Anxiety Disorder

Question 1

Panic Disorder

Answer 1

Symptoms- intense serge if anxiety, psychological worry and physical symptoms, tachycardia, tight chest, shaking, dizziness and nausea
Treatment- management of panic attack, stay with the person, breathin coaching
long term- CBT, education

Question 2

Social Phobia

Answer 2

Symptoms- pronounced, persistent fear of social situations, especially where they fear criticism regarding failure, performance
Treatment-

Question 3

Agoraphobia

Answer 3

Symptoms- fear of not being able to escape an area e.g. mall if becoming anxious.
Treatment- panic management

Question 4

Specific Phobia

Answer 4

Symptoms- disappropriate fear of risk to an object or situation poses.
Treatment- CBT with gradual exposure

Question 5

Adjustment Disorder

Answer 5

Symptoms- intense stress response to a potential or actual serious illness or significant event
Treatment- support of psychological stress/distress
mindful, solution focused nursing no need for pharmacological intervention

Question 6

Acute Stress Disorder

Answer 6

Symptoms- similar to PTSD except shorter time frame of symptoms exhibited
Treatment- trauma focused CBT

Question 7

Post Traumatic-Stress Disorder

Answer 7

Symptoms- presents following direct witness to a traumatic event
Treatment- trauma focused CBT, trauma focused therapy, SSRI’s or SNIR’s potentially

Question 8

Obsessive Compulsive Disorder

Answer 8

Symptoms- intrusive thoughts that become obsessed with associated behaviour aim to reduce feelings of anxiety associated with thoughts
Treatment- CBT, SSIR’s

Question 9

Generalised Anxiety Disorder

Answer 9

Symptoms- constant, excessive worry that is not specific
Treatment- education and active monitoring non-facilitated self-help, guided self-help, CBT, SSRI
applied relaxation

Question 10

Outline causes of anxiety disorder

Answer 10

genes, trauma, and nurture

Question 11

Panic Attack

Answer 11

Symptoms- feeling of doom, death, or panic. increased heart rate, increase resps BP, pupils dilate, chest pains, tingling in extremities
Nursing management- remain with the person, remain calm, reasure they will not faint, die or loose control, encourage to continue breathing

Question 12

Hyperventilation

Answer 12

Symptoms- rapid, shallow breathing, may be associated with dizziness, tingling in extremities
Nursing management- guided breathing, paper bag, cupped hands.

Question 13

Therapeutic/interpersonal use of self; Anxiety

Answer 13

psychoeducation, relaxation and distraction, mindfulness, validation of experience, encouraging social support, trauma informed care.

Question 14

Cognitive behavioural therapy; Anxiety

Answer 14

helps make sense of consumers experiences, values, beliefs, attitudes and day to day thoughts in the context of emotional and behavioral response.

Question 15

Antidepressants; Anxiety

Answer 15

useful in managing associated mood disorders. do not provide an immediate response

Question 16

Mood stabilizers; Anxiety

Answer 16

useful in managing associated mood disorder do not provide an immediate response

Question 17

Anti-anxiolytics; Anxiety

Answer 17

short term management only. can be sedating and addictive

Question 18

Levels of anxiety

Answer 18

normal
- perceptual field is open, person is in a relaxed state, calm voice, direct and purposeful in action, positive feelings of security, solid levels of confidence and satisfaction
moderate
- perceptual field narrows and the person is less conscious of the other factors around them but good for learning as focus on solving the problems/ issues intensifies.
severe
- perception is restricted, difficulty in solving problems, become agitated, disorganised, behaviour reflects this, pacing, hand wringing fidgeting, sweating, trembling and dizzy.
panic levels
- destructive, person is unable to execute simple motor tasks, fumbles and disorganised, cloudy thinking

Question 19

What is anxiety

Answer 19

• normal, anxiety affects everyone
• common
• uncomfortable, distressing
• progressive levels of anxiety

Question 20

Characteristics of anxiety

Answer 20

• anxiety is red by fear (without fear you cannot have anxiety. even if fear is not triggered by a specific object, there has to be a fear of something for anxiety to be triggered in the first place)
• influenced by need to control fear
• encourages avoidance of fearful stimuli

Question 21

Epidemiology

Answer 21

• anxiety disorders are the most common mental disorders experienced by adults in NZ
• influenced by socioeconomic circumstances
• PTSD most common
• least common OCD
• Gender; male to female @ 1;2
• age of onset variable
• highest rate of co-morbidity with substance use

Question 22

Aetiology

Answer 22

causes remain contentious

- 2 main theories; biological and learning

Question 23

biological theories

Answer 23

evolutionary argument- we remain predisposed to fear and what our ancestors feared, a safety mechanism to protect is from predators
genetic inheritance- anxiety disorder, particularly panic disorders do run in families, research indicates a 3-to-5 fold increase risk in first degree relatives developing an anxiety disorder
altered brain chemistry- neurotransmitters not flowing or being absorbed properly may stimulate the sympathetic nervous system activating the fight or flight mechanism

Question 24

learning theories

Answer 24

• cognition theory- result of a chain of events whereby a trigger in the environment leads to the person thinking in distorted ways exacerbating anxious feelings and behaviours. catastrophizing and avoiding situations that are likely to invoke anxiety
  socio-ecological theory- the environment as well as social events create stress. while some stress is necessary as per moderate levels, high levels can lead to an overload on the mind and body depleting coping mechanisms leading to a breakdown. sometimes stress breakdowns manifest in physical ways (illness) and sometimes psychological (anxiety)

Question 25

Generalised anxiety disorder

Answer 25

Definition: excessive anxiety and worry occuring more days than not for a period of at least 6 months, about a number of events or activities. the individual finds it difficult to control the worry”

• also known as free-flowing anxiety
• can leave people feeling helpless and depressed
• typically worry about everyday things
• heightened startle response
• high co-existence rate with other disorders

Question 26

somatoform disorder

Answer 26

• focus on physical symptoms in anticipation of a serious illness or disease
• people often have a strong convection they are seriously unwell and will frequently go to hospital and medical centres in attempts to find a solution