Test 2 psych Flashcards
Moderate Anxiety
- perceptual field narrows
- some details are excluded
- selective inattention
- ability to think clearly is hampered, but learning and problem solving can still tke place-not optimal
- phys symptoms:tension, pounding heart, increased pulse and RR, HA, gastric discomfort, urinary urgency
- voice tremors, shaking
- can be constructive
Severe Anxiety
- perceptual field greatly reduced
- may focus on one particular detail, or scattered details; difficulty noticing what’s going on even when pointed out.
- learning and problem solving-NOT possible
- may be dazed and confused
- behavior is automatic, aimed at reducing anxiety
- SOMATIC: trembling, pounding heart, hyperventilation, impending doom, HA, nausea, dizziness, insomnia
*Severe/Panic levels prevent problem solving/effective solutions. Unproductive relief behaviors=vicious cycle.
Panic
- most extreme level of anxiety
- markedly disturbed behavior
–unable to process what’s going on, lose touch with reality
- pacing, running, shouting, or withdrawal
- hallucinations/false sensory perceptions
- behavior may be erratic, uncoordinated, impulsive
- may lead to exhaustion
Mild Anxiety
- normal, everyday life
- allows person o see, hear, grasp more info
- problem solving = MORE effective
- physically: slight discomfort, restless, irritable
- mild tension relieving behaviors: nail biting, foot tapping)
*mild/moderate levels can alert the person that something is wrong and can stimulate appropriate action
Interventions:
Mild to Moderate Anxiety
–help client focus/solve problems
- provide calm presence
- recognize client’s distress
- willingness to listen
- communication: open ended questions, broad openings, clarification seeking.
Interventions:
Severe Anxiety
Panic
- physical needs (fluids, rest) must be met to prevent exhaustion
- quiet environment; reduce stimuli
- meds/restraints may be used after less restrictive interventions have failed
- communicate with firm, short, simple statements
- provide safe environment
- meet physical needs
Defenses against Anxiety
- automatic psychological processes that protect the person against anxiety
- Healthy, Intermediate, Immature
Healthy Defense Mechanisms
- Sublimation-unconscious process-substituting constructive, socially acceptable acivity for unacceptable activity/impulses: woman angry with boss writes short story about heroic woman.
- Humor-deal with stress/conflict by using amusing aspects of the conflict
- Suppression-conscious denial of disturbing situations or feelings (don’t worry about bills until after exams)
Intermediate Defense Mechanisms
- Repression-exclusion of unpleasant/unwanted experiences or emotions from conscious awareness-unconscious level-someone who has been sexually abused but can’t remember it. *cornerstone of defense mechanisms.
- Displacement-placing emotions associated with one person/thing/situation on to another person/thing/situation that is non-threatening-a pt criticizes a nurse after family fails to visit.
- Reaction formation-unaceptable feelings or behaviors ar controlled and kept out of awareness by develping the opposite behavior or emotion.
- Somatization-transfer of anxiety from the psychological to a physical symptom that has n organic cause. Aka conversion.
- Undoing-making up for an argument with a gift to undo
- Rationalization-justifying illogical ideas, actions, or feelings by developing acceptable explanaions that satisfy the teller as well as the listener-I didn’t get the raise bc my boss doesn’t like me.
Immature Defense Mechanisms
- Passive aggression-indirectly and unassertively expressing aggression toward others.
- Acting Out-dealing with conflicts/stressors by actions rather than reflections or feelings.
- Dissociation-feeling unattached to self, others or environment.
- Devaluation-giving negative value to self or others to try to appear good and reduce stress/anxiety.
- Idealization-emotional stressors are dealt with by idealizing or exaggerating another’s qualities.
- Splitting-inability to integrate positive and negative attributes at the same time (prevalent in people with borderline personality disorders)j.
- Projection-placing one’s own negative attributes onto another.
- Denial-excaping from unpleasant realities by ignoring their existence (hallmark of alcoholics/drug addicts).
Anxiety
Most common of all psychiatric disorders
Affects up to 13.3% of population
Women more than men
Tends to run in families
Evidence of specific genetic contributions.
Co-morbidities=major depression, substance abuse
Panic Disorders
panic attack
terror
feels like heart attack-palpitations, chest pain, breathing difficulties
occurs out of the blue
intense, recurrent, unexpected
impending doom
Agoraphobia
Fear of being in an environment or situation from which excape may be difficult
Anxiety Disorders
- Panic Disorder
- Phobias-agoraphobia, social phobia, specific phobia
- OCD
- Generalized Anxiety Disorder (more days than not for 6 months)
- Stress Related: PTSD/Acute Stress Disorder-stress response of the hypothalamus-pituitary-adrenal system is abnormal.
SSRI’s are first line of treatment.
OCD
Obsessions: thoughts, impulses, or images that persist
Compulsions: ritualistic behaviors that help reduce anxiety
Drugs: SSRI’s, Luvox
Effective: thought stopping and response prevention
SSRI’s
- First line of tx for anxiety
- rapid onset, few SE’s
- SE’s-GI, weight gain/loss, sexual, sweating, RLS
- BBW in 2004 (since then suicid rate has increased 18%)
Meds for Anxiety
- SSRI’s=first line
- Anxiolytics/benzodiazepines (addictive)
- Xanax, librium, klonopin, valium, ativan
- don’t stop abruptly (withdrawl, DTs, seizures)
- additive effect with alcohol
- tolerance
- short term only
-Buspar=non-addictive (2-4 wks for full effect)
