Anxiety Flashcards
Things to Remember
Anxiety is a normal and unavoidable human response to an actual or perceived threat.
Adaptive anxiety consists of three parts: physiological arousal, cognitive appraisal, and coping strategies
Anxiety
an emotion characterized by apprehension or dread of a potentially threatening or uncertain outcome. It is triggered by the perception of a threat and it manifested in physical, emotional, cognitive, and/or behavioural ways
- a “future oriented” state that helps one prepare for potentially adverse situations.
Generalized Anxiety Disorder
unwarranted, enduring anxiety across life situations, especially those in which the individuals feels a lack of control.
- these anxiety symptoms significantly impact the person’s functioning and bring with it associated physical symptoms.
- a common anxiety disorder
Specific Anxiety Disorders
- Generalized Anxiety Disorder
- Social Anxiety
- Obsessive Compulsive Disorder
- Phobias
- Panic Disorder
Difference between fear and anxiety
key difference between anxiety and fear relate to characteristics of the trigger (stimulus). Characteristics of the trigger include its immediacy or temporal orientation and its ambiguity or specificity
Worry
thoughts and images centering on adverse outcomes that engender negative affect and are relatively uncontrollable
- considered a symptom of fear and anxiety
Fear
an emotional response to a specific and proximal threat to an organism’s life or integrity - ex. being eld at gunpoint or encountering a snarling dog.
Existential anxiety
The foreboding that arises from an awareness of human mortality. Also referred to as angst.
Obsession
unwanted, intrusive and persistent thoughts, impulses or images that are incongruent with the person’s usual thought patterns and cause significant anxiety and distress. The person tries to ignore, suppress, or neutralize the thoughts by some other thought or action but is unable to do so
Compulsion
behaviours performed repeatedly, in a ritualistic fashion, with the goal of preventing or relieving anxiety and stress caused by obsessions
Neurobiology of anxiety
- Fear conditioning: neutral stimulus elicits an automatic emotional response previously associated with the aversive one, and the individual is conditioned to respond with fear to what was once a neutral stimulus.
- anxiety disorders reflect an exaggeration of the normal fear response.
- Extinction: the gradual decrease in a conditioned fear response can happen when repeated exposure to the conditioned stimulus does not elicit an anxiety or fear response although the memory is still there and can be reestablished to produce fear in response to a similar threat.
- explain the chronicity of anxiety
- the hippocampus and the amygdala are involved. hippocampus involved with memory acquisition the amygdala is a crucial area for encoding and storing fearful memories
- functional magnetic resonance imaging (fMRI) have shown increased amygdalar activity during associative learning
Anxiety Assessment Scales
- Generalized Anxiety Disorder Scale (GAD-7)
- assessment of persons with GAD must include assessment of mood, somatic symptoms, specific worries, and worry management strategies employed
- Hamilton Rating Scale for Anxiety
- Panic-associated symptom scale
- acute panic inventory
- national institute of mental health panic questionnaire
- anxiety sensitivity index
- agoraphobia cognitions questionnaire
- fear questionnaire
- state-trait anxiety inventory
- penn state worry questionnaire
- beck anxiety inventory
Degrees/Levels of Anxiety
- Mild (learning is possible. The nurse assists the patient to use the energy that anxiety provides to encourage learning.)
- Moderate (The nurse needs to check his or her own anxiety so that the patient does not empathize with it. encourage the patient to talk: to focus on one experience, to describe it fully, then to formulate the patients generalizations about that experience)
- Severe (learning is less possible. Allow relief behaviours to be used but do not ask about them. Encourage the patient to talk: ventilation of random ideas is likely to reduce anxiety to a moderate level. When this is observed by the nurse, proceed as above
- Panic (learning is impossible. the nurse needs to stay with the patient. Allow pacing and walk with the patient. No content inputs to the patient’s thinking should be made by the nurse. Pick up on what the patient says. short phrases by the nurse - direct to the point of the patients comment, and investigative - match the current attention span/ do not touch the patient.
Panic
can be normal but extreme, overwhelming form of anxiety often initiated when an individual is placed in a real or perceived life-threatening situation
Anxiety management strategies
- Biologic Domain: Physical activity, breathing control, nutrition planning, relaxation techniques, Pharmacotherapy (SSRIs and SNRIs, Tricyclic Antidepressants therapy, benzodiazepine therapy )
- Psychologic Domain: distraction, cognitive behavioural therapy, positive self-talk.
- Social Domain: Family responses to anxiety, to do lists,
