T3L7 anxiety disorders- clinical Flashcards
acute stress reaction
- hours to 3 days
- response to exceptionally stressful effects
- initial daze
- mixed and usually changing picture
typical symptoms of acute stress
- numbness or being dazed
- insomnia
- restlessness
- poor concentration
- autonomic arousal
- anger/anxiety/depression
adjustment disorder
- wide range of emotional and behavioural symotoms
- stressor isn’t necessarily life threatening
- up to 6 months
- losing job or relationship
ptsd
- response to emotionally threatening or catastrophic event
eg experienced a event that threatened their life
reponse inbolved intense fear, helplessness, horror
symptoms:
- reexperiencing flashback
- detachment
- insomnia
- anxiety
- depression
- immediate onset
- most recover within 1yr
- women more likely to develop ptsd following trauma (except in rape)
generalised anxiety disorders
physiological symptoms:
- fearful anticipation
- irritability
- sensitivity to noise
- restlessness
- poor concentration
- worrying thoughts
- sleep disturbance
- sadness
- depersonalisation
women > men
- high level of comorbidity
- 5 fold^ in first degree relatives
causes:
- stressful or traumatic life events
- one very important negative event associated with 3x more likely to develop in gad
early environmental factors: attachment theory
- One hypothesis is that the relationship of these early parenting experiences to the subsequent development of anxiety or depression is mediated by the early formation of cognitive vulnerability best described as a sense of uncontrollability regarding future events in one’s life
panic disorder
The heart beats quickly and violently so that it palpitates and knocks against the ribs…the skin instantly becomes pale…under a great sense of fear…in connection with the disturbed action of the heart, the breathing is hurried…one of the best marked symptoms is the trembling of all the muscles of the body.
pshycic:
- fear of losing control
- going mad
- fainting
- death
- derealisation
somatic:
- palpitations
- tachycardia
- faintness
- trembling
panic syndrome differentials
- arrhythmia
- drugs
- seizures
- vestibular
- PE
- hypoglycaemia
agoraphobia
anxiety in specific context:
- away from home
- in crowds
- in situations they cant leave easily
- leads to being housebound
symptoms of anxiety and panic attacks
panic attacks vs disorder
disorder must have lots
7-9% of population have some panic attacks
panic risk factors
- widowed, divorced, separated individuals in cities
- limited education, early parental loss, sexual abuse
- females
panic genetic risk
7x more likely in 1st degree relative
- at least 50% environmental influence
biological panic models
- triggered in locus coeruleus
- ^firing>^co2
- ssri treatment
- gaba has role
- benzos are effective
specific phobia
- inapproapriate anxiety in presence of one or more particular objects
response to phobias
biphasic anxiety reaction:
- initial short lived sympathetic arousal
- followed by parasympathetic arousal
- vasovagal syncope
desire to escape
11% lifetime prevelance
women>men
genetics:
- all specific phobias have some level of genetic transmission
aetiology:
- classical conditioning
- preparedness theory
- may be acquired through observational learning
social phobia
inappropriate anxiety in:
- situation where patient is observed
- situation where there is potential for criticism
leads to avoidance of trigger situations
- eating in public
- dinner parties
- other shit
symptoms:
- anticipatory anxiety
- blushing
- trembling
- relieved by alcohol
- ## genetic and environmental factors
