Week 6 Flashcards
What is agoraphobia?
anxiety about being in places or situations from which escape might be difficult ( or embarrassing) or in which help may not be available in the event of having a panic attack or panic like symptoms. Ie using public transport / shopping.
What is Anacastic Personality?
associated with client’s with OCD where preoccupation with orderliness, need for control and detail, can be rigid and inflexible.
What is Anxiety?
Feeling apprehension caused by anticipation of danger, which may be internal or external threat to one’s integrity.
What is Behaviour Therapy?
interventions that reinforce desired behaviours and reducing undesirable behaviours.
What is a compulsion?
the recurrent thought or behaviours such as counting, checking, touching.
What is exposure Therapy?
the client is exposed to the feared item/situation until the client no longer experiences anxiety
What is Fear?
intense unpleasant reactions to a known threat
What is flooding?
a therapeutic approach used to expose the client to the anxiety provoking situation in a sustained manner until the client’s anxiety dissipates
What are Obsessions?
intrusive ideas, emotions or impulses that a client cannot remove from their conscious state
What is a Phobia?
an intense irrational fear of situations, places or people, where the level of distress experienced is excessive to the level of threat to the client.
What is a Social Phobia?
client’s feel they will be negatively judged by others and believe themselves to be flawed / worthless if found to be incompetent, therefore avoid situations or complete tasks to perfection as means of coping.
What is a Specific Phobia?
intense fear of a particular situation / object, when confronted with the item become highly anxious & have a panic attack and go to excess lengths to avoid the feared situation/object. Ie. Needle phobic
What is systematic desensitization?
the client utilises muscle relaxation techniques when progressively exposed to the anxiety provoking situation
What levels of Anxiety are there?
Anxiety can be a normal and healthy emotion that in mild forms can motivate us to act and complete tasks, i.e.; assignments.
However when anxiety is experienced in sustained moderate or severe levels this reduces your ability to complete tasks to the best of your ability and anxiety can manifest itself as disturbances in;
•Cognition
•Affect
•Behaviour
•Physical status
Cognitive responses to Anxiety
Impaired attention •Poor concentration •Forgetfulness •Errors in judgement •Preoccupation •Blocking of thoughts •Decreased perceptual field •Frightening visual images •Reduced creativity •Diminished productivity •Confusion •Hyper vigilance •Self consciousness •Loss of objectivity •Fear of loosing control •Fear of injury or death
Affective responses to Anxiety?
- Edgy
- Impatient
- Uneasy
- Tense
- Nervous
- Fearful
- Fright
- Alarm
- Terror
- Jittery
- Jumpy
Behavioural responses to Anxiety
- Restlessness
- Physical tension
- Tremors
- Startle reactions
- Rapid speech
- Lack of coordination
- Accident prone
- Interpersonal withdrawal
- Inhibited
- Avoidance
- Hyperventilate
Physical responses to Anxiety
- Increased blood pressure
- Palpitations
- Decreased blood pressure
- Low pulse rate
- Faint
- Rapid shallow breathing
- Shortness of breath
- Choking sensation
- Gasping for air
- Flushed face
- Face pale
- Increased perspiration
- Loss of appetite
- Abdominal discomfort / pain
- Diarrhoea
- Nausea
- Vomiting
- Dilated pupils
- Increased urine output
What is Mild Anxiety?
- Slightly elevated heart rate and blood pressure
- Feels safe and comfortable
- Perceptual field increased
- Ability to learn is increased
What is Moderate Anxiety?
- Occasional shortness of breath
- Mild gastric symptoms “butterflies in the stomach”
- Facial twitching, trembling lips
- Selective inattention
- Narrowing of the perceptual field
What is Severe Anxiety?
- Frequent shortness of breath
- Increased heart rate
- Elevated blood pressure
- Dry mouth, upset stomach, anorexia, diarrhoea or constipation
- Bodily trembling, fearful facial expression, tense muscles, restless, exaggerated startle response, inability to relax, difficulty falling asleep
- Extremely narrowed perceptual field
- Difficulty problem solving or organizing
What is Panic?
- Shortness of breath, choking or smothering sensation, sweating
- Hypotension, dizziness, chest pain or pressure, palpitations, chills or hot flushes
- Nausea
- Agitation, poor motor coordination, involuntary movements, entire body trembling, facial expression of terror
- Feeling of losing control, fear of dying
- Completely disrupted perceptual field
What are coping mechanisms for Mild Anxiety?
