anxiety Flashcards
1
Q
anxiety disorders
A
panic disorders phobias obsessive compulsive disorder generalized anxiety disorder PTSD acute stress disorder substance induced anxiety disorder somatic disorders anxiety due to medical conditions functional neurologic disorders/conversions disorders
2
Q
acute stress resp
A
- flight or fright response
- acute stress response first coined in 1920’s
- body responses; sympathetic stimulates adrenals, triggers catecholamines, which include adrenaline and noradrenaline
- increases HR, BP, R
- body returns to pre-arousal state in 20-60 min
- triggers can be both real or imaginary
3
Q
chronic stress response
A
- human response to prolonged stress over which a person perceives he/she has no control
- involves endocrine system, corticosteroids
- if continues can cause damage to physical and mental health
4
Q
stress vs anxiety
A
- stress is a response to a threat in a situation
- stress comes from the pressures we feel in life, as we are pushed by work or any other task that puts undue pressure on our minds and body. Adrenaline is released, extended stay of the hormone causes anxiety, depression, a rise in the blood pressure and other negative changes
- anxiety is a reaction to the stress
- anxiety is stress that continues after that stressor is gone
- anxiety is a feeling of apprehension or fear. it is almost always accompanied by feelings of impending doom. the source of this uneasiness is not always known or recognized, which can add to the distress you feel
5
Q
anxiety responses
A
- physical
- affective
- cognitive
- behavioural
6
Q
manifestations of anxiety
A
physiological - cardiovascular - respiratory - gastrointestinal - neuromuscular - urinary tract - skin behavioural - restless - rapid speech - inhibition - hypervigilance - lack of co-ordination cognitive - impaired attention - blocking of thoughts - loss of objectivity - flashbacks - preoccupation affective/emotional - edginess - impatience - terror - guilt - helplessness - social - increasing isolation
7
Q
Peplau, 1963 levels of anxiety
A
- anticipated
- mild
- moderate
- severe
- panic
8
Q
Peplau anticipated and mild anxiety
A
- associated with the tensions of daily living, person alert, perceptual field increased
- motivates learning, growth, creativity
- S/S; restlessness, irritability, impatience, relieving behaviour such as finger tapping, fidgeting
9
Q
Peplau moderate anxiety
A
- person focuses on immediate concerns, narrowing of perceptual field
- person hears, sees, grasps less
- S/S: voice tremours, difficulty concentrating, pacing, increase VS, urinary frequency, headache
10
Q
Peplau severe anxiety
A
- significant reduction in perceptual field
- person focuses on specific detail and not anything else
- all activity directed to relieving anxiety, much direction needed to focus on another area, requires supervision
- focuses on self, environment blocked out, sense of dread
- S/S: inability to process info and make decisions, purposeless activity
11
Q
Peplau panic anxiety
A
- associated with sense of terror
- person unable to do things even with direction
- disorganized personality, loss of rational thought
- distorted perception, emotionally paralyzed
- unable to communicate and function
- S/S: sense of terror, dilated pupils, pallor, speaks unintelligibly or is mute, severe tremours, hallucinations, extreme withdrawal or out of control aggitation
12
Q
anxiety and perception
A
perceptual field increases with mild anxiety, becomes increasingly constricted as anxiety increases and completely disrupted at panic levels
13
Q
facilitate therapeutic relationships w/ each anxiety level
A
- mild: as usual
- moderate: ask focused questions to allow client to voice concerns, to ventilate, remain calm, provide direction, provide outlet for tension
- severe: maintain a calm disposition, remain with person give direction and assure safety, reduce environmental stimuli, use calm low pitched voice, short clear direction
- panic: remain with client, offer support and keep talking to the person even though they may not be able to respond, provide safety, solitude, kindness. if person extremely agitated provide for physical safety, seclusion
14
Q
constructive means to cope w/ anxiety
A
- finding comfort in our social network
- talking it out
- intense expression of feeling
- relying on self discipline, breathe
- avoidance and withdrawal
- working it off
- reframing the situation, question thought pattern
- engaging in self healing practices (mind body practices)
- prayerfulness, mindfulness
- using symbolic substitutes
15
Q
common defense mechanisms
A
dissociation: disruption in the function of consciousness
repression: unconscious blocking from awareness that which is threatening or painful
displacement: discharging pent up feelings, usually of hostility, on objects less dangerous than those that initially aroused the emotion
rationalization: justifying ones failures with socially acceptable reasons instead of the real reasons
reaction formation: transforming anxiety producing thoughts into their opposites in consciousness
regression: returning to more primitive levels of behaviour
denial: refusing to admit that something unpleasant is happening or that a taboo emotion is being experienced
16
Q
anxiety theories
A
genetic - 50% panic disorders - 40% GAD - 20% phobias - OCD strong family link biochemical - amygdala/hippocampus - sensitivity to CO2 neurotransmitters involved in experience of anxiety: GABA, serotonin, dopamine, epinephrine, and more psychodynamic interpersonal - family dynamics behavioural traumatic event medical conditions - migraines, sleep apnea, mitral valve prolapse, IBS, chronic fatigue syndrome, PMS - pediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS)
17
Q
Hamilton Anxiety Rating Scale (HAM-A)
A
- scale 0 to 4 (not present or very severe)
- 14 items
- anxious mood
- tension
- fears
- insomnia
- intellectual
- depressed mood
- somatic (muscular)
- somatic (sensory)
- cardiovascular symptoms
- respiratory symptoms
- gastrointestinal symptoms
- genitourinary symptoms
- autonomic symptoms
- behaviour at interview
18
Q
generalized anxiety disorder (GAD)
A
- difficult to determine the exam boundary between GAD and normal worries
- worry that is excessive, persistent, and pervasive for more days than not for a period of 6 months
- “generalized” if it focuses on a variety of life events and activities
- the amount of time spent on worrying, the degree of control over ones worry, the impact on personal, social, and occupational functioning are key components of the assessment
- diagnosis of exclusion
