Post Traumatic Stress Disorder (PTSD) and Anxiety Disorders Flashcards
(24 cards)
Anxiety vs fear
- Anxiety: anticipation of future real/imagined threat
- Fear: response to real/imagined threat
Anxiety involves upregulation of which arm of the nervous system?
Sympathetic nervous system
Symptoms of anxiety (psych, resp, gastro, cardio, neuro)
- Psych: restlessness, irritability, poor concentration
- Resp: dyspnoea/tachypnoea
- Gastro: nausea/vomiting, dry mouth, weight loss
- Cardio: hypertension, palpitations, tachycardia, chest pain
- Neuro: dizziness, headache, tremor, vertigo
What kind of drugs can cause anxiety?
- SSRIs (initially; warn patients first)
- Anticholinergics
- Dopaminergics
- Stimulants (cocaine, caffeine, amphetamine)
Anxiety is a normal function that helps us perform. At what point does it become a disorder?
- Timeframe (typically most of the day for at least 6 months)
- Severity of symptoms (affecting functioning)
- Inappropriate for context
- Not due to underlying medical illness/substance use
GAD key diagnostic criteria
- Excessive anxiety/worry about a number of events (e.g. school, social, money etc.)
- Lasts for at least 6 months
- Associated with three or more of: fatigue, restlessness, difficulty concentrating, irritability, muscle tension, sleep diturbance
Social anxiety disorders key diagnostic criteria
- Fear or anxiety about one or more social situations (e.g. being made fun of by others)
- Social situations almost always produce anxiety/fear
- Symptoms out of proportion to threat
Panic disorder key diagnostic criteria
- Recurrent and unexpected panic attacks
- At least one panic attack followed by >=1 month of one or both of: persistent worry about another panic attack, maladaptive behaviour change related to panic attack
Agoraphobia key diagnostic criteria
- Fear of situations where escape/help is hard to find:
- Public transport
- Very open/enclosed spaces
- Crowds/lines
- Leaving home alone
Panic attack symptoms
At least four of, peaking within 10 minutes:
- Palpitations
- Sweating
- Trembling/shaking
- Dyspnoea/smothering
- Feeling of choking
- Chest pain or discomfort
- Nausea/abdo distress
- Dizziness/unsteadiness/lightheadedness
- Fear of losing control
- Fear of dying
- Tingling sensations
- Chills/hot flushes
Specific phobia key diagnostic criteria
- Marked fear/anxiety of a specific object/situation
- Usually provokes immediate anxiety
- Out of proportion to actual danger
Features of OCD
- Obsessions: recurrent, unwanted, distressing thoughts/images, that the person tries to resist
- Compulsions: repetitive behaviours/rituals that the person feels they must complete to temporarily reduce anxiety from obsessions (even if they’re not actually useful)
Common comorbidities with anxiety disorders
- Other anxiety disorders
- Substance use
- MDD
Derive one logical common comorbidity with anxiety disorders, and the two most common ways it can present
- Substance abuse disorder (like self-medication)
- Common substances are alcohol and cannabis
First vs second line treatment of anxiety disorders
- First line: psychological -> psychoeducation and psychotherapy (such as CBT)
- Second line: pharmacological (SSRI/SNRI)
Explain exposure and response therapy for OCD
- Make a list from least to most feared situation
- Therapist assists them to confront these situations in a controlled, increasing environment
Side effects of SSRIs
- Insomnia
- Sexual dysfunction
- Constipation
- Nausea
DSM definition of trauma
Exposure to actual or threatened death, serious injury, or sexual violence.
COmmon kinds of trauma
- Medical/accidents
- Sexual
- Physical (violence)
- Psychological (neglect, manipulation)
- War or torture
Child maltreatment predisposes to what other conditions later in life?
- MDD/anxiety disorders
- PTSD
- Alcohol use disorder
PTSD risk factors (pre/peri/post-trauma)
- Pre: Poor social support, financial stress, women
- Peri: severity, intensity, frequency, duration, unpredictability
- Post: social support, access to treatment
Which areas of the brain (w/ corresponding function) are implicated in trauma response?
- Amygdala (anxiety and fear)
- Hippocampus (long term memory)
- Parahippocampal gyrus (spatial memory)
- Hypothalamus (autonomic + basic function regulation)
- Mammilary body (recollective memory :) )
= Nucleus accumbens (reward pathways)
Which areas of the brain become more/less in control during traumatic events?
- Less control: pre-frontal cortex
- More control: amygdala and limbic system
Key diagnostic criteria for PTSD
- Exposure to actual/threatened death, serious injury, or sexual violence, either first hand, witnessing/hearing of, or repeated extreme descriptions of
- Intrusive symptoms (recurrent memories, dreams, dissociate reactions, prolonged psych distress, or physiological reactions
- Persistent avoidance of associated stimuli (incl. internal memories/thoughts or external reminders)
- Negative alterations in mood/cognition (inability to remember, negative beliefs, distorted cognition, anhedonia, detachment)
