Anxiety diisorders Flashcards
Acute anxiety is known as?
State anxiety
Chronic anxiety is known as?
Trait anxiety
Anxiety is often associated with?
Depression
Responses to anxiety? Four Fs
Fight or flight - Fight or Flee - response to perceived threat
Freeze or Fawn - Unable to move or Please/avoid conflict
Physiologic and perceptual changes in response to anxiety?
- Increased alertness
- Increased muscle stimulation
- Changes in perceptual field
- Rerouting of blood supply
Causes of anxiety?
- Stressors that threaten ones self- real or perceived
- Anticipated
- Fear of punishment
Observable responses to anxiety?
Affective, Behavioral (psychomotor), Cognitive
ABC
can be a positive force; provides an impetus for changing behavior?
Mild to moderate anxiety
occur when anxiety impairs normal functioning. When can psychiatric problems arise?
Generalized Anxiety Disorder
*When anxiety is overwhelming and/or ineffective coping
(Panic, compulsions, phobias)
Intense expression of feelings that originates on unconscious level to relieve anxiety and tension.
What is this called? What is this known as? What are some examples?
- Acting out*
- coping mechanism for anxiety
- examples - anger, laughing, crying
Experiencing psychic stress as a physical reaction as a result of anxiety? What is this called? What is this known as? What are some examples
- Somatizing*
- coping mechanism for anxiety
- examples - headache, stomach ache
Evading as a result of eye contact. What is this called? What is this known as? What are some examples
- Avoidance*
- coping mechanism for anxiety
- lack of eye contact, daydreaming
characterized by the pervasive existence of severe anxiety with no apparent cause.
generalized anxiety disorder
characterized by acute onset of panic levels of anxiety
panic disorder
what are some of the theoretical explanations for anxiety?
- Psychodynamic - internal conflicts
- Behavioral - learned conditions
- Biologic - physical, chemical, genetics
- Others - PANDAS
Looking for a solution for anxiety? What is this? What is this known as?
- Problem solving*
* Coping mechanism
remove from anxiety producing situation
Withdrawl
-coping strategy
action to confront or resolve anxiety source
Attack
-coping strategy
An appropriate response when attack or withdrawal is not appropriate or effective. Used to change a usual way of responding.
Compromise
In GAD, symptoms interfere with?
Normal daily activities
what may people do to control symptoms of GAD?
Become dependent on alcohol/drug/substances
What non pharmacological treatment has proven successful for GAD?
Combo of cognitive therapy and relaxation training
Pharmacological treatment for GAD?
SSRIs, SNRIs, TCAs, buspirone
What can the nurse encourage the client to do in GAD?
*Rethink perceptions of stressors
*Recognize some anxiety is a normal part of life
*
In OCD clients, _______will increase if obsessive thoughts and compulsive behaviors are
interrupted.
Anxiety
Complications of OCD?
Depression and/or substance abuse
Behavioral techniques used to treat OCD?
- Relaxtion
- Flooding (maximum exposure to anxiety)
- Thought stopping
when is the best time to teach a client with OCD?
immediately following the completion of a ritual
when the client’s level of anxiety is at its lowest
unwanted, persistent, intrusive thoughts, impulses,
or images related to anxiety
obsessions
unwanted behavioral patterns or acts)
compulsions (short term relief for anxiety)
Most effective meds for treating ocd?
SSRIS,
Tricyclics
What is sometimes used to treat depression associated with OCD?
ECT
4 therapies recommended for PTSD?
Cognitive Behavioral, Cognitive Reprocessing, Cognitive, Prolonged Exposure
Which medications are used to treat PTSD? Which are FDA approved for PTSD?
- Antidepressants - SSRIs
* sertraline and paroxetine
The onset of a panic attack is,,,,
- SUDDEN
* source of anxiety may not be identifiable
Individuals with panic attacks frequently associate their symptoms with?
Physical illness and concerns about death.
Feelings of hopelessness, helplessness, and despair may lead to
suicidal ideations
Medications for panic disorder? Acute? Chronic?
- Benzos for acute
- SSRIs- fluoxetine, paroxetine, sertraline
- SNRIS - venlafaxine
In phobias, Contact with the feared stimuli, or mere thoughts of the stimuli,
causes
IMMEDIATE and SEVERE anxiety
Pharmacological treatment for SAD
- SSRI - paroxetine, sertraline
- SNRI - Venlafaxine
- 3 Bs - Benzos, Betablocker (proranolol), Buspirone
Nonpharmacological treatment for SAD
- Cognitive behavioral therapy
* Exposure therapy
General treatments for phobias.
Cognitive therapy and graduated exposure
Recurrent complaints frequent medical attention is sought,
no medical pathology present.
somatization
Belief in and fear of having a disease, misinterpretation of physical signs
as “proof” of the disease
Hypochondriasis
Transferring: a mental conflict into a physical symptom, which has no organic cause
conversion disorder
describes the lack of concern over
physical illness; seen in ____
La belle Indifference
*seen in conversion reacitons
A decrease in anxiety resulting from the
ability to deal with a stressful situation.
Primary gain
Reward obtained from the sick role,
e.g., gain sympathy, excluded from
certain responsibility.
secondary gain
When dealing with somoatoform disorders it is important to convey
Convey a nonjudgmental attitude
when dealing with somatoform disorders you want to identify
- needs met by the sick role*
e. g., attention and freedom from responsibility
Summarization of what the nurse should do for somatoform client. Hint: ARD
- Acknowledge symptom or complaint
- Reaffirm that diagnostic tests reveal no organic pathology
- Determine secondary gains acquired by client
