Stress and anxiety Flashcards
Personality and behavior patterns- Type A
competitive, aggressive, ambitious, impatient, alert, tense, restless
Personality and behavior patterns- Type B
relaxed, easygoing, easily satisfied
Personality and behavior patterns- Type C
introverted, respectful, conforming, compliant, and eager to please
Personality and behavior patterns- Type D
increased negative emotions, pessimism, nonsharing of emotions
What is known as consideration of demands, constraints, resources, and personal goals and beliefs
appriasal
What is primary appraisal?
evaluation of events as s threat, harm, or challenge
–goal relevant? goal consistent with values and beliefs? personal commitment?
What is secondary appraisal?
explanation of outcome of events
–what would happen if…??
What are the two factors that determine if a person experiences stress response?
Person-environment relationships and appraisal
What do we know about acute stress?
leading to physiologic overload which causes negative impact on health
What do we know about chronic stress?
clearly linked to negative health outcomes
What is the role of stress in mental health
Stress in a transactional process arising from real or perceived internal or external environmental demands that are appraised as threatening or benign
What happens to immune function with chronic stress
Immune function goes down
What is allostasis
A term used to describe the the dynamic regulatory process that maintains homeostasis through a process of adaptation
___________ is the consequence of the wear and tear on the body and brain that leads to ill health
Allostatic load
When the situation is viewed as a challenge the emotions are likely to be…
Positive
What are borderline emotions
Somewhat ambiguous: hope, compassion, empathy, sympathy, and contentment
What are nonemotions
Connote emotional reactions but are too ambiguous to fit into any of the preceding categories: confidence, awe, confusion, and excitement
Deliberate, planned, and psychological effort to manage stressful demands
Coping
What are the two types of positive coping
Problem focused and emotional focused
What happens in problem focused coping
Actually changes the person-environment relationship
What happens in emotion focused coping
Changes the meaning of the situation
What is adaption
Persons ability to survive and flourish
What are the three important areas adaption affects
Health, Psychological well-being, and social functioning
What are the goals for those who are at high risk for stress
Recognize the potential for stressful situations and strengthen positive coping skills
Assessment of biologic domain
Gender differences, review of systems, physical functioning, and pharmacological assessment
Interventions for biological domain
Activities of daily living, nutrition, exercise, relaxation techniques, referral for hypnosis or biofeedback
Assessment of psychological domain
Emotions and their severity, how person reacts to emotions, coping strategies (problem and emotion focused)
Interventions for psychological domain
Assist patients to develop appropriate problem solving strategies and have patient discuss person-environment situation and develop alternative coping strategies
Assessment of social domain
Recent life changes; social network: size and extent of network, functions that network serves, degree of reciprocity between the patient and other network members, degree of interconnectedness
Interventions for social domain
Facilitation of family functioning, assistance in expanding social network, support of family unit functioning, parent education, family therapy
Examples of anxiolytics
Benzodiazepines, SSRIs, other antidepressants, beta blockers, barbiturate sedatives, antihistamines
Examples of benzodiazepines for anxiolytics? Where do they work?
*pam. Alprazolam, lorazepam, diazepam, clorazepam. They work at gaba receptors
Where do SSRIs work? Examples of anxiolytics?
Work on serotonin. Can see mood changes. Zoloft, Prozac, citalopram, escitalopram
Examples of beta blockers for anxiolytics? What do they do?
Propranolol, metoprolol. Slow down sympathetic response, decease HR
Example of barbiturate sedative anxiolytic
Phenobarbital
Example of antihistamine anxiolytic
Diphenhydramine (Benadryl)
Sudden, discrete periods of intense fear or discomfort accompanied by significant physical and cognitive symptoms
Panic attacks
When is panic normal? Abnormal?
Normal during periods of threat, abnormal when continuously experienced in situations of no real physical or psychological threat
What is agoraphobia
Fear of open spaces
Risk for panic disorder
Female, middle aged, low socioeconomic status, widowed/separated/divorced
What race has the highest rate of panic disorders
Whites
How can smoking tobacco be a risk for panic disorder
Because nicotine can cause tachycardia and tachypnea which can trigger a panic attack
What neurotransmitter do you need more of to calm the body? What does it do when we don’t have enough?
Need more serotonin to calm the body. Lack of serotonin will jazz the body
Priority care issue with panic disorder
Safety because high risk of suicide. People are not thinking clearly when they have a panic attack
What medication do we give to stipe a panic attack right away
Benzodiazepines
Emergency care with panic disorder
Stay with the patient, reassure them that you will not leave, give clear, concise directions, assist patient to an environment with minimal stimulation, walk or pace with the client, administer prn anxiolytics, afterward allow patient to vent their feelings
What is obsessive-compulsive disorder
Obsessions are thoughts, compulsions are behaviors. Obsessions are excessive, unwanted, intrusive, and persistent thoughts, impulses, or images causing anxiety and distress. They are not under the patients control and are incongruent with the patients usual thought patterns. Compulsions are repeatedly performed behaviors in a ritualistic fashion with the goal of preventing or relieving anxiety and distress caused by obsessions
Onset of obsessive-compulsive disorder
Early 20s-mid 30s with symptoms often beginning in childhood
What do women have a higher incidence with obsessive-compulsive disorder
Of checking and cleaning rituals, with onset typically in the early 20s
Are men or women more often affected as children?
Men
Are men most commonly affected by obsessions or compulsions?
Obsessions
Psychopharmacology for obsessive compulsive disorder
Sertaline, fluvoxamine, paroxetine, fluoxetine
What is the diagnosis that is used when they can’t exactly figure out what it is
Generalized anxiety disorder
What is generalized anxiety disorder?
Feelings of frustration, disgust with life, demoralization, and hopelessness. Sense of ill-being and uneasiness and fear or imminent disaster
What is going on with the sympathetic nervous system with generalized anxiety disorder
The sympathetic nervous system is always on alert
Is GAD more common in men or women
Twice as common in women
Most common psychopharmacology for GAD
Benzodiazepines
Psychopharmacology for GAD
Benzodiazepines
Paroxetine, imipramine, venlafaxine
Buspirone (BuSpar)
Beta blockers
What is the difference between acute stress disorder and post traumatic stress disorder
ASD is short term (within 1 month) disorder r/t experience of major trauma and PTSD is long term disorder (beyond 1 month) r/t experience of major trauma
What symptoms may a person with PTSD have
Reexperiencing of event through distressing images, thoughts or perceptions; recurrent nightmares; flashbacks; extreme stress on exposure to event or image that resembles traumatic event
Risk factors of PTSD
Prior diagnosis of ASD; extent, duration, and intensity of trauma; environmental factors
Are women or men more likely to experience PTSD
Women are twice as likely
____% of females and ____% of male veterans are diagnosed with PTSD
27% of females and 35% of male veterans
What is the treatment of choice for specific phobia
Exposure therapy , but anxiolytics may be used for short term relief of anxiety
What is the treatment for social phobia
SSRIs to reduce social anxiety and phobic avoidance
What are dissociative disorders
Response to extreme external or internal events or stressors; failure to integrate identity, memory, and consciousness
Inability to recall
Dissociative amnesia
Unexpected travel away from home
Dissociative fugue
Being detached from ones body
Depersonalization disorder
What are symptoms of anxiety
Increased Herat rate, diaphoresis, tachypnea, chest tightness
