Week 2

Question 1

What is meant by anxiolytic?

Answer 1

Anti anxiety

Question 2

What is stress?

Answer 2

Perceived imbalance between demands (pressure) and resources (ability to cope)

Question 3

What is the difference between distress and eustress?

Answer 3

Distress - negative

Eustress - positive

Question 4

In the transactional model of stress, what is primary appraisal?

Answer 4

Evaluation of potential threat e.g. Irrelevant, challenge, harm

Question 5

In the transactional model of stress, what is secondary appraisal?

Answer 5

Evaluation of controllability and coping resources

Question 6

What are some cognitive symptoms of distress?

Answer 6

Worry, apprehension, confusion, indivisible, irritable, agitation

Question 7

What are some somatic symptoms of distress?

Answer 7

Raging heart, tense muscles, perspiration, nausea, loss of appetite

Question 8

What are some behavioural symptoms of distress?

Answer 8

Nail biting, clumsiness, avoidance, substance use, tearfulness

Question 9

What is the flight or fight response?

Answer 9

Linked to somatic stress - sense heightened to maximise success
Enables us to save ourselves from certain dangers
Comes from the autogenic nervous system

Question 10

What is general adaptation syndrome?

Answer 10

Alarm stage

• arousal
• fight/flight

Resistance stage

• adaptation
• protection

Exhaustion stage

• overload
• stress related illness

Question 11

What are psychological stressors?

Answer 11

Stress response frequently activated despite no physical danger

Question 12

What is the impact of prolonged stress on the body - neck?

Answer 12

Sore throat

Mouth ulcers

Question 13

What is the impact of prolonged stress on the body - arteries?

Answer 13

High BP
Cholesterol
Stroke

Question 14

What is the impact of prolonged stress on the body - lungs?

Answer 14

Cough
Cold
Asthma

Question 15

What is the impact of prolonged stress on the body - liver/pancreas?

Answer 15

Liver disease

Diabetes

Question 16

What is the impact of prolonged stress on the body - sex glands?

Answer 16

Irregular periods
Low libido
Night sweats

Question 17

What is the impact of prolonged stress on the body - hair?

Answer 17

Hair loss/thinning

Question 18

What is the impact of prolonged stress on the body - muscles/joints?

Answer 18

Pain
Tension
Fluid retention
Fibromyalgia

Question 19

What is the impact of prolonged stress on the body - heart?

Answer 19

Heart disease

Irregular heart beat

Question 20

What is the impact of prolonged stress on the body - stomach?

Answer 20

Ulcers 
Malnutrition 
Anorexia 
IBS
Constipation

Question 21

What is the impact of prolonged stress on the body - brain?

Answer 21

Depression 
Anxiety
Insomnia 
Low energy 
Migraines

Question 22

What is the impact of prolonged stress on the body - skin?

Answer 22

Ageing
Acne
Eczema
Allergies

Question 23

How is the 1998 football world cup used as an example of psychological stress and cardiovascular health?

Answer 23

Hospital admissions for myocardial infarctions on the day, and two days after England lost penalty shoot out

Admissions rate 25% higher than in previous month and on the same date in 1997 and 1999

Question 24

What is the role of exercise in managing stress?

Answer 24

Stress response occurs in anticipation of physical action but mobilised energy unused

Regular exercise is a natural way of counteracting this metabolic disturbance to prevent harmful effects

Temporary distraction from stressful stimuli

Physical fitness leads to reduced stress activity

Question 25

What did a meta analysis of 34 studies of the effect of aerobic fitness on resistance to psychological stressors in the lab show?

Answer 25

Higher effect size (greater reduction) for HR, BP, muscle tension, skin responses, self report Protective/inoculation mechanism - reduced physiological response to stressors Recovery/coping mechanisms - faster recovery of nervous system

Question 26

What is anxiety?

Answer 26

Feelings of fear, worry, apprehension, accompanied by somatic symptoms and behavioural responses. State - situational Trait - predispositional Clinical - functional impairment

Question 27

What is generalised anxiety disorder?

Answer 27

Non specific persistent anxiety

Question 28

What is panic disorder?

Answer 28

Recurrent brief attacks of intense anxiety

Question 29

What is agoraphobia?

Answer 29

Anxiety in situations where you feel escape is hard

Question 30

What is social phobia?

Answer 30

Anxiety regarding social situations

Question 31

What are specific phobias?

Answer 31

Intense irrational fear of specific objects/situations

Question 32

What are the defining features of generalised anxiety?

Answer 32

``` Excessive worry about many things Difficulty controlling the worry Restlessness Fatigue Concentration problems Irritability Muscle tension ```

Question 33

What is the diagnostic criteria (DSM-V) for generalised anxiety disorder?

Answer 33

Excessive worry that is difficult to control for 6 or more months most days and 3 or more symptoms

Question 34

What is panic disorder?

Answer 34

Recurrent panic attacks along with fear of consequences and/or avoidance behaviour for 1 or more months.

Question 35

What are the symptoms of panic attacks?

Answer 35

``` Palpitations Nausea Sweating Dizziness Shaking/trembling Shortness of breath Choking sensation Chest pain Numbness Fear of losing control ```

Question 36

What was the effect of clomipramine in an exercise intervention for panic disorder?

Answer 36

First few weeks steep drop in anxiety, for med, exercise group and placebo group Placebo then increases again, clomipramine decreases more rapidly than exercise effect but both approx the same at 10 weeks

Question 37

What is exposure therapy?

Answer 37

Exposure to feared symptoms helps to reattribute to recognisable cause (desensitisation)

Question 38

Exercise vs cognitive behavioural therapy on panic related distress

Answer 38

Randomised trial for 12 week intervention and 12 month follow up Both CBT and exercise bring a significant reduction in panic related distress, at 6 month follow up approx the same, at 12 months exercise effects increased again slightly but still lower than base levels.

Question 39

What are the NICE recommendations in management in primary, secondary and community care?

Answer 39

Self help Offer bibliotherapy based on CBT principles Offer info about support groups Discuss the benefits of exercise