Chapter 14: Anxiety and Anxiety Disorders

Vocabulary flashcards covering key concepts from the notes.

Anxiety

A vague feeling of dread or apprehension, described as an “uneasy buzz,” with no clear trigger.

Fear vs. Anxiety

Fear is a response to identifiable danger; anxiety is vague worry without a specific threat.

Anxiety disorders

Excessive anxiety that disrupts daily life, with behavioral (avoidance), emotional (irritability), cognitive (persistent worry), and physiological (↑ heart rate) components.

Stress

Wear and tear on the body from life’s demands; cumulative effect on coping ability.

General adaptation syndrome (GAS)

Selye’s model of the body's response to chronic stress: alarm, resistance, and exhaustion.

Alarm reaction (fight or flight)

Initial stage with adrenaline surge, ↑ heart rate, and energy mobilization for defense.

Resistance stage

Body adapts to stress; hormones stay elevated; coping focused on defense.

Exhaustion stage

Prolonged stress depletes body stores; emotional needs remain unresolved; fatigue and immune suppression may occur.

Hypervigilance / hyperarousal

A heightened state of alertness and arousal in response to stress.

Mild anxiety

Anxiety level where functioning is still possible; alert, focused, and learning can be enhanced.

Moderate anxiety

Nervousness with agitation; difficulty concentrating; thoughts become distractible.

Severe anxiety

Impaired thinking; muscle tension; heightened vital signs; focus narrowed to the worry.

Panic

Fight, flight, or freeze response with extreme autonomic arousal and impaired rational thought.

Agoraphobia

Fear of places or situations where escape might be difficult or help unavailable.

Panic disorder

Recurrent, unexpected panic attacks with ongoing worry about future attacks; possible agoraphobia.

Specific phobia

Persistent, excessive fear of a specific object or situation (e.g., heights, animals, flying).

Social anxiety disorder

Marked fear of social or performance situations where one may be judged or embarrassed.

Generalized anxiety disorder (GAD)

Chronic, excessive worry about multiple events or activities for ≥6 months.

Selective mutism

Failure to speak in specific social situations despite speaking in others, due to anxiety.

Separation anxiety disorder

Excessive fear of separation from attachment figures.

Genetic etiology (anxiety)

Family history increases risk for anxiety disorders.

GABA/serotonin dysregulation

Neurochemical dysregulation implicated in some anxiety disorders.

Intrapsychic theory (Freud)

Unconscious conflicts and defense mechanisms underlying anxiety.

Interpersonal theory (Sullivan, Peplau)

Anxiety from unmet needs in relationships and learned family dynamics.

Behavioral theory

Anxiety as a learned response through conditioning and avoidance.

Cultural humility in anxiety care

Awareness of cultural differences in expressing and coping with anxiety without stereotyping.

Cognitive–behavioral therapy (CBT)

Therapy combining cognitive restructuring and behavioral strategies to treat anxiety.

Positive reframing

Turning negative thoughts into balanced, positive ones.

Decatastrophizing

Challenging worst-case thinking to realistic appraisals.

Assertiveness training

Building skills to negotiate interpersonal situations and set boundaries.

SSRIs as first-line treatment

Selective serotonin reuptake inhibitors are commonly the first-line antidepressants for many anxiety disorders.

Clonidine and propranolol

Medications used for anxiety: clonidine (α2 agonist) and propranolol (β-blocker) for physical symptoms or situational anxiety.

Age-related considerations in anxiety

Children show higher anxiety prevalence (e.g., selective mutism, separation anxiety); older adults commonly have phobias and GAD; panic less common and often linked to other illness.

Childhood anxiety disorders

Selective mutism, separation anxiety, and social anxiety often begin in childhood and may persist.

Late-life anxiety disorders

Phobias and GAD are common; panic attacks may be related to other illnesses; ruminative thoughts often present.

Mental Health Promotion: anxiety

Anxiety signals ineffective stress management; goal is effective stress management, not total elimination.

Stress management tips

Positive attitude, assertive communication, relaxation, realistic goals, balanced diet, exercise, sleep, limit caffeine/alcohol, coping strategies.

Panic attack (definition)

Discrete episode of intense fear with physical symptoms, often without a clear trigger.

Primary gain (panic context)

Relief from anxiety achieved by performing anxiety-driven avoidance behaviors.

Secondary gain (panic context)

Attention or other benefits received from others due to avoidance and related behaviors.

Nursing assessment tool: Hamilton Rating Scale for Anxiety

Standardized scale used to assess anxiety severity.

Phobias (types)

Major types include agoraphobia, specific phobia, and social anxiety disorder.

Systematic desensitization

Gradual exposure to feared stimuli while in a relaxed state.

Flooding

Intense, prolonged exposure to the feared stimulus to reduce anxiety quickly.

Benzodiazepines in phobias/panic

Short-term use for acute anxiety symptoms; risks with long-term use.

Beta-blockers in situational anxiety

Medications such as propranolol used to reduce physical symptoms in performance anxiety.

Self-awareness in nursing

Nurses should recognize their own anxiety, avoid escalating clients’ anxiety, and practice personal stress management.