Psych: Anxiety Disorders
this disorder does concur with vertigo, cardiac disease, GI disorders, asthma, and those related to cigarette smoking
panic disorder
many ______ over the counter herbal remedies contain substances that may induce panic by increasing the heart rate, basal metabolic rate, bp, and sweating
ASIAN
Edgy Impatient Uneasy Nervous Tense Wound-up Anxious Fearful Apprehensive Scared Frightened Alarmed Terrified Jittery Jumpy these are all what type of symptoms in anxiety??
affective symptoms
in this type of anxiety disorder you are fearful, anxious about open spaces, being enclosed, or being outside of house
agoraphobia
this type of defense mechanism is satisfies internal needs through helping others
altruism
abnormalities in the benzodiazepine-_______-chlroide ion channel complex have been implicated in PANIC DISORDER
GABA
physical symptoms of anxiety include loss of appetite, revulsion about food, abdominal discomfort, diarrhea, abdominal pain, nausea, heartburn, vomiting
GI
this is an unavoidable human condition that takes many forms and serves different purposes
anxiety
pimrary symptoms of anxiety disorders are
anxiety and fear
why is it important to determine with culture someone is in terms of panic disorders??
bc some cultures don't have a word to describe "anxiety" and instead may use words or meanings to suggest physical complaints
Inhibited Tonic immobility Flight Avoidance Speech dysfluency Impaired coordination Restlessness Postural collapse Hyperventilation these are all what type of symptoms of anxiety??
behavioral symptoms
what's the onset of panic disorder??
between 20 and 24 years of age
There appears to be a substantial familial predisposition to panic disorder with an estimated heritability of 48% (Konishi et al., 2014). Studies show brain abnormalities in the "fear network" (amygdala, hippocampus, thalamus, midbrain, pons, medulla, and cerebellum) and changes in volume in different brain areas what type of theories is this for panic disorder?
biological thery
physical symptoms of anxiety include palpitations, heart racing, increased blood pressure
cardiovascular
in this type of theory for panic disorder suggests that one learns a fear response by linking an adverse or fear-provoking event, such as a car accident, with a previously neutral event, such as crossing a bridge. one becomes conditioned to associate fear with crossing a bridge
classic conditioning theory
this part of an emotional response to anxiety decipher the situation and decide whether the perceived threat should be approached or avoided
cognitive
the goal of this type of therapy include helping the patient o manage his or her anxiety and correcting anxiety-provoking thoughts through interventions including cognitive restructuring, breathing training, and psychoeducation
cognitive behavior therapy
in this type of therapy for panic disorder it is the first line treatment for those with panic and other anxiety disorders and is often used in conjunction with medications, including the SSRI's intreating those with panic disorder
cognitive behavioral therapy
Sensory-Perceptual Mind is hazy, cloudy, foggy, dazed Objects seem blurred or distant Environment seems different or unreal Feelings of unreality Self-consciousness Hypervigilance Thinking Difficulties Cannot recall important things Confused Unable to control thinking Difficulty concentrating Difficulty focusing attention Distractibility Blocking Difficulty reasoning Loss of objectivity and perspective Tunnel vision Conceptual Cognitive distortion Fear of losing control Fear of not being able to cope Fear of physical injury or death Fear of mental disorder Fear of negative evaluations Frightening visual images Repetitive fearful ideation these are all what type of symptoms of anxiety??
cognitive symptoms
this part of an emotional response to anxiety disorder is used to resolve the threat
coping strategies
generally speaking, the prevalence of anxiety disroders ________ with age
declines
the combination of depressive and anxiety symptoms in elderly patients has been shown to: ________ social functioning __________ somatic symptoms _________ depressive symptoms
decrease increase increase
these are used to reduce anxiety by preventing or diminshingunwanted thoughts and feelings they are helpful with everyday problems but they become problematic when overused
defense mechanisms
this type of defense mechanism is when you avoid feelings associated with recognizing a problem
denial
being detached from oneself
depersonalization
this type of defense mechanism is taking out frustrations on an unsuspecting or vulnerable person, animal, or object, anxiety is reduced, and the individual is protected from anticipated reatilationf ro the source of the frustration
displacement
T or F: panic disorder can be improved through active participation in a routine ___________ program
exercise
this type of therapy for panic disorder is the treatment of choice for phobias the patient is repeatedly exposed to real or simulated anxiety-provoking situations until he or she becomes desensitized and anxiety subsides
exposure therapy
physical symptoms of anxiety incdlue dilated pupils
eyes
these questions are asking about what: how has the disorder affected your family's social life? what limitations related to travel has the disorder placed on you or your family? what coping strategies have you used to manage symptoms? how has the disorder affected your family members or others?
family factors
Risk factors for Panic disorder: being _______ gender ______ aged _____ socioeconomic status separated or divorced!!! ________ history substance and stimulant ______ smoking _________ and severe _________ early life ________ history of physical or sexual _______ socioeconomic or personal disadvantages and behavioral inhibition
female middle low family use tobacco stressors traumas abuse
a patient with ohidiophobia (morbid fear of snakes) might be presented with a real snake repeatedly anti the patient's anxiety decreases this is an example of what type of therapy??
flooding
this is at technique used to desensitize the patent to the fear associated with a particular anxiety-provoking stimulus ; you present feared objects or situations repeatedly without session breaks until the anxiety dissipates
flooding
in this type of anxiety it is persistent, excessive anxiety or worry about many aspects of life
generalized anxiety disorder
is hyper or hypoventilation common in panic disorder??
hyperventilation
a way to explain this theory of panic disorder is that stress hormones are activated, anxiety increases, which can lead to a panic attack
hypothalamic pituitary adrenal axis
this type of therapy for panic disorder is a provocative technique useful in treating panic disorder and agoraphobia in which the therapist identifies phobic stimuli fro the patient and then presents highly anxiety-provoking imagery to the patient describing the feared scene as dramatically and vividly as possible
implosive therapy
separation anxiety disorder usually occurs
in childhood
in this type of defense mechanism you are able to analyze events i a distant, objective analytical way
intellectualization
this is an association between physical discomfort, such as dizziness or palpitations, and an impending panic attack fore example during a car accident, the individual may experience rapid heartbeat, dizziness, shortness of breath, and panic
interoceptive conditioning
how is sleep in regards to someone with panic disorder?
it's disturbed, panic attacks might happen in sleep so patients may fear sleep, fatigue INCREASES ANXIETY and susceptibility to panic attacks
patients can be encouraged to keep a daily _______ of the severity of anxiety and the frequency, duration, and severity of panic episodes this will be a basic tool for monitoring progress as symptoms decrease
log
these type of statements are used when individuals who fear ___________- during a panic attack: "I feel trapped" "I'm afraid others will know or that I'll hurt someone" "I feel alone. I can't help myself." "I'm losing control."
loss of control
caffeine, pseudoephedrine, amphetamines, cocaine, tobacco, withdrawal from CNS depressants such as alcohol or other stimulants are associated with this disorder
panic disorder
during this assessment common findings include anxiety symptoms, including restlessness, irritability, poor concentration, and apprehensive behavior, disorganized thinking, irrational fears, and a decreased ability to communicate often occur during a panic attack use direct questioning whether the patient is experiencing suicidal thoughts
mental status examination
in this type of anxiety perceptual field widens slightly able to observe more than before and to see relationships learning is possible
mild anxiety
in this type of anxiety you are aware, alert, can see hear, grasps more than before, usually able to recognize and identify anxiety easily
mild anxiety
in this type of anxiety perceptual field narrows slightly. selective inattention: does not entice what goes on peripheral to the immediate focus but can do so if attention is directed there by another observer
moderate anxiety
in this type of anxiety you see, hear, grasps less than previously. Can attend to more if directed to do so. Able to sustain attention on a particular focus; selectively inattentive to contents outside the focal area. usually able to state "I am anxious now"
moderate anxiety
physical symptoms of anxiety include increased reflexes, startle reaction, eyelid twitching, insomnia, tremors, rigidity, spasm, fidgeting, pacing, strained face, unsteadiness, generalized weakness, wobbly legs, clumsy motions
neuromuscular
do lab tests exist to confirm anxiety disorders??
nooo
does drastically changing lifestyle to avoid stuations aid recovery in panic disorder??
nope
this neurotransmitter for panic attacks is responsible for cardiovascular, respitary and GI systems
norepinephrine
what are the two neurotransmitters believed to be involved in panic disorders?
norepinephrine and serotonin
this type of anxiety is described as being of realistic intensity and duration for the situation and is followed by relief behaviors intended to reduce or prevent more anxiety
normal anxiety
in this type of anxiety says, "I'm in a million pieces" "I'm gone" or "what is happening to me?" perplexity, self absorption,f feelings of unreality, flights of ideas or confusion, fear, repeats a detail, many relief behaviors used automatically. The enormous energy produced by panic must be used and may b mobilized as rage. May pace, run, or fight violently. With dissociation of contents of self-system, there may be a very rapid reorganization of the self, usually going along pathologic lines
panic
in this type of anxiety the perceptual field is reduced to a detail which is usually blown up or the focus is on scattered details; the speed of scattering tends to increase. Massive dislocation, especially of contents of self system felt as enormous threat to survival learning is impossible
panic
this is an extreme overwhelming form of anxiety often experienced when an idnivdua is placed in a real or perceived life threatening situation
panic
what type of assessment is this?? what were you doing when the panic attack occurred? what did you experience before and during the panic episode, including physical symptoms, feelings, and thoughts? when did you begin to feel that way? How long did it last? do you have an explanation for what caused you to feel and think that way? have you experienced these symptoms int he past? If so, under what circumstances?? Has anyone in your family ever had similar experiences? What do you do when you have these experiences to help you to feel safe? Have the feelings and sensations ever gone away on their own??
panic attack assessment
physical symptoms of this include palpitations, chest discomfort, rapid pulse, nausea, dizziness, sweating, paresthesias, tumbling or shaking, and a feeling of suffocation or shortness of breath, cognitive symptoms include disorganized thinking, irrational fears depersonalization, and a decreased ability to communicate
panic attacks
these are a major finding in panic disorder of a sudden, discrete period of intense fear or discomfort that reaches its peak within a few minutes and is accompanied by physical discomfort and cognitive stress they usually peak in about 10 minutes but can as as long as 30 minutes
panic attacks
this type of treatment involves exposure through exercise to panic-invoking sensations such as dizziness, hyperventilation, tightness in the chest, and sweating identified patterns become targets of treatment in this type of treatment patients are taught to use breathing training and cognitive restructuring to manage their responses and are instructed to practice these techniques between therapy sessions to adapt the skills to other situations
panic control treatment
this is chronic condition that has several exacerbations and remissions during the course of the disease can lead to phobias other diagnostic symptoms include palpitations, sweating, shaking shortness of breath, smothering, sensation of choking, chest pain, nausea, or abdominal distress, dizziness, derelaization or depersonalization, fear of going crazy, fear of dying, paresthesias, and chills or hot flashes
panic disorder
physical symptoms of anxiety include actual fainting, decreased blood pressure, decreased pulse rate
parasympaethic
substance use, sleep patterns, physical activity, medications, pregnancy are apart of what part of the assessment for panic disorder?
