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anxiety Flashcards

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1
Q

Define anxiety and anxiety disorder

A
  • uncomfortable feeling of apprehension or dread
  • response to a threat that is unknown, vague or conflictual
  • response to internal or external stimuli
  • physical, emotional, cognitive, and behavioral symptoms
  • basic, evolutionary response to impending doom
    “fight or flight response”

anxiety that is there to propel you forward in life - eustress is a healthy form of stress, stress that gets in the way of being productive or allowing a person to find joy is a disorder

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2
Q

Differentiate normal anxiety responses from those of an anxiety disorder

mild anxiety vs. moderate anxiety vs. severe anxiety

A

defense mechanisms
coping behaviors
spirituality
cultural
social supports

If these behaviors are effective anxiety is relieved if they are not anxiety increases

Adaptive
* problem-solving
* talking
* crying
* sleeping
* exercising
* deep breathing
* imagery
* relaxation

Maladaptive
*withdrawal
*negative self-talk
* obsessive-compulsive behaviors
* excessive eating, drinking, spending, gambling, drug use, sexual activity
* blaming
*aggressive acting-out

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3
Q

Identify interventions for each levels of anxiety

Compare and contrast the four levels of anxiety
in relation to perceptual field, ability to problem solve, and physical and other defining
characteristics

A

mild to moderate
* recognizing distress, identify source
* listen and talk about it
* providing a calm presence
* evaluating past coping
* providing alternative coping
that may help to temporally
relieve anxiety
*prevention strategies
*outlet for energy

Severe to panic
*safety
*stay with them
*simplify environment and directions
*reorient to reality
*offer meds
*suicide assessment

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4
Q

Identify genetic, biological, psychological, and
cultural factors that may contribute to anxiety
disorders

A

Strong genetic predisposition
* Symptoms often begin in childhood &
early adulthood
* Often recognizes that
thoughts/behaviors are irrational &
emotion is an overreaction
* Behaviors are used to reduce/manage
/experience of overwhelming anxiety
* Allow continuation of behavior until
other strategies are in place to manage
the anxiety

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5
Q

Identify defense mechanisms

A

Automatic coping styles
*Protect people from
anxiety
*Maintain self-image
by blocking
Feelings
Conflicts
Memories
*Can be healthy or unhealthy

*Compensation
*Conversion
*Denial
*Displacement
*Dissociation
*Identification
*Intellectualization
*Projection
*Rationalization
*Reaction Formation
*Regression
*Repression
*Splitting
*Sublimation
*Suppression
*Undoing

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6
Q

Describe clinical manifestations of each anxiety disorder

  • Generalized Anxiety Disorder (GAD)
  • Separation Anxiety Disorder
  • Social Anxiety Disorder (SAD)
  • Phobias
  • Panic Disorder/Panic Attack
  • Obsessive Compulsive
    Disorders (OCD)
  • Body Dysmorphic Disorder
  • Hoarding Disorder
  • Trichotillomania
  • Excoriation Disorder
  • Acute Stress Disorder (ASD)
  • Post Traumatic Stress Disorder (PTSD)
A

See my notes

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7
Q

Discuss the classes of medications used to treat
anxiety disorders.

A

see notes
SSRI
SSNI
benzo’s
tricyclics
MOAI’s

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8
Q

Discuss treatments for anxiety disorders

A

cognitive behavioral therapy and medications

deep breathing exercises
* physical exercise
* progressive relaxation
* mental imagery
* meditation
* biofeedback

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9
Q

acute stress ASD

A

Occurs within the FIRST MONTH of exposure to
extreme trauma; combat, rape, physical assault, near-
death experience or witnessing a murder.
* Symptoms begin 3 days to one month following the
traumatic event
* The person continually re-experiences the event,
avoids situations that remind him/her of the event and
has increased anxiety and excitation that negatively
affects lifestyle.
* The individual must have at least three of the
following dissociative symptoms:
Numbing
Detachment
reduction of awareness to one’s surroundings
Derealization
Depersonalization
dissociative amnesia
* ASD usually resolves within 2-28 days following
exposure to the trauma
* If the symptoms continue beyond one month, the
diagnosis is changed to PTSD

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10
Q

agoraphobia

A

 Most severe & persistent phobic disorder
 May be afraid or have anxiety about:
 being outside of the home alone
 being alone at home
 traveling in a car, bus, or airplane
 being on a bridge
 riding in an elevator
 being in a crowd
 Believe that escape from the situation would be difficult or embarrassing or that help might be unavailable

adolescents, female, stress or genetics

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11
Q

body dysmorphic disorder

A

Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others;
most common is the skin, hair, and nose, stomach, teeth, weight and breast/chest
* The individual has performed repetitive behaviors (checking mirror, excessive grooming, skin picking, reassurance
seeking) or mental acts (comparing appearance to others) in response to the
appearance concerns
* The preoccupations are intrusive, unwanted,
time-consuming (average 3-4 hours/day) and difficult to control
* Prevalence in the US is 2.4% (2.5% in women and 2.2% in men)
* Most common age of onset is 12-13 years, 2/3 of individuals have onset before age 18
* High risk for suicide

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12
Q

compulsions

A

Behaviors that are performed
repeatedly, in a ritualistic fashion,with the goal of preventing or relieving anxiety and distress caused by obsessions
*Performing the compulsive act temporary reduces anxiety, but because the relief is only
temporary the compulsive act
must be repeated
*Examples: hand washing,
touching things in sequence,
counting things, locking &
unlocking doors…

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13
Q

defense mechanisms***

A

see my notes

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14
Q

excoriation disorder

A

Most picked areas are the face, arms, & hands
* In addition to skin picking, there may be skin rubbing, squeezing,
lancing, or biting
* The skin picking causes clinically significant distress or impairment
in social, occupational or other areas of functioning

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15
Q

flooding vs systematic desensitization

A

Systematic Desensitization
The individual is gradually introduced to the feared object or experience through a series
of steps, from the least frightening to the
most frightening; gradual
The individual is taught to use a relaxation techniques at each step when anxiety
becomes overwhelming

Flooding
* The individual is exposed to a large amount of an undesirable stimulus to extinguish the anxiety
response
* The individual learns through
prolonged exposure that survival is
possible, and that the anxiety
diminishes

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16
Q

generalized anxiety disorder (GAD)

A

DSM-5 Generalized
Anxiety Disorder (GAD)A. Excessive worry and anxiety occurring more days than not for at least 6 months, about
several events or activities.
B. The individual finds it difficult to control the worry.
C. The anxiety and worry are accompanied by at least three (or more) of the following 6
symptoms for at least 6 months:
1. restlessness, or feeling keyed up or on edge
2. being easily fatigued
3. difficulty concentrating or mind going blank
4. irritability
5. muscle tension
6. sleep disturbance
D. The anxiety, worry or physical symptoms cause clinically significant distress or
impairment in social,
occupational, or other important areas of functioning.
E. The disturbance is not attributed to the physiological effects of a substance or another
medical condition.
F. The disturbance is not better explained by another mental disorder

17
Q

hoarding disorder

A

persistent difficulty discarding or parting with possessions, regardless of their value
* The hoarding causes clinically significant distress or impairment in social, occupational, or other areas of functioning
* males more
* emerge in adolescence,
begin to interfere in functioning in the 20’s,
and significantly impair functioning in the 30’s.
The condition worsens with each decade of life
* 75% also experience MDD and/or anxiety disorders
* 20% also have a diagnosis of OCD
* Safety

18
Q

obsessive-compulsive disorder
(OCD)

A

Repetitive unwanted
thoughts/obsessions
*Repeated activities/rituals
compulsions
the obsessions or compulsions are time-consuming or cause clinically significant distress or impairment in social, occupational, or other areas of functioning.
*Cognition may be impaired
*Stress can increase OCD symptoms
*Sexual and physical abuse in childhood or trauma increases the risk
*Genetic are strongly associated with OCD

19
Q

obsession

A

Unwanted, intrusive, and persistent thoughts, impulses, or images that that persist and recur so that they cannot be dismissed from the mind even though the individual attempts to do so
* Obsessions often seem senseless to the individual who experiences them
* The obsessions experienced or expressed are often not consistent with the individual’s self-perception or usual thought pattern causing extreme distress.
* Examples: fear of contamination, need for symmetry, thoughts of hurting someone

20
Q

panic

A

panic attacks: a sudden onset of extreme
apprehension or fear usually associated with:
* suspended normal functioning
* perceptual field severely limited
* feelings of impending doom, fear of dying, fear of losing control
or “going crazy”
* misinterpretation of realty may occur
* they occur “out of the blue” and last for a matter of minutes
and then subside
* chest pain or discomfort, palpitations, pounding heart, or accelerated heart rate, sweating, trembling or shaking
* sensations of shortness of breath or smothering
* feelings of choking
* nausea or abdominal distress
* feeling dizzy, unsteady, lightheaded, or faint chills or heat sensations
* paresthesia (numbness or tingling)
* derealization (feelings of unreality) or depersonalization (being
detached from one-self)

21
Q

panic disorder

A

panic attacks: a sudden onset of extreme apprehension

Characterized by two important psychological symptoms:
Anticipatory anxiety: fearful
expectation of panic anxiety onset
Avoidance anxiety: personal
strategies used to increase feeling of control and decrease the risk of panic
anxiety

22
Q

post-traumatic stress disorder
(PTSD)

A
  • Post Traumatic Stress Disorder (PTSD)
    Four core symptoms:
    Re-experiencing Symptoms-1
    Avoidance Symptoms-1
    Arousal & Reactivity symptoms-2
    Cognitive & Mood
    ymptoms-2
    Stem from a traumatic event:
    Diagnosis for PTSD requires specific types of trauma exposure:
    Directly experiencing a traumatic event
    Witnessing, in person, a traumatic event that happened to someone else
    Learning about a traumatic event happening to a close friend or family member( cases of death must be violent or unexpected)
    Experiencing repeated or extreme exposure to aversive details of a traumatic event
23
Q

separation anxiety disorder

A

Individuals with separation anxiety disorder exhibit developmentally inappropriate levels of concern over being away from a significant other

Anxiety is so intense it interferes with normal activities, causes sleep
disturbances, nightmares, and
physical symptoms

24
Q

social anxiety disorder

A

severe anxiety or fear provoked by exposure to a social or a performance situation that could be evaluated negatively by others
Intense fear of being criticized by others
Persistent fear of humiliation
Negative evaluation of embarrassment in social situations
Withdraw from situations or experience intense discomfort

inherited, learned, amygdala-fear response

25
Q

specific phobias

A

“A phobia is a persistent fear attached to a specific object, activity, or situation out of proportion to the actual danger posed by the specific object or situation that results in a compelling desire to avoid it. If it cannot be avoided, the phobia stimulus is endured with marked distress.”
DSM 5

26
Q

trichotillomania

A

Recurrent hair pulling may occur from any region on the body; the most common areas are the scalp, eyebrows and eyelids (lashes)
* The hair pulling causes clinically significant distress or impairment in social, occupational or other areas of functioning

Psych 329 (7 decks)

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