Anxiety
what are somatic complaints for severe anxiety?
nausea, headache, dizziness, insomnia
certain things in the environment are seen or heard unless pointed out
selective inattention
condition in which children do not speak d/t fears of negative responses or evaluation, they will speak at home around immediate family
selective mutism
What are the different anxiety disorders?
separation anxiety disorder, specific phobia, social anxiety disorder, panic disorder, agoraphobia, generalized anxiety disorder
what are environmental factors for separation anxiety?
significant loss, death of a relative, separation from significant other, change of environment, immigration
physical symptoms with mild anxiety
slight discomfort, restlessness, nail biting, foot or finger tapping, fidgeting
a persistent, irrational fear of a specific object or situation, that leads to the desire to avoid it/all
specific phobia
symptoms of anxiety, panic attacks, obsessions, and compulsions that develop with the use of substances
substance induced anxiety disorder
Obessions and compulsions that develop with the use of a substance or within a month of stopping use of the substance
substance-induced OCD
gradual introduction of fear
systematic desensitization
What are can we teach/promote to those with anxiety?
teach about disorder available TX/medications relaxation techniques S/S of disorder presumed causes of risk factors
What is the ratio for trichotillomania female to males?
10:1
what is the TX for OCD?
-SSRI's -SNRI's (Venlafaxine/effexor) -antipsychotics in conjunction with antidepressants -Tricyclic's (clomipramine/anafranil) -deep brain stimulation -flooding/exposure and response prevention
TX for anxiety
-SSRI's(1st line) -SSNRI's(duloxetine/ cymbalta and Venlafaxine/effexor) -Benzodiazepines -Buspirone/BuSpar -Beta blockers -Antihistamines -Anticonvulsants -Antipsychotics
What the female to male ratio for GAD?
2:1
What the female to male ratio for agoraphobia?
2:1
Which medication class can place an infant at risk for floppy infant syndrome? (dystonia and muscle weakness)
Benzodiazepines
Fear of being in places or situations from which escape might be difficult or in which help might not be available. (being alone at home, traveling in a car or bus or plane, being on a bridge, riding in elevator)
agoraphobia
Causes of Agoraphobia
ACE's, genetics
unique phobia-cardiovascular response, begins with tachycardia, then bradycardia, hypotension, diaphoresis, and fainting
Blood injury and injection
What may occur to fetus if benzo is taken during PG?
Cleft palate/lip floppy infant syndrome(dystonia/muscle weakness)
Why are benzodiazepines not recommended for older adults?
Delirium, falls, fractures
comorbidity's seen with separation anxiety
Depression, bipolar, anxiety, PTSD, OCD, and personality disorder
What two disorders are seen with child separation disorder?
GAD and specific phobias
excessive worry about numerous things, out of proportion to the tur impact of event or situations
Generalized Anxiety disorder
What is the first time treatment for anxiety?
SSRI's
hair masses in the GI tract
Trichobezoar/Rapunzel syndrome
What does SSNRI's do?
blocks the reuptake of norepinephrine and serotonin which in turn boots mood
preoccupation with an imaged defective body part, mirror checking, wants to be perfect, 1st degree relatives often share this condition
body dysmorphic disorder
ritualistic behaviors an individual feels driven to perform in an attempt to reduce anxiety
compulsions
For moderate anxiety is perceptual field heightened or decreased?
decreased. learning and problem solving not at optimal level
skin picking as a way to deal with stress and relieve anxiety, onset is in adolescence years, usually confined to the face
excoriation
What may acute panic lead to?
exhaustion
reaction to a specific danger
fear
are child males or females more likely to be affected by separation anxiety?
females
increased/faster exposure to fear
flooding
For severe anxiety is perceptual field heightened or decreased?
greatly reduced. focus is on scattered details or one specific detail
panic symptoms
hallucinations, erratic, uncoordinated, impulsive, losing touch with reality
For mild anxiety is the perceptual field heightened or decreased?
heightened
accumulation on belonging, fills every surface of home to where it can become inhabitable
hoarding disorder
Symptoms for severe anxiety
hyperventilation, sense of impending doom, trembling, pounding heart
Thoughts, impulses, or images that persist and recur, so that they cannot be dismissed from the mind
obessions
What many hair in the GI tract cause?
obstruction or perforation
What are the complications of excoriation?
pain, sores, scars, infection
what is the most extreme for of anxiety?
panic
sudden onset of extreme apprehension/fear, impending doom. feelings of terror are severe. feels like have MI
panic attack
before the onset of agoraphobia, what will individuals tend to experience?
phobias, panic, and social anxiety disorder
Somatic nervous system symptoms for moderate anxiety
pounding heart, increase pulse and respirations, diaphoresis
secretly swallowed the pulled out hair
trichophagia
hair pulling, varying in degrees(small patch to baldness), linked to OCD, tends to run in family, more often in children
trichotillomania/ hair pulling disorder
What are some sleep promotion interventions?
warm bath, warm milk, relaxing music
Are benzodiazepines addictive?
yes, for short term use