[N108] LEC 3.1 - Anxiety, Anxiety Disorders, and Panic Disorders

False; anxiety doesn't have a stimulus. Minsan, hindi known yung source of anxiety

True or false? Anxiety comes from an external stimulus

1. Alarm stage

2. Resistance stage

3. Exhaustion stage

What are the 3 stages of the General Adaptation Syndrome?

Alarm stage

Stage in the General Adaptation Syndrome wherein fight or flight reactions are triggered

Resistance stage

Stage in the General Adaptation Syndrome wherein the body tries to cope with anxiety

1. Mild

2. Moderate

3. Severe

4. Panic

What are the 4 levels of anxiety?

Mild

The following psychological responses manifest in which level of anxiety?

• Wide perceptual field

• Sharpened senses

• Increased motivation

Moderate

The following psychological responses manifest in which level of anxiety?

• Perceptual field narrowed to immediate task

• Selectively attentive

• Cannot connect thoughts or events independently

Severe

The following psychological responses manifest in which level of anxiety?

• Perceptual field reduced to one detail or scattered

• Cannot complete task

Panic

The following psychological responses manifest in which level of anxiety?

• Distorted perceptions

• Loss of rational thought

• May be suicidal

Mild

The following physiological responses manifest in which level of anxiety?

• Restlessness

• Fidgeting

• GI “butterflies”

• Difficulty sleeping

Severe

The following physiological responses manifest in which level of anxiety?

• Severe headache

• Nausea, vomiting, and diarrhea

• Vertigo

• Chest pain

Panic

The following physiological responses manifest in which level of anxiety?

• Dilated pupils

• Increased BP and pulse

• Fight, flight, or freeze

Patient safety

What should be the priority during the severe and panic stages of anxiety?

Selective mutism

Diagnosed in children when they fail to speak in social situations even though they are able to speak

Anxiety disorder to another medical condition

Diagnosed when the prominent symptoms of anxiety (e.g., panic attacks) are judged to result directly from physiological condition (i.e. thyroid disease, mitral valve prolapse)

Substance/medication-induced anxiety disorder

Anxiety directly caused by drug abuse, a medication, or exposure to a toxin

Separation anxiety disorder

Excessive anxiety concerning separation from home or persons, parents, or caregivers

GABA

Which neurotransmitter regulates anxiety?

Serotonin

Which hormone regulates anxiety?

Harry Stack Sullivan

Who created the interpersonal theory?

15 to 30

Panic disorder is composed of discrete episodes of panic attacks lasting for _____ to _____ minutes of rapid, intense, escalating anxiety, a storm of emotions of fear, and physiologic discomfort

1 MONTH

A person diagnosed with panic disorder has periodic, unanticipated panic attacks followed by AT LEAST _____ of persistent anxiety or concern about future attacks.

Peaks in late adolescence and the mid-30s

When is the clinical onset of panic disorder?

Agoraphobia

Type of anxiety disorder: “fear of the marketplace" or fear of being outside

False; others can leave the house but feel safe from the anticipatory fear of having a panic attack only within a limited area

True or false? People with agoraphobia cannot leave the house

True

True or false? Agoraphobia can also occur alone WITHOUT panic attacks

Secondary gain

The attention received from others as a result of anxiety-driven behaviors

Natural environmental phobias

Type of specific phobia: fear of storms, water, heights, or other natural phenomena

Blood-injection phobia

Type of specific phobia: fear of seeing ones' own or others blood, traumatic injury, or an invasive medical procedure such as injection

Situational phobia

Type of specific phobia: fear of being in a specific situation such as on a bridge or in a tunnel, elevator, small room, hospital, or airplane

Animal phobia

Type of specific phobia: fear of animals or insects (usually the specific type)

Social anxiety disorder

Social phobia is also known as _____

Social phobia

Type of anxiety disorder: the person becomes severely anxious to the point of panic or incapacitation when confronting situations involving people

Generalized anxiety disorder

Type of anxiety disorder: worries excessively and feels highly anxious at least 50% of the time for 6 MONTHS OR MORE

True

True or false? Patients with generalized anxiety disorder may have one or several social phobias

A. Irritability

B. Muscle tension

D. Fatigue

E. Difficulty thinking

F. Sleep alterations

A person with generalized anxiety disorder has THREE OR MORE of the following symptoms (select all that apply):

A. Irritability

B. Muscle tension

C. Suicidal ideation

D. Fatigue

E. Difficulty thinking

E. Compulsion

F. Sleep alterations

BONUS: drugs used to treat anxiety disorders

Cognitive behavioral therapy

Treatment that focuses on the way the patient thinks

• Positive reframing

• Decatastrophizing

• Assertiveness training

What are the 3 techniques used in CBT?

Positive reframing

Technique in CBT: involves turning negative messages into positive messages

Decatastrophizing

Technique in CBT: involves the therapist's use of questions to more realistically appraise the situation

Assertiveness training

Technique in CBT: aims to help the person negotiate interpersonal situations and foster self-assurance

Behavioral therapy

Treatment that focuses in teaching the client what is anxiety, identifying anxiety responses, teaching relaxation techniques, goals setting, visualization of phobic situations

• Desensitization

• Flooding

What are the 2 techniques used in behavioral therapy?

Desensitization

Technique in behavioral therapy: involves progressively exposing the client to the threatening object in a safe setting until the anxiety decreases

Flooding

Technique in behavioral therapy: form of rapid desensitization; the behavioral therapist confronts client with phobia object until anxiety is eliminated

A) History of panic attacks in the past

When assessing a patient's history for anxiety, what is important to ask about?

A) History of panic attacks in the past

B) History of family disputes

C) History of medication use

D) History of sleep patterns

C) Increased speech rate, pitch, and volume; difficulty sitting still

During the assessment of general appearance and motor behavior in a client with anxiety, which of the following might be observed?

A) Slow speech and lethargic movement

B) Normal appearance with no signs of anxiety

C) Increased speech rate, pitch, and volume; difficulty sitting still

D) Calm demeanor with steady motor behavior

C) Tearfulness and self-directed anger for "being unable to control myself"

What might a client with anxiety express when discussing their panic attacks?

A) Happiness and relief

B) Anger at others for their condition

C) Tearfulness and self-directed anger for "being unable to control myself"

D) Indifference to the situation

B) Themselves

Clients experiencing panic attacks are at risk for harm primarily towards:

A) Others

B) Themselves

C) Animals

D) Property

B) Problems with sleeping and eating

Which of the following physiological and self-care concerns are commonly reported by clients with anxiety?

A) Improved appetite and sleep

B) Problems with sleeping and eating

C) Excessive physical activity

D) Poor self-care routines

• Promoting safety and comfort

  • Provide a safe environment and privacy

• Use of therapeutic communication

  • Simple and calm communication

• Managing anxiety

• Teach relaxation techniques such as deep breathing exercise and guided imagery

• Client and family education

  • Relaxation techniques

  • Emphasis on importance on compliance with medication regimen

  • Importance of participating in the community such as involvement with support groups

Provide at least 2 interventions in managing anxiety