36: Worry and Anxiety- Streyffeler Flashcards
the alert system that helps to keep us alive turns on quickly, but ____
shuts down more slowly
fear system
amygdala –> hypothalamus –> release of stress hormones to blood stream
a response to worried pts: the BATHE model
Background “tell me about the stressors in your life”
Affect “how do you feel about it”
Trouble “what troubles you most about it”
Handling “how are you handling or coping with it”
Empathy “that must be very difficult”
who is the ‘affect regulator’
provider
a response to a known and definite threat
fear
a response to a threat that is sometimes known, but may also be unknown, internal, vague or conflictual
anxiety
anxiety that is severe, persistent and disabling and persists beyond developmentally appropriate periods of times = disorder
one in ______ people meet the criteria for one disorder in their lifetime
four
more prevalent in women than men
prevalence increases with lower levels of socio-economic status
3 As of anxiety disorders
anticipation/appraisal
arousal
avoidance
avoidance leads to ***
anxiety
exposure leads to extinciton
developmentally inappropriate, excessive and recurring fear related to separation from home and/or attachment figures
separation anxiety
adult- 6mos; child - 4wks
primary complication in panic attack
fear of future attacks
goals of panic attack interventions
- resolve or reduce panic attacks
- reduce general and anticipatory anxiety; and sensitivity to physical symptoms
- minimize avoidance behaviors
- treat any comorbidities
panic disorder =
at least one panic attack followed by 1 mo of persistent worry of another attack, or maladaptive behavioral changes to avoid an attack
heart disturbances, SOB, chest pain, fear of dying, dizzy/lightheaded
tx for panic disorder
cognitive-behavioral therapy
family therapy
agoraphobia =
fear of (at least 2): public transportation open spaces enclosed spaces being caught in a crowd or line being outside the home alone
80% of diagnosed agoraphobia pts are
female
relief reinforces the avoidance and number of safe places narrows until pt is homebound
social anxiety disorder
marked fear/anxiety of social situations involving exposure to the possible scrutiny of others; concern for acting in a way that is humiliating or embarrassing
most common fear is public speaking
excessive anxiety/worry (more days than not) about a number of events or activities
gneralized anxiety disorder
including at least 3 of following restlessness on edge easily fatigued difficulty concentrating or mind goes blank irritability muscle tension sleep disturbance
often seek attention for somatic complaint
suspicious anxiety
- onset of symptoms after age 35
- lack of a psychosocial history of anxiety
- no childhood issues related to anxiety
- lack of exacerbating life events
- lack of avoidance behaviors
- poor response to antianxiety medications
