Anxiety, OCD, and Trauma-related Disorders

Question 1

mild anxiety characteristics

Answer 1

perceptual field widens, alertness, heightened senses, can identify source of anxiety, increased motivation, problem solving, and learning ability

Question 2

moderate anxiety characteristics

Answer 2

perceptual field narrows, selective inattention, able to problem solve but not optimally, benefits from guidance of others, voice tremors difficulty concentrating, headache, muscle tension, GI upset, edgy, tense, increased pulse/respirations, dry mouth, urinary frequency, increased tension relieving behaviours eg: pacing, insomnia

Question 3

severe anxiety characteristics

Answer 3

perceptual field greatly reduced, focus is on scattered details or one specific detail, unable to problem solve or learn effectively, does not make connections, confusion, crying, feelings of dread/horror, alarmed, frightened, distorted perceptions, does not respond to direction, purposeless activity, more intense somatic complaints, pale, rigid stance, hyperventilation, tachycardia, chest pain

Question 4

panic state characteristics

Answer 4

unable to focus on environment, complete focus is on self, state of terror/emotional paralysis, may feel he/she ceases to exist, loss of rational thought, may be mute, immobility or severe hyperactivity, terrified appearance, dilated pupils, increased BP&P, severe shakiness, withdrawal, may not recognize potential danger

Question 5

GAD - Clinical manifestations

Answer 5

longstanding, unrealistic, and excessive worry associated with experiences of daily life

Question 6

OCD clinical manifestations

Answer 6

severe obsessions (excessive, unwanted, intrusive thoughts or impulses that occur repeatedly causing distress and anxiety, eg: fear of contamination) and compulsions (repetitive actions or behaviours used as attempt to neutralize anxiety felt from obsessions (eg. washing hands repeatedly) that interfere with normal daily routines

Question 7

Social Phobia - clinical manifestations

Answer 7

persistent anxiety in social situations, highly sensitive to criticism, low self-esteem,

Question 8

panic disorder clinical manifestations

Answer 8

extreme, overwhelming anxiety experienced in real or perceived life-threatening situation, panic attack, limits function socially, occupationally, interpersonally.

Question 9

agoraphobia

Answer 9

fear of open places, social isolation, avoidance

Question 10

PTSD clinical manifestations

Answer 10

reliving the traumatic experience, avoidance, inability to concentrate (altered thinking), alterations in arousal level

Question 11

medical treatment of anxiety -

Answer 11

antidepressants (SSRIs, SNRIs), anti-anxiety drugs (benzos), beta blockers, TCAs

Question 12

non-pharm approaches for anxiety management

Answer 12

physical activity, abdominal breathing, balanced nutrition, relaxation, distraction, journaling, positive self talk, therapy, family education/support, meditation

Question 13

benzodiazepines - clonazepam, lorazepam

Answer 13

Clonazepam - GABA, long half life effect in 1-4 hours, ataxia, behavioural changes, drowsiness,
lorazepam - GABA, rapid onset within an hour, dizziness, drowsiness, lethargy
prolonged use may lead to dependence and abuse (~2 weeks)

Question 14

Assessment of anxiety: biological

Answer 14

rule out physical illness, assess triggers and history of similar experiences, assess substance use, sleep patterns, nutritional patterns, physical activity, and skin and joint damage

Question 15

Assessment of anxiety: psychological

Answer 15

assess patterns of anxiety/panic attacks, emotional, cognitive, and behavioural responses, overall mental status, co-morbid depressive symptoms, present/past coping

Question 16

Assessment of anxiety: social

Answer 16

assess for social isolation and understanding of effects anxiety has on his/her social functioning and on relationships, family/friends, be conscious of cultural considerations

Question 17

Assessment of anxiety: spiritual

Answer 17

assess guilt/sin, fears of death, levels of hope/helplessness and alienation/estrangement

Question 18

crisis intervention principles

Answer 18

early intervention, stabilization (order), establishing client understanding, intervening (prioritization and problem-solving), shifting to self-reliance