Anxiety Flashcards
Feeling of discomfort, apprehension or dread related to anticipation of danger, the source of which is often nonspecific or unknown
considered a disorder (pathological) when fears and anxieties are excessive and there are associated behavioral disturbances such as interference with social and occupational functioning.
anxiety
epidemiology of anxiety
The most common of all psychiatric illnesses
More common in women than in men
Likely familial predisposition
prevalence of anxiety
19.1% in recent years in the US adult population
31.1% of adults during some part of their life
32% for adolescents aged 12-18 years of age
Characterized by chronic, unrealistic and excessive anxiety and worry
Generalized Anxiety Disorder (GAD)
predisposing factors for anxiety
Generalized Anxiety Disorder (GAD)
Characterized by chronic, unrealistic and excessive anxiety and worry
Panic and GAD Theories of Etiology
-Psychodynamic Theory:
–Overuse or ineffective use of ego defense mechanism
-Cognitive Theory:
–Distorted or counterproductive thinking patterns
–Mistaken or dysfunctional appraisals of a situation
-Biological Aspects
–Genetics
–Neuroanatomical
–Biochemical
–Neurochemical
increases and decreases of neurotransmitters in anxiety
serotonin decreases
GABA decreases
norepi increases
Areas of the brain affected by anxiety disorders and the symptoms that they mediate include the following:
Amygdala: Fear; particularly important in panic and phobic disorders
Hippocampus: Associated with memory related to fear responses
Brainstem: Respiratory activation; heart rate
Hypothalamus: Activation of stress response
Frontal cortex: Cognitive interpretations
Thalamus: Integration of sensory stimuli
Basal ganglia: Tremor
Most severe form of emotional anxiety
Usually accompanied by behavioral, cognitive and physiological signs and symptoms considered extremely intense and frightening
panic disorder
at least four of the following symptoms must be present to identify the presence of a panic attack.
■Palpitations, pounding heart, or accelerated heart rate
■Sweating
■Trembling or shaking
■Sensations of shortness of breath or smothering
■Feelings of choking
■Chest pain or discomfort
■Nausea or abdominal distress
■Feeling dizzy, unsteady, lightheaded, or faint
■Chills or heat sensations
■Paresthesias (numbness or tingling sensations)
■Derealization (feelings of unreality) or depersonalization (feelings of being detached from oneself)
■Fear of losing control or going crazy
■Fear of dying
Persistent, intensely felt and irrational fear
Specific object, activity, or situation
Compelling desire to avoid feared stimulus
Anxiety or panic attacks are common manifestations
phobias
fear of being in open public places, but more specifically, is defined as the fear of being vulnerable and unable to get help or escape the setting (Kimmel & Roy-Burn, 2017) should panic symptoms occur. The individual may have experienced the symptoms in the past and is preoccupied with fears of their recurrence.
Agoraphobia
an excessive fear of situations in which a person might do something embarrassing or be evaluated negatively by others. The individual has extreme concerns about being exposed to possible scrutiny by others and fears social or performance situations in which embarrassment may occur
social phobia
what is psychoanalytic theory
unconscious fears may be expressed symbolically as phobias. For example, a female child who was sexually abused by an adult male family friend when he was taking her for a ride in his boat grew up with an intense, irrational fear of all water vessels.
anxiety Etiology can be related to many body systems including:
Cardiac – MI or CHF – In pediatrics this is also common for congenital abnormalities and POTS features.
Endocrine: Thyroid disease and hypoglycemia
Respiratory: COPD, Hyperventilation – In pediatrics this is also common with children with Cystic Fibrosis and even asthmatics.
Neurological: Seizure disorders, neoplasms, encephalitis. Also consider the increased incidence of anxiety in clients with autism spectrum
substance-induced anxiety disorder
Substance intoxication related or in withdrawal:
Alcohol, sedatives, hypnotics, and anxiolytics
Amphetamines or cocaine
Hallucinogens
Caffeine
Cannabis
Other substances
Obsessions:
Recurring thoughts, impulses or images
Intrusive and stressful – DYSTONIC
Unable to be stopped by logic or reasoning
Compulsions:
Repetitive ritualistic behaviors or thoughts
Purpose of preventing or reducing distress
Preventing dreaded event or situation.
Hair Pulling
Trichotillomania
assessment for body dismorphic disorder
Exaggerated belief that body is deformed or defective
If true defect is present, concern is unrealistically exaggerated and grossly excessive
Depression and Obsessive-Compulsive personality are common
hoarding disorder assessment
Persistent difficulty discarding possessions regardless of their value
Possible need for excessive acquiring of items
By purchase or other means
More men than women are diagnosed.
implementation for anxiety disorders
Maintain calm, nonthreatening approach
Keep the immediate surroundings low in stimuli
Teach the client signs of escalation anxiety
Include client in making decisions
Provide a structured schedule of activities
Make referrals to support groups
Practice stress management techniques
Encourage the client to explore underlying feelings
evaluation of anxiety disorders
Can the client recognize signs/symptoms of escalating anxiety?
Can the client use skills learned to interrupt the escalating anxiety before it reaches panic level?
Can the client demonstrate the activities most appropriate for them that can be used to maintain anxiety at a manageable level?
Can the client maintain anxiety at a manageable level without medication?
treatment modalities for anxiety disorders
Individual Psychotherapy
Cognitive Therapy
Behavioral Therapy
Systemic Desensitization
Implosion Therapy
Psychopharmacology
Acute anxiety treatment with benzodiazepines
Panic Disorder, GAD and Phobias
Anxiolytics
Antidepressants
Antihypertensive agents
OCD and body dysmorphic disorder
Antidepressants
Hair pulling disorder
Chlorpromazine
Amitriptyline
Lithium Carbonate
SSRI and pimozide
Olanzapine
