social / performance situations in which the person is exposed to unfamiliar people or possible scrutiny by others NOTE - this is not just being "shy"
38
Features of social phobias?
Person fears they will act in a way that will be embarrassing or that they may show anxiety symptoms Usually occurs in relatively SMALL SOCIAL SETTINGS, unlike agoraphobia (occurs in crowds, etc) Exposure almost invariably provokes anxiety, which can take the form of a situationally bound panic attack
39
Common symptoms of anxiety in a social phobia?
Blushing or shaking Fear of vomiting Urgency or fear of micturition or defaecation
40
Signs of social phobias in toddlers / pre-school children?
It is linked to behavioural inhibition, which is a tendency to react to novel situations by avoidance and withdrawal to safety
41
Biological cause of social phobia?
Increased bilateral activation of the amydala and increased rCBF to the amygdala and related limbic area NOTE - this normalises on successful treatment (pharmacological or psychological)
42
Treatment of social phobias?
CBT SSRIs / SNRIs Benzodiazepines for short-term use only
43
What is OCD?
Recurrent obsessional thoughts and/or compulsive acts
44
Describe the obsessional thought component of OCD
Ideas, images or impulses entering the mind in a stereotyped way; these are recognised as the patient's own thoughts Often they are unpleasant, resisted and EGO-DYSTONIC (thoughts, impulses and behaviors that are distressing to the patient)
45
Describe the compulsive acts component of OCD
Repeated rituals or stereotyped behaviours; these are not enjoyable and are non-functional Person recognises them as pointless Resistance to them may diminish over time
46
Diagnostic criteria for OCD?
Obsessional symptoms OR compulsive acts must be present most days for at least 2 weeks AND They must be a source of distress and interference with activities
47
Other criteria for OCD?
Obsessions must be the person's own thoughts Resistance must be present Rituals are not pleasant Obsessional thoughts / images / impulses must be repetitive
48
Common types of obsession in OCD?
Contamination Fear of harm Excessive concern with order or symmetry Obsession with body or physical symptoms Religious, sacrilegious or blasphemous thoughts Sexual thoughts, e.g: being a paedophile or homosexual Urge to hard useless / worn out possessions Thoughts of violence or aggression
49
Common types of compulsion in OCD?
Checking Cleaning, washing Repeating acts Mental compulsions, e.g: special worse or prayers in a set manner Ordering, symmetry or exactness Hoarding / collecting Counting
50
Occurrence of OCD?
No gender bias or effect from socio-economic stats Onset can occur from any age, inc. children and adolescents, by mean age is 20 Many will have had at least 1 major depressive episode
51
Co-morbidities with OCD?
Schizophrenia, tourettes and other tic disorders, body dysmorphic disorder, eating disorders, trichtillomania (hair pulling disorder)
52
FH of OCD?
Familial but no genes identified
53
Treatment of OCD?
CBT (inc. response prevention) SSRIs / clomipramine
54
Function of the GABA-A receptor
Inhibitory ionotropic receptor; in the presence of GABA, ion channels allows Cl- ion influx and the membrane hyperpolarises, resulting in an i.p.s.p Agonists at the BZD site produce relaxation and anti-convulsant effects Antagonists cause anxiety and are pro-convulsant
55
Mechanism of action of benzodiazepines?
Enhance the effect of GABA via allosteric modulation
56
Other drugs that act upon the GABA-A receptor?
Alcohol and barbiturates
57
Issues with benzodiazepines?
``` If used for over 2 weeks: • Sedation and psychomotor impairment • Discontinuation / withdrawal problems • Dependency and abuse • Interaction with alcohol • Can worsen co-morbid depression ```
58
Diagnostic pathway for anxiety disorders?
ADD IMAGE (slide 40)

Year 3 Clinical (100 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions