Stress/coping and anxiety disorders notes

Flashcards based on lecture notes about stress, coping, and anxiety disorders.

Stress

An internal or external event or demand of life experienced by the individual that is perceived and appraised for scope and meaning.

Stressor

An event or stimulus that disrupts a person’s sense of equilibrium.

Stress Appraisal

The process by which a person interprets a stressor as a threat or a challenge.

Coping

The dynamic cognitive and behavioral efforts to manage demands that are appraised as exceeding immediately available resources.

Distress

Negative stress.

Eustress

Positive stress.

Physiologic Stress

The body’s potentially harmful reaction to a stimulus.

Psychological Stress

The emotional and cognitive factors involved in the appraisal of threat.

Sociocultural Stress

The stress when social systems are challenged by factors such as racism, economic hardship, or political upheaval.

Fight or Flight

Survival mechanism to meet threat or stress.

Sympathetic Nervous System (SNS)

Signals adrenals; release of epinephrine & norepinephrine.

Rest and Digest

Connects the CNS to limbs, organs, a relay between brain and spinal cord.

General Adaptation Syndrome (GAS)

Physical response to stress.

Pituitary Gland

Releases ACTH in response to stress.

Hypothalamus

Stimulates the autonomic nervous system in response to stress.

Hypothalamus

Stimulates the HPA axis.

Corticotropic-releasing hormone (CRH)

Travels to the pituitary gland during stress.

Cortisol

Released from the adrenal glands during stress.

Maladaptive Coping

Inability to accurately assess a stressor; denial or avoidance.

Problem-focused coping

Uses the cognitive process to take in the situation and the action to manage or change the situation or circumstances that are associated with the stressors.

Emotion-focused coping

Emphasizes the regulating the emotional response to the situation.

Meaning-focused coping

Uses the process based on the values, beliefs and goals of the individual to modify the personal interpretation and respond to the problem.

Reframing

Changes the way we look at and feel about things.

Coping

What people do to try to minimize stress.

Coping

Directed at reducing the threats and losses of the illness, or emotion-focused, namely directed at reducing the negative emotional consequences.

Defense Mechanisms

Predominantly unconscious, protective coping methods that individuals may assume in response to a perceived threat.

Compensation

Focusing on strengths rather than perceived weaknesses.

Conversion

Converting stress and psychological symptoms into physical symptoms.

Denial

Ignoring aspects of reality that induce anxiety or contribute to a loss of self-esteem.

Displacement

Redirecting negative emotions perceived as unacceptable or threatening to a safer focus.

Intellectualization

Overthinking a challenging situation or impulse to avoid dealing with the emotions it elicits.

Projection

Attributing one’s own motives, values, desires, situational responses, and personality traits to another person.

Rationalization

Explaining personal actions in a way that enhances one’s own self-image.

Regression

Reverting to behavior associated with an earlier stage of development when challenged by thoughts and stressors.

Repression

Blocking unacceptable thoughts and feelings from consciousness.

Reaction Formation

Responding to negative thoughts or feelings by demonstrating opposite emotions and actions.

Sublimation

Rechanneling unacceptable impulses into socially acceptable activities.

Post-traumatic Stress Disorder (PTSD)

Usually occurs after a traumatic event outside the range of usual human experience.

Flashbacks

Dissociative reactions in which the individual feels as if the traumatic event were recurring.

Avoidance of Stimuli Associated with Trauma

Avoiding situations or people that could trigger memories of the event.

Numbing

Experience of persistent numbing of responses.

Hyperarousal

Persistent symptoms of increased arousal, such as hyperarousal or hypervigilance.

Compassion Fatigue

Describes the emotional effect that nurses and other health care workers may experience by being indirectly traumatized when helping or trying to help a person who has experienced primary traumatic stress.

Compassion Fatigue Symptom

Feeling overwhelmed physically and mentally exhausted.

Compassion Fatigue Symptom

Interferes with ability to function.

Compassion Fatigue Symptom

Intrusive thoughts/images of another’s critical experience.

Compassion Fatigue Symptom

Difficulty separating work from personal life.

Compassion Fatigue Symptom

Becoming pessimistic, critical, irritable, prone to anger.

Compassion Fatigue Symptom

Dread of working with certain individuals.

Anxiety Disorders

Panic disorder (PD), Phobia, Social anxiety disorder (SAD) or social phobia Generalized anxiety disorder (GAD)

Panic Disorders

This consist of recurrent and unexpected “out of the blue” panic attacks

Panic Attack

The sudden onset of extreme apprehension or fear, usually associated with feelings of impending doom.

Panic Attack Symptom

Feelings of terror.

Panic Attack Symptom

Suspension of normal function.

Panic Attack Symptom

Severely limited perceptual field.

Panic Attack Symptom

Misinterpretation of reality.

Panic Disorders Symptoms

Palpitations, chest pain, diaphoresis, muscle tension, urinary frequency.

Panic Disorders Symptoms

Hypertension, difficulty breathing, feelings of choking, chills, hot flashes.

Benzodiazepines

Medication treatment of choice for panic attack. Increased sedation.

Flumazenil (Romazicon)

Antedote for Benzodiazepines.

SSRIs

Medication used for long term prevention of Panic Disorder. Side effects- wieght gain, sexual dysfunction, hypotension.

Serotonin Syndrome

Flu-like symptoms, agitation, tachycardia, course temors. Can occurs as a result of taking SSRI's

Specific Phobia

Irrational fear of a specific object, activity, or situation.

Social Phobias or Social Anxiety Disorder

Anxiety with exposure to a social situation or performance situation.

Agoraphobia

Excessive or fear about being in a place or situation from which help might not be available and escape might be difficult.

Generalized Anxiety Disorder (GAD)

Characterized by excessive, persistent, and uncomfortable anxiety, and by excessive worrying.

Obsessions

Unwanted, intrusive, persistent ideas, thoughts, impulses, or images that cause significant anxiety or distress.

Compulsions

Unwanted, repetitive behavior patterns or mental acts intended to reduce anxiety but not to provide pleasure or gratification.

Body Dysmorphic Disorder

Obsessive thinking with an imagined defective body part.

Hoarding behavior (with OCD)

Excessively collects items and exhibits a failure to discard items.

Hoarding behavior (without OCD)

Exhibits compulsive and disabling hoarding.

Buspar (Buspirone)

Anxiolytic- multi time dosing throughout the day- cumulative effect

Tricyclic Antidepressants (TCAs)

Second or third line anxiety medication due to side effects.

Atenolol (Tenormin)

BETA 1; Blocks epinephrine effect on heart and blood vessels.

Propranolol (Inderal)

BETA 2; Inhibits sympathetic stimulation of the heart and the lungs.

Benzodiazepines

Anxiolytic; class of medications for anxiety

Cognitive Behavioral Therapy (CBT)

Psychotherapeutic treatment- teaching to restructure their thinking.

Milieu Therapy

structures the daily routine to offer physical safety and predictability thus reducing anxiety.

Andrew, a Hospice nurse (INCORRECT Action)

Avoid mentioning these observations because you are only a peer.

Andrew, a Hospice nurse (CORRECT Action)

Ask Andrew what he feels is causing him to fall behind in his work.

Andrew, a Hospice nurse (NEUTRAL Action)

Immediately report your concerns to the nurse manager in charge of your tema.

Andrew, a Hospice nurse (NEUTRAL Action)

Take Andrew to lunch and keep the conversation light and humorous.

Jon, a ER nurse- Action

Tell Jon that he needs to end his shift right away.

Jon, a ER nurse- Action

Tell him he needs to nap for 30 minutes and then return to work.

Jon, a ER nurse- Action

Tell him to go to the cafeteria, relax, and drink strong coffee.

Jon, a ER nurse- Action

Tell him to eat a high carbohydrate snack, take a 30 minute break, and then return to work.

Rene, action response

Rene asks you, her nurse, why she is so drowsy. “Drowsiness is a side effect of this medication.”

Rene, action response

Rene asks you, her nurse, why she is so drowsy. “Don’t worry about being drowsy at this time.”

Rene, action response

Rene asks you, her nurse, why she is so drowsy. “Aren’t you glad you will finally get to sleep?”

Charlie question-action

“This has to be extremely difficult for you to face.”

Charlie question-action

“Don’t worry about that now. Just get well!”

Charlie question-action

“I will ask your doctor to increase your medicine.”

Charlie question-action

“If a girl really likes you, the bag won’t matter.”

Phobias Medications

Acute anxiety: Benzodiazepines; Long-term TX of anxiety- SSRIs

Anxiety disorder management

Medications with the psychotherapeutic treatments

Medications to use for Anxiety disorder

Beta Blockers

Medications to use for Anxiety disorder

TCAs

Medications to use for Anxiety disorder

SNRIS

Medications to use for Anxiety disorder

SSRIs

Medications to use for Anxiety disorder

Benzodiazepines