physical assessment
this part of an emotional response to anxiety is the fight or flight response is the signal that an individual is facing a threat
physiologic arousal
a normal emotional response to anxiety consists of three parts which are?? (3)
physiologic arousla, cognitive processes, and coping strategies
the relationship between depression and anxiety disorder is
pretty strong
in this type of defense mechanism by assigning unwanted thoughts, feelings, or behavior to another person or object, the individual does not have to acknowledge undesirable or unacceptable thought or feeligns
projection
in this type of theory for panic disorder it examines anxiety that develops after separation and loss;
psychoanalytic and psychodynamic theories
this part of the assessment for panic disorder includes the patient's report of the symptoms and a careful cognitive, behavioral, and social assessment
psychosocial assessment
in this type of defense mechanism avoids anxiety by explaining an unacceptable or disappointing behavior or feeling in a logical, rational way. May protect self esteem and self concept
rationalization
in this type of defense mechanism reduces anxiety by taking the opposite feeling hides true feelings which may be appropriate in many situations
reaction formation
in this type of defense mechanism avoids unwanted thoughts and anxiety by blocking thoughts, experiences from conscious awareness
repression
physical symptoms of anxiety include rapid breathing, difficulty getting air, shortness of breath, pressure of chest, shallow breathing, lump in throat, choking sensations, gasping, spasm of bronchi
respiratory
in this type of anxiety disorder you are consistent failure to speak in social situations when there is an expectation to speak
selective mutism
this is a rare disorder typically seen in childhood in which children do no initiate speech or respond when spoken to by others they're often very anxious when asked to speak in school or read aloud may suffer from academic impairment because they can't communicate
selective mutism
in this type of anxiety disorder you are fearful, anxious about separation from attachment figures that is developmentally inappropriate
separation anxiety
this neurotransmitter in panic attacks is distributed in central autonomic and emotional motor control systems regulating anxiety sates and anxiety-related physiologic and behavioral responses
serotonin
in this type of anxiety the perceptual field is greatly reduced. Tendency toward dissociation: to not notice what is going on outside the current reduced focus of attention; largely unable to do so when another observer suggests it
severe anxiety
in this type of anxiety you see, hear, and grasps far less than previously. Attention is focused on a small area of a given event, inferences drawn may be distorted because of inadequacy of observed data. May be unaware of and unable to name anxiety. Relief behaviors generally used
severe anxiety
physical symptoms of anxiety include flushed face, pale face, localized sweating, genralized sweating, hot and cold spells, itching
skin
in this type of anxiety disorder you are fearful, anxious or avoid social situations that involves possibility of being scrutinized
social anxiety disorder
in this type of anxiety disorder you are fearful, anxious or avoid a specific object or situation
specific phobias
these are examples of what in a patient?? pt doesn't drink or use tobacco, pt likes to exercise, pt has a supportive partner or family member
strengths
in this type of defense mechanism you avoid anxiety and channels maladaptive feelings or impulses into social acceptable behaviors. Maintains socially acceptable behaivior
sublimation
in this type of anxiety it's due to excessive substance use, substance withdrawal, and medication use
substance/medication induced anxiety disorder
people with panic isroder are often depressed and consequently are at high risk for this
suicide
in this defense mechanism reduces anxiety by intentionally avoiding thinking about disturbing problems, wishes, feelings or experiences useful in many situations such as test taking situations
suppression
what happens if anxiety is left untreated in children and adolescents??
symptoms persist and worsen and lead to suciidal ideation sometimes, early parenthood, drug and alcohol dependence, and educational underachievement
this is a treatment for panic disorder that exposes the patient to a hireracrchy of feared situations that the patient has rated from least to most feared the patient is taught to use muscle relaxation levels of anxiety increase through umltisituational exposure
systematic desensitization
this type of treatment for panic disorder is useful for home health psychiatric nurses
systematic desensitization
controlled exposure to anxiety-provoking situations and cognitive countering techniques has proven successful in reducing
the symptoms of panic
persons with a panic disorder may cause excessive fears, phobias, or excessive worry to who??
their family members
T or F: detecting and treating anxiety is an important component of pain mangement
trueeeee
physical symptoms of anxiety include pressure to urinate, increased frequency of urination
urinary tract
what gender experiences anxiety disorders more men or women?
women
can panic attacks also occur in depression, bipolar disease, eating disorders, and some medical conditions ??
yes
is panic normal during periods of threat??
yes
is panic order treatable?
yes but you still may remain symptomatic