anxiety (halter ch 3, 15, 16, 25, 49, 40, 51) Flashcards by McKenna Michael

necessary emotional response for survival, a normal response to threatening situations or unknown origin; Is subjective

anxiety

How well did you know this?

Not at all

Perfectly

“pressure” that is brought to bear on the individual

stress

How well did you know this?

Not at all

Perfectly

innate intellectual response to a dangerous or life-threatening situation

fear

How well did you know this?

Not at all

Perfectly

emotional level of anxiety:

Part of day-to-day living
can motivate learning
increased perceptual field

mild

How well did you know this?

Not at all

Perfectly

emotional level of anxiety:

Focus only on immediate concern
Perception narrows
“Selective Inattentiveness”
Decreased clarity of thinking

moderate

How well did you know this?

Not at all

Perfectly

two categories stressors

physical (environmental or physical)

- psychological (situational)

How well did you know this?

Not at all

Perfectly

emotional level of anxiety:

Greatly reduces perceptual field
Either singularly focused or not focused at all
No learning

severe

How well did you know this?

Not at all

Perfectly

emotional level of anxiety:

Awe, dread, terror
frightened, paralyzed
Behaviors not purposeful
Unable to process. Possible psychosis

panic

How well did you know this?

Not at all

Perfectly

4 emotional levels of anxiety (lowest to highest)

mild
moderate
severe
panic

How well did you know this?

Not at all

Perfectly

when might stress be considered pathological (4)

response is out of proportion to risk and severity of danger/threat
response continues beyond existence of potential danger/threat
intellectual, social, or occupational functioning impaired
individual suffers psychosomatic effect

How well did you know this?

Not at all

Perfectly

defense mechanism: largely unconscious motivation to feel caring and concern for others and act for the well-being of others

altruism

How well did you know this?

Not at all

Perfectly

defense mechanism: used to counterbalance perceived deficiencies by emphasizing strengths

compensation

How well did you know this?

Not at all

Perfectly

defense mechanism: involves escaping unpleasant, anxiety-causing thoughts, feelings, wishes, or needs by ignoring their existence

denial

How well did you know this?

Not at all

Perfectly

defense mechanism: transference of emotions associated with a particular person, object, or situation to another nonthreatening person, object, or situation

displacement

How well did you know this?

Not at all

Perfectly

defense mechanism: attributing to oneself the characteristics of another person or group. This may be done consciously or unconsciously

identification

How well did you know this?

Not at all

Perfectly

defense mechanism: process in which events are analyzed based on remote, cold facts and without passion, rather than incorporating feeling and emotion into the processing

intellectualization

How well did you know this?

Not at all

Perfectly

defense mechanism: unconscious rejection of emotionally unacceptable features and attributing them to others

projection

How well did you know this?

Not at all

Perfectly

defense mechanism: justifying illogical or unreasonable ideas, actions, or feelings by developing acceptable explanations that satisfy the teller and the listener

rationalization

How well did you know this?

Not at all

Perfectly

defense mechanism: when unacceptable feelings or behaviors are controlled and kept out of awareness by developing the opposite emotion or behavior

reaction formation

How well did you know this?

Not at all

Perfectly

defense mechanism: reverting to an earlier, more primitive and childlike pattern of behavior that may or may not have been exhibited previously

regression

How well did you know this?

Not at all

Perfectly

defense mechanism: unconscious exclusion of unpleasant or unwanted experiences, emotions, or ideas from conscious awareness

repression

How well did you know this?

Not at all

Perfectly

defense mechanism: unconscious process of transforming negative impulses into less damaging and even productive impulses

sublimation

How well did you know this?

Not at all

Perfectly

cognitive distortion: Thinking in black and white, reducing complex outcomes into absolutes

all or nothing thinking

How well did you know this?

Not at all

Perfectly

cognitive distortion: Using a bad outcome (or a few bad outcomes) as evidence that nothing will ever go right again

overgeneralization

How well did you know this?

Not at all

Perfectly

cognitive distortion: A form of generalization in which a characteristic or event becomes definitive and results in an overly harsh label for self or others

labeling

cognitive distortion: Focusing on a negative detail or bad event and allowing it to taint everything else

mental filter

cognitive distortion: Maintaining a negative view by rejecting information that supports a positive view as being irrelevant, inaccurate, or accidental

disqualifying the positive

cognitive distortion: Making a negative interpretation despite the fact that there is little or no supporting evidence

jumping to conclusions

cognitive distortion: inferring negative thoughts, responses, and motives of others

mind reading (jumping to conclusions)

cognitive distortion: Anticipating that things will turn out badly as an established fact

fortune telling error (jumping to conclusions)

cognitive distortion: Exaggerating the importance of something (e.g., a personal failure or the success of others) or reducing the importance of something (e.g., a personal success or the failure of others)

magnification or minimization

cognitive distortion: extreme form of magnification in which the very worst is assumed to be a probable outcome

catastrophizing

cognitive distortion: Drawing a conclusion based on an emotional state

emotional reasoning

cognitive distortion: Rigid self-directives that presume an unrealistic amount of control over external events

"should" and "must" statements

cognitive distortion: Assuming responsibility for an external event or situation that was likely outside personal control

personalization

DSM 5 anxiety disorders (6)

- separation anxiety disorders - phobias - social anxiety disorder - panic disorder - agoraphobia - generalized anxiety disorder (GAD)

DSM 5 OCD related disorders (4)

- obsessive compulsive disorder (OCD) - body dysmorphic disorder - hoarding disorder - trichotrillomania and excoriation disorders

physical S+S anxiety disorder

- dizziness - sweating - chest pain - decreased sex drive - rapid breathing and breathlessness - heart palpitations - increased bp - numbness - N/D - chills/hot flashes - weakness - tremors

assessment of anxiety disorders (7)

- assess for safety - rating scales (hamilton) - history (onset triggers, duration, pattern, intensity) - MSE - level of impact on life - attempts to cope (attack v withdrawal behavior) - rule out medical causes

defense mechanism: attaching to something positive

introjection

defense mechanism: override negative with habit

ritual and undoing

Recurrent unexpected panic attack (out of the blue) peaks within minutes. Followed by worry of another attack and/or maladaptive change in behavior in response to having had an panic attack

panic disorder

DSM 5 for panic attack (4+ symptoms peaked within 10 minutes)

- palpitations, pounding heart - sweating - trembling, shaking - SOB - feeling of choking - chest pain - nausea - feeling dizzy/faint - de-realization or depersonalization - numbing/tingling sensation - chills/hot flashes - fear of dying or "going crazy"

• Concern of being apart from significant other • Fear that something bad will happen to significant other • Unable to function or difficulty in functioning

separation anxiety disorder

• Fear of being somewhere without chance of escape or without help or might be embarrassing • Use of avoidance behaviors

agoraphobia

- Severe anxiety triggered by social or performance situation - Fear of potentially negative outcomes - May result following a horrifying (perceived) social event

social anxiety disorder

- Irrational, Persistent Fear - Desire to avoid or change in behavior to avoid - May be manifested after traumatic situation

specific phobias

mnemonic for GAD DSM 5

"EGADS, im so MISERAble"

DSM 5 criteria for generalized anxiety disorder

``` Excessive Generalized Anxiety Daily (or most days) Six months ``` ``` Muscle tension Irritability Sleep disturbance Energy (fatigue) Restlessness Attention (difficulty concentrating) ```

Anxiety disorder characterized by recurrent obsessions or compulsions that are inordinately time-consuming or that cause significant distress or impairment

obsessive compulsive disorder (OCD)

DSM 5 criteria for OCD

``` "I MURDER" Intrusive Mind-based Unwanted Resistant Distressing Ego-dystonic Recurrent ```

A persistent and intrusive idea, thought, | impulse or image

obsession

repetitive and seemingly purposeful behavior performed in response to uncontrollable urges or according to a ritualistic or stereotyped set of rules

compulsion

3 major dimensions of OCD

- checking compulsions - symmetry and order - cleanliness

OCD disorder: - preoccupation with defects - Perfectionistic and fear of rejection - Leads to feeling shame, depression, disgust with self

body dysmorphia

OCD disorder: - Accumulation of belongings - Anxiety over getting rid of things - People are indecisive and often have depression/ anxiety

hoarding disorder

OCD disorder: Hair pulling. Sometimes with trichophagia

trichotillomania

OCD disorder: skin picking leads to damage of skin

excoriation

interventions for mild-moderate anxiety (3)

- good time to teach - direct pt to decrease anxiety - prevent escalation of anxiety

interventions for severe anxiety (4)

- safety - decrease stimuli - firm, short, concise statements - meds or restraints if other interventions fail

interventions for pts with cognitive distortions (6)

- reframing - challenging beliefs - flooding - imaginal flooding - graduated exposure - thought stopping

1st line meds for anxiety

SSRIs

med options for anxiety (5)

- SSRIs (1st line) - benzos (short term, need to taper) - buspirone (non-benzo anxiolytic, takes time) - antihistamine/noradrenergic - b blocker, clonidine

benzodiazepine meds (5)

- lorazepam - clonazepam - alprazolam - diazepam - oxazepam

trauma induced disorder : An anxiety disorder that develops during the 4 weeks after event and lasting at least 2 days

acute stress disorder

after what period of time is Dx changed from acute stress disorder to PTSD

1 month

DSM 5 criteria for PTSD

"TRAUMA" - Traumatic event - Re-experiencing (1+) - Arousal (increased sensory arousal - 2+) - Unable to function - Month or more - Avoidance (3+)

An alteration of conscious awareness of behavior, | affect, thoughts, memories

dissociation

feelings of being detached from one’s body or | thoughts

depersonalization

body has an unreal or strange quality

derealization

examples of re-experiencing in PTSD (4)

- images/thoughts - flashbacks - dreams - response to cues that symbolize trauma

examples of avoidance in PTSD (5)

- thoughts, feelings, convos about trauma - avoid reminders - unable to remember all/some - diminished interest/feelings - feeling of detachment from others

examples of increased sensory arousal (3)

- hyper-startle response - anger outbursts - impaired sleep, concentration

Tx PTSD (3 stages)

STAGE 1: - safety first - stop self-destructive behaviors STAGE 2: - memory work, reducing arousal, integrating emotions - accepting help and comfort - decreasing dissociation - transforming memories STAGE 3: - develop problem solving - develop variety coping skills - variety of social supports

meds for PTSD

- SSRIs (sertaline and paroxetine) - SNRIs (venlafaxine) - phenalzine or TCA if SSRI not effective - prazosin for nightmares - clonidine/propranolol for hyperarousal

med for nightmares with PTSD

prazosin

med for hyperarousal for PTSD

clonidine or propranolol

should you forcibly prohibit pt with OCD from performing compulsions

Tx self injury (6)

- address underlying issues - identify triggers - feel and express emotions avoided by injury - self sooth and calm - use less injurious behaviors - distraction (delay, exercise, call friend)

DSM 5 criteria for acute stress disorder (3/6)

- dissociative symptoms - re-experiencing event - avoiding situation - intense anxiety - hypervigilence - impairment of everyday functioning