Ch 15 Anxiety & OCD Flashcards by Tara Prater

cause unknown

anxiety

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cause is known

fear

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perceptual field -heightened
focus- flexible & aware of anxiety
Problem solving- able to work effectively towards goal & examine alternatives
Ability to learn- Yes
can alert a person that something is wrong & can stimulate appropriate action
Somatic complaints- slight discomfort, attention seeking behaviors, restlessness, easily startled, irritability or impatience or mild tension relieving behaviors

Mild Anxiety

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Perceptual field- narrowed; grasps little of what is going on
focus- on source of anxiety; less able to pay attention
Problem Solving- able to problem solve; but not at optimal ability
Ability to learn- yes
can stimulate a person that something is wrong & can stimulate appropriate action
Somatic complaints- voice tremors, change in voice pitch, poor concentration, shakiness, increase in R, P & muscle tension, somatic complaints, more tension relieving behaviors

Moderate Anxiety

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Perceptual field- greatly reduced & distorted
focus- on details or one specific detail; attention is scattered
Problem Solving- feels impossible, unable to see connection between events or details
Ability to learn- NO
prevents problem solving; unproductive behavior perpetuates vicious cycle
Somatic complaints- feelings of dread, confusion, purposeless activity, sense of impending doom, more intense somatic complaints, diaphoresis, withdrawal, loud & rapid speech, threats & demands

Severe Anxiety

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Perceptual field-unable to attend to the environment
focus- is lost; may feel unreal or that the world is unreal
Problem Solving- completely unable to process what is happening; disorganized or irrational reasoning
Ability to learn- NO
prevents problem solving; unproductive behaviors perpetuate vicious cycle
Somatic complaints- experience of terror, immobility or severe hyperactivity or flight, unintelligible communication or inability to speak, somatic complaints increase, severe withdrawal, hallucinations or delusions, likely out of touch with reality

Panic

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tapping, pacing, shaking foot, biting nails or lip

relief behaviors

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relaxation training
modeling
systematic desensitization
flooding
response prevention
thought stopping

behavioral approaches to reduce stress

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cognitive reframing
journal
humor

cognitive approaches to reduce stress

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Simple
Empathetic
Feeling
Confrontational

Four forms of Assertive communication

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going to bed 30-60 mins earlier
exercise 30 mins a day
decrease caffeine
listen to music
pets
massage

other forms of stress reduction

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Help pt ID anxiety
Anticipate anxiety provoking situations
