Psych, 3Rd Semester, Nursing, Part 3

Front 1

a state wherein a person feels as strong sense of dread, frequently accompanied by physical symptoms of increased heart rate, respiratory rate, elevated blood pressure (autonomic nervous system) without having a specific source or reason for the emotions

Back 1

• ANXIETY

Front 2

ANXIETY IS PATHOLOGICAL IF:
(4) things

Back 2

• The response is greatly disproportionate to the risk and severity of the danger threat.

Front 3

ANXIETY IS PATHOLOGICAL IF:
(4) things

Back 3

• The response continues beyond the existence of a potential danger or threat.

Front 4

ANXIETY IS PATHOLOGICAL IF:
(4) things

Back 4

• Intellectual, social, or occupational functioning is impaired.

Front 5

ANXIETY IS PATHOLOGICAL IF:
(4) things

Back 5

• The individual suffers from a psychosomatic effect. (colitis,dermatitis

Front 6

: behavioral or psychological retreat from anxiety-provoking experiences

Back 6

 Withdrawal:

Front 7

discharge of anxiety through aggressive behaviors

Back 7

 Acting out:

Front 8

visceral or physiological expression of anxiety

Back 8

 Psychosomatization:

Front 9

management of anxiety-laded experiences through evasive behaviors

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 Avoidance:

Front 10

using anxiety in the service of learning adaptive behavior

Back 10

 Problem solving

Front 11

LEVELS OF ANXIETY:
–Increased motivation
–Sharpens the senses
–Learning is enhanced

Back 11

LEVEL ONE
 Mild Anxiety

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LEVELS OF ANXIETY:
–Perceptual field diminishes
–Attention span decreases
–Needs help with problem solving
•Diaphoresis, tremors, muscle tension

Back 12

LEVEL TWO
 Moderate Anxiety:

Front 13

LEVELS OF ANXIETY:
–Can focus on only one detail
–Severely limited attn. span
–Physical symptoms common

Back 13

LEVEL THREE
 Severe Anxiety

Front 14

LEVELS OF ANXIETY:
–Behavior aimed @ relief of anxiety
•Tacycardia, dilated pupils, hyperventilation.
•Stay with person in panic: Safety, tunnel vision can’t make decisions for themselves

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LEVEL THREE
 Severe Anxiety

Front 15

LEVELS OF ANXIETY:
–Unable to focus on any detail
–Misperception of environment (delusion & hallucinations)

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LEVEL FOUR
 Panic Anxiety

Front 16

Level of Anxiety:
–Fear of dying or going insane
–Prolonged episode leads to physical and emotional exhaustion
•Tunnel vision, not able to make decisions, stay with them

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LEVEL FOUR
 Panic Anxiety

Front 17

Phobic disorder, Agoraphobia
Symptoms include:

Back 17

Intense anxiety,Acute anxiety in crowds,Fear of losing control,Fear of inability to escape or

Front 18

Phobic disorder, Agoraphobia
Symptoms include: (cont)

Back 18

find secure place,Avoiding situations, Fear of being alone

Front 19

persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way that will be humiliating

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• Social Phobia
• Treatment:
• SSRI : Paxil

Front 20

marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation, such as animals, insects, heights, flying or seeing blood

Back 20

• Specific Phobias:

Front 21

• Characterized by excessive anxiety and worry that occurs more days than not, for at least 6 months.

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• Generalized Anxiety Disorder:

Front 22

• Symptoms: restlessness or feeling on edge, being easily fatigued, difficulties with concentration, irritability, muscle tension, and sleep disturbance.

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• Generalized Anxiety Disorder

Front 23

recent and unexpected panic attacks are present, a at least one of the attacks has been followed for 1 or more months by persistent concern about having additional attacks

Back 23

• Panic disorder

Front 24

• Symptoms: Palpitations, sweating, trembling, shortness or breath, choking sensation, chest pain, fear of loosing control, fear of dying, altered sense of reality.

Back 24

Panic disorder: SSRI’s, Zoloft
TCA’s, Benzodiazepines, Clonazepam, Anticonvulsants,Beta Blockers

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• They are sudden, spontaneous episodes accompanied by symptoms such as a racing heart or palpitation, dizziness, dyspnea, and feeling that death is imminent.

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• Panic attack:• Treatment: SSRI, Paxil

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recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance as intrusive and inappropriate and cause marked anxiety or distress.

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• Obsessions:

Front 27

repetitive behaviors that the person feels driven to perform in response to an obsession.

Back 27

• Compulsions

Front 28

Symptoms:Obsessive recurrent, intrusive thoughts untrollable compulsive impulses or actions recognition of unreasonable nature of thoughts and behaviors

Back 28

Obsessive compulsive disorder (OCD):

Treatment:SSRI,TCA

Front 29

Sx: Recurrent, intrusive recollections and memories, dreams,Nightmares,Flashbacks,
relives” traumatic experience
Anxiety, panic, despair

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Post traumatic stress DO:

Treatment:SSRI,Nefazodone & bupropion,Benzodiazepines

Front 30

• Different from PTSD dissociation occurs, duration of symptoms shorter.

Back 30

• Acute stress disorder:

Front 31

Treatment for anxiety Disorders: (3)

Psychotherapy:

Back 31

Insight based treatments, acquiring new skills to face stressful events.

Front 32

Treatment for anxiety Disorders: (3)

• Pharmacotherapy:

Back 32

Anxiolytics (benzodiazepines, Xanax, Valium, Ativan, Librium). Hypnotics
Buspirone/BuSpar: not addicting.

Front 33

Formerly called multiple personality disorders.
Presence of two or more distinct identities that recurrently take control of the individual’s behavior.

Back 33

• Dissociative identity disorder (DID):

Front 34

Sudden, unexpected travel away from home or work, accompanied by the inablility to recall one’s past or identity. Many assume new identity

Back 34

• Dissociative Fugue

Front 35

Inability to recall important personal info, usually of a traumatic or stressful nature.

Back 35

• Dissociative Amnesia:

Front 36

Persistent or recurrent feelings of being detached from one’s mental processes or body that is accompanied by intact reality testing

Back 36

• Depersonalization disorder:

Front 37

Physical symptoms in the absence of clinical significant organic disease
Pt frequently seeks and obtains medical treatment for multiple, clinically significant somatic complaints.

Back 37

Somatoform disorders:

Front 38

Complaints must begin before age 30 and the complaints cannot be adequately explained by any general medical disorder or the direct effects of a substance

Back 38

Somatoform disorders:

Front 39

A long standing dependency. A preoccupation with the “sick role”. A fear or belief that one has a serious illness in spite of medical reassurances to the contrary.

Back 39

• Hypochondriasis

Front 40

Predominant focus in one or more anatomical sites, and pain is of sufficient severity to warrant clinical attention. Pain is better accounted psychological factors (mood & anxiety) vs. severity & maintenance of symptoms.

Back 40

• Pain disorder:

Front 41

Exhibits one or more symptoms or deficits that affect voluntary motor or sensory function and that appear to be related to a neurological or general medical condition

Back 41

• Conversion Disorder:

Front 42

Drugs for pts with anxiety, dissociative, and somatoform disorders

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Psychopharmacological agents (anxiolytics)

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Psychopharmacological agents (anxiolytics)

Back 43

Benzodiazepine agents (anti-anxiety agents)
Xanax (alprazolam)
Valium (Diazepam)
Ativan (lorazepam)
Antidepressants