•Exercise •Phone a friend •Cry •Eat – seek comfort foods •Sleep – avoid your stressors •Distraction – movies •Talk about your concerns •Relaxation techniques Read •Maladaptive coping mechanisms •Increased risk taking behaviours •Increased use of alcohol / illicit drugs to reduce anxiety
What are coping mechanisms for moderate and severe anxiety?
When anxiety is perceived by the client to be painful, ego defence mechanisms are utilised at the unconscious level and are used to protect oneself. A range of ego defence mechanisms include: •Suppression Compensation •Repression Displacement •Regression Identification •Projection Introjections •Rationalisation Reaction Formation •Denial Splitting •Dissociation Sublimation
What are the ranges of Anxiety Disorders?
•General Anxiety Disorders (GAD) •Panic Disorders •Phobias – Agoraphobia –Specific Phobias – Social Phobia •Obsessional Compulsive Disorder (OCD) •Post Traumatic Stress Disorder (PTSD)
What is generalised Anxiety disorder?
Generalised anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about several events or activities. (work or school performance)
•The client finds it difficult to control the worry (APA, 2000 p 476)
•No single factor has been established as the cause of GAD
•More prevalent in women than men
•Co morbid mood disorders & substance related disorders
•Headaches are common
•50 % of clients complain their symptoms have been present since childhood or adolescence.
What is the criteria for Generalised anxiety disorder?
The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months.)
•Restlessness or feeling keyed up or on edge
•Being easily fatigued
•Difficulty concentrating or mind going blank
•Irritability
•Muscle tension
•Sleep disturbance (difficulty falling or staying asleep, restless unsatisfying sleep)
The above symptoms create significant distress / impairment in social/ occupational or other areas of functioning.
What is Panic Disorder?
- Most clients will experience extreme attacks in situations where most people would not be afraid
- Many client’s will have co-morbid Depression
- Peak onset is adolescence
- Rare in children & people over 45 yrs. of age
- Common in families – 8 times more likely
- Long term treatment
- Recurrent unexpected panic attacks
What is the criteria for Panic Disorder?
Criteria for Panic Attack:
A discrete period of intense fear or discomfort , in which four or more of the following symptoms developed abruptly and reached a peak within 10 mins:
• palpitations, pounding heart or accelerated heart rate
• sweating
• trembling or shaking
• sensation of shortness of breath or smothering
• feeling of choking
• chest pain or discomfort
feeling dizzy, unsteady gait, light headedness or faint
• derealisation or personalisation fear of losing control or going crazy
• fear of dying
• paraesthesia (numbness or tingling sensations)
• chills / hot flushes.
Panic attack and initial nursing management
- Stay with the client, reassure and encourage the client they will be ok
- If in a high stimulus environment, move to a quieter area
- Remove the trigger, remove the client from the trigger
- Reinforce desired behaviours
- Keep communication in short simple sentences
- Remain calm, use reassuring tone of voice with open body language
- Instruct the client to use abdominal breathing
- Administer benzodiazepine medications to assist the client resume control.
Panic attack and post Nursing Management
- Educate the client that they have experienced a “panic attack” provide written materials where possible due to residual anxiety
- Many client’s will be fearful of a reoccurrence.
- Keep explanations short and simple to assist retention of information
- Provide the client with a list of symptoms associated with panic attacks
- If no history of panic attacks and or prior symptoms, refer the client to the GP for further investigations
Panic disorder without Agoraphobia
•At least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:
• persistent concern about having additional attacks
• worry about the implications of the attack or its consequences (e.g.
losing control, having a heart attack, “going crazy”)
• a significant change in behaviour related to the attacks
• the panic attacks are not due to the direct physiological effect of a
substance (e.g. drug abuse, medications) or a general medical
condition (hyperthyroidism)
• the panic attacks are not better accounted for another mental
disorder
What is Agoraphobia?
Agoraphobia – anxiety about being in places or situations from which escape might be difficult ( or embarrassing) or in which help may not be available in the event of having a panic attack or panic like symptoms. i.e.; using public transport / shopping.
The situation is avoided (travel is restricted) or endured with marked distress or anxiety about having a panic attack or panic – like symptoms, or client may require the presence of a companion
