Second most common CMD in England after GAD, with one week prevalence 3.3% (NHS Digital, 2014).
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DSM-V Criteria Depression (core symptoms)
Over last 2 weeks, at least 1 core symptom (most of the day, nearly every day): 1) Persistent sadness or low mood 2) Marked diminished interest or pleasure in activities
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DSM-V Criteria Depression (other symptoms)
Over last 2 weeks, at least 5 other symptoms: insomnia/sleeping too much, weight, fatigue, agitation/slow movements, concentration, worthlessness, suicidal thoughts
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GAD prevalence
Most common CMD in 2014, with one week prevalence 5.9% (NHS Digital, 2014).
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Difference between GAD and Panic
even though there are physical symptoms, they are not catastrophically misinterpreted
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Difference between GAD and illness anxiety
illness anxiety is more present focussed e.g. “I have cancer”, GAD is more future focussed e.g. “what if I get cancer”
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DSM-V Criteria: GAD (MR FISC) 3 or more of following for 6 months
• Causes clinically significant impairment in functioning • Not attributable to physiological effects of a substance or medical condition • Not better explained by other disorder (e.g. anxiety about panic attacks in PD
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Panic prevalence
PD is more common in women. One-week prevalence 0.6% in UK (NHS Digital, 2014)
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Panic Cognitions (Clark, 1996)
Appraisal of a threat (either to an internal or external trigger) and the catastrophic misinterpretation (according to the vicious cycle model of panic, Clark, 1986).
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Panic Cognitions (Healy & Bourne, 2005)
Reduced attention capacity
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Panic behaviours
Safety behaviours: distraction behaviours e.g. having water on self, standing near exit. Also avoidance and hyper vigilance.
One week prevalence in England 2.4% (NHS Digital, 2014).
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Phobia cognitions
Thoughts are about the danger of the object/situation, e.g. heights, “I’ll fall over the edge”. There is no catastrophic misinterpretation of physical symptoms- there is still a feared outcome but it is not specific to the physical sensations.
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Panic emotions (Matthews & Mackintosh, 2000)
Like with panic, when someone feels like there is danger then they think there is danger (Matthews & Mackintosh, 2000)
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Panic behaviours
Avoidance, hypervigilance, safety behaviours (e.g. gripping tightly to railings when high up)
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Illness anxiety cognitions
Overestimation of symptoms as serious illness. Overestimation of severity of illness. Underestimation of coping ability. Often triggered by stress, someone close becoming ill, death of someone close, has recovered from an illness which may come back
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Illness anxiety behaviours
Focus on body more, checking body for signs, internet searchers, safety seeking behaviours like using different towels, re-assurance seeking
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Illness anxiety physical sensations
Usual physical feelings of anxiety, and a noticing of changes in the body e.g. any blemishes, lumps, fluttering of heart
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Social Anxiety prevalence
One week prevalence rate 12.1% in UK (Office of National Statistics, 2007).
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OCD prevalence
1.3% one week prevalence England (NHS Digital, 2014).
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OCD cognitions
Intrusive thoughts, doubts, images often in confliction with sense of self, causes distress when thoughts are appraised to bear significance. Having this thought means it will happen. Excessive sense of responsibility.
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OCD behaviours
Seeking re-assurance, avoidance, suppressing thoughts. Compulsions to prevent harm and reduce anxiety. Compulsions become safety behaviours which maintain problem.
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PTSD cognitions
Re-experiencing- intrusive memories, nightmares, dissociative reactions e.g. flashbacks, negative beliefs and expectations of the self, others or world.
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PTSD behaviours
Avoidance- of thoughts, feelings, conversations about the event, activities, places, people. Inability to remember key aspects of the event. Reckless or self-destructive behaviour, hypervigilance.
Over last 2 weeks, at least 1 core symptom (most of the day, nearly every day): 1) Persistent sadness or low mood 2) Marked diminished interest or pleasure in activities
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