anxiety and ocd

Question 1

what is anxiety?

Answer 1

a universal experience that consists of feelings of apprehension, uneasiness, uncertainty, or dread to an unknown threat

“fight or flight”

Question 2

what is the difference between fear and anxiety?

Answer 2

fear is the reaction to a specific danger, where as anxiety is apprehension,
uneasiness,
uncertainty, or dread
from real or
perceived threat

Question 3

what is the etiology of anxiety?

Answer 3

-genetics
-neurobiology (serotonin, GABA)
-psychological factors(harsh parents, ACE, abuse, disapproval)
-cultural considerations
-enviornmental factors (caffeine, or stressful event)

Question 4

what are some cultural considerations for anxiety disorder?

Answer 4

-express through somatic symptoms

e.g. LA and norther europeans involve sensation of choking, smothering, numbness and fear of death

Question 5

what are the four different levels of anxiety?

Answer 5

-mild
-moderate
-severe
-panic

Question 6

what are the s/s of mild anxiety?

Answer 6

occurs in the normal experience of everyday living

-heightened perceptual field
-observations are sharper
-ABLE to work effectively
-slight discomfort
-attention seeking behaviors
-restlessness
-easily startled
-irritability
-MILD tension relieving activity
-aware of their anxiety

Question 7

s/s of moderate anxiety

Answer 7

-SNS symptoms
-may experience tension, a pounding heart, tachy, and mild somatic symptoms
- voice tremors, poor concentration
-narrowed preceptual field
-less able to pay attention
-less able to solve problems

Question 8

s/s of severe anxiety

Answer 8

-distorted perceptual field
-can’t problem solve
-dazed or confused
-behavior is aimed at reducing anxiety
-feeling of dreas
-confusion
-purposeless activity
-more intense somatic
-withdrawal
-diaphoresis
-loud and rapid speech

Question 9

s/s of panic

Answer 9

-unable to process environment
-focus is lost
-completely unable to process what is happening
-disorganized or irrational
-terror
-immobility or hyperactivity
-inability to speak or speak clearly
-somatic complaints increase
-severe withdrawal
-hallucinations or delusions
-out of touch with reality

Question 10

what are some defense mechanisms against anxiety?

Answer 10

-altruism
-compensation
-conversion
-denial
-displacement
-dissociation
-identification
-intellectualization
-projection
-rationalization
-reaction formation
-repression
-splitting
-sublimation
-suppression
-undoing

Question 11

what are adaptive defense mechanisms?

Answer 11

those that are beneficial and productive behaviors

e.g. problem solving, talking, crying, sleeping, exercising, etc

Question 12

what are maladaptive defense mechanisms?

Answer 12

behaviors that are NOT beneficial or productive

e.g. blaming, negative self talk, obsessive behaviors, agression, excessive eating, drinking, spending, etc.

Question 13

what commonly differentiates adaptive from maladaptive?

Answer 13

their frequency, intensity, and duration of use

Question 14

how do we treat mild-moderate anxiety?

Answer 14

a lot of talking to determine cause and level of anxiety
-provide a calm presence
-explore behaviors to alleviate anxiety

Question 15

how to treat severe/panic anxiety?

Answer 15

-SAFETY
-assess risk for suicide
-provide a low stimulating environment
-ALWAYS stay with the person
-assess need for medication

Question 16

what are the 10 anxiety orders?

Answer 16

1. Generalized (GAD)
2. Separation
3. Social (SAD)
4. Phobias
5. Panic Disorder
6. OCD
7. Body Dysmorphic
8. Hoarding
9. Trichotillomania
10. Excoriation Disorder

Question 17

what do all anxiety disorders have in common?

Answer 17

they all experience excessive irrational fear and dread

Question 18

describe separation anxiety

Answer 18

a normal part of development in an infant and should decline after 18 months

becomes a problem when adults or older children expereince this

Question 19

describe GAD

Answer 19

-excessive and persistent worry for MORE THAN 6 MONTHS
-aware that they are being irrational
-accompanied with some somatic symptoms

Question 20

r/f of GAD

Answer 20

-unresolved conflict
-cognitive misinterpretations
-life stressors
-GENETICS
-behavioral inhibition

Question 21

what are some comorbididties of GAD?

Answer 21

-MDD or other anxiety disorders
-alcoholism
-one concurrent psychiatric diagnosis

Question 22

what are common worries for children/adolescents with GAD?

Answer 22

-future events
-past behaviors
-social acceptance
-personal abilities
-school
-natural disasters

Question 23

what medications are used to treat GAD?

Answer 23

-antidepressants (SSRI, SNRI, MAOI)
-anti anxiety drugs (buspirone, benzos)
-beta blockers, antihistamines (hydroxizine), anticonvulsants, and anti-psychotics

Question 24

what teaching needs to go along with benzos?

Answer 24

-use lowest dose necessary
-avoid caffeine
-monitor for sedative effects
-take with food
-do NOT quit abruptly (seizures)
-avoid alcohol can be fatal

Question 25

what are some nonpharmalogical treatments for GAD?

Answer 25

-psychotherapy -CBT -systematic desensitization -meditation -exercise

Question 26

what is gradual systemic desensitization?

Answer 26

introduce fear through a series of tests from least scary to most scary

Question 27

what is flooding desensitization?

Answer 27

exposure to a large amount of an undesirable stimulus to extinguish anxiety

Question 28

what is agoraphobia?

Answer 28

fear about being in places or situations from which escape may be difficult or embarrassing. feared places are avoided sometimes to the extreme of not leaving the house

Question 29

r/f for agoraphobia

Answer 29

female, ACE, stressful life events, overprotective and emotionally cool families, genetics usually begins in late adolescence/early adulthood

Question 30

what situations are commonly avoided with agoraphobia?

Answer 30

-being alone outside -being alone at home -traveling in a car, bus, or airplane -being on a bridge -riding in an elevator -being in a crowd

Question 31

what is social anxiety disorder "social phobia"

Answer 31

severe anxiety or fear of a social or performance situation that could be seen as negatively by others can worry for days or weeks before a situation

Question 32

r/f for social anxiety disorder

Answer 32

-childhood mistreatment -shyness -having shy parents -genetics?

Question 33

those who have SAD are at risk for what?

Answer 33

MDD and SUD

Question 34

what is panic disorder?

Answer 34

a chronic condition characterized by panic attacks

Question 35

what is a panic attack?

Answer 35

an "out of the blue" feeling of terror so severe that normal function is suspended, perceptual field is severely limited, and disrupted reality

Question 36

what is anticipatory anxiety?

Answer 36

the fearful expectation of panic anxiety onset

Question 37

what is avoidance anxiety?

Answer 37

personal strategies used to increase feeling of control and decrease the risk of panic attack

Question 38

what are some risks with panic disorder?

Answer 38

-depression -HTN -smoking -marijuana use

Question 39

what is the treatment of panic disorder?

Answer 39

-CBT -positive self talk -flooding therapy -relaxation therapy -anti depressants -benzos (second line)

Question 40

how do you care for someone having a panic attack?

Answer 40

-rule out medical problem (cardiac) -stay with the patient -reassure them -give clear directions -assist patient to an environment with minimal stimulation -walk with the patient -administer PRN antianxiety

Question 41

what is an obsession?

Answer 41

unwanted, intrusive, and persistent thoughts that persist and recur even when the individual tries to stop them

Question 42

what is a compulsion?

Answer 42

behaviors that are performed repeatedly in a ritualistic fashion with the goal of preventing or relieving anxiety and distress caused by obsession

Question 43

why are compulsive acts repeated?

Answer 43

because it only relieves the anxiety temporarily

Question 44

s/s of OCD

Answer 44

-onset is gradual -repetitive unwanted thoughts (obsessions) -repeated activities/ rituals (compulsions) -time consuming and may be distressing

Question 45

what is the treatment of OCD?

Answer 45

-SSRI -CBT -Exposure therapy -Deep brain stimulation -Transcranial Magnetic Stimulation

Question 46

What is Body Dysmorphic Disorder?

Answer 46

intrusive and unwanted preoccupation with one or more perceived defects in physical appearance that are not observed by others

Question 47

what is the treatment of Body Dysmorphic Disorder?

Answer 47

-CBT -SSRI -biofeedback -meditation -relaxation strategies

Question 48

what is hoarding disorder?

Answer 48

persistent difficulty discarding with possessions regardless of their value most have MDD

Question 49

what is the main priority with hoarding

Answer 49

Safety

Question 50

what is trichotillomania?

Answer 50

recurrent hair pulling that can occur on any region of the body treated with CBT and SSRI

Question 51

what is excoriation disorder?

Answer 51

recurrent skin picking resulting in skin lesions usually in the face, arm, and hands. may be to relieve anxiety but not all. often seen with OCD and trichotillomania treated with SSRI and CBT