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

True or false? Anxiety comes from an external stimulus

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

What are the 3 stages of the General Adaptation Syndrome?

1. Alarm stage

2. Resistance stage

3. Exhaustion stage

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

Alarm stage

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

Resistance stage

What are the 4 levels of anxiety?

1. Mild

2. Moderate

3. Severe

4. Panic

The following psychological responses manifest in which level of anxiety?

• Wide perceptual field

• Sharpened senses

• Increased motivation

Mild

The following psychological responses manifest in which level of anxiety?

• Perceptual field narrowed to immediate task

• Selectively attentive

• Cannot connect thoughts or events independently

Moderate

The following psychological responses manifest in which level of anxiety?

• Perceptual field reduced to one detail or scattered

• Cannot complete task

Severe

The following psychological responses manifest in which level of anxiety?

• Distorted perceptions

• Loss of rational thought

• May be suicidal

Panic

The following physiological responses manifest in which level of anxiety?

• Restlessness

• Fidgeting

• GI “butterflies”

• Difficulty sleeping

Mild

The following physiological responses manifest in which level of anxiety?

• Severe headache

• Nausea, vomiting, and diarrhea

• Vertigo

• Chest pain

Severe

The following physiological responses manifest in which level of anxiety?

• Dilated pupils

• Increased BP and pulse

• Fight, flight, or freeze

Panic

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

Patient safety

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

Selective mutism

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)

Anxiety disorder to another medical condition

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

Substance/medication-induced anxiety disorder

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

Separation anxiety disorder

Which neurotransmitter regulates anxiety?

GABA

Which hormone regulates anxiety?

Serotonin

Who created the interpersonal theory?

Harry Stack Sullivan

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

15 to 30

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

1 MONTH

When is the clinical onset of panic disorder?

Peaks in late adolescence and the mid-30s

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

Agoraphobia

True or false? People with agoraphobia cannot leave the house

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? Agoraphobia can also occur alone WITHOUT panic attacks

True

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

Secondary gain

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

Natural environmental phobias

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

Blood-injection 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

Situational phobia

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

Animal phobia

Social phobia is also known as _____

Social anxiety disorder

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

Social phobia

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

Generalized anxiety disorder

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

True

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

A. Irritability

B. Muscle tension

D. Fatigue

E. Difficulty thinking

F. Sleep alterations

BONUS: drugs used to treat anxiety disorders

Treatment that focuses on the way the patient thinks

Cognitive behavioral therapy

What are the 3 techniques used in CBT?

• Positive reframing

• Decatastrophizing

• Assertiveness training

Technique in CBT: involves turning negative messages into positive messages

Positive reframing

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

Decatastrophizing

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

Assertiveness training

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

Behavioral therapy

What are the 2 techniques used in behavioral therapy?

• Desensitization

• Flooding

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

Desensitization

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

Flooding

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

A) History of panic attacks in the past

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

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

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

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

A) Others

B) Themselves

C) Animals

D) Property

B) Themselves

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

B) Problems with sleeping and eating

Provide at least 2 interventions in managing anxiety

• 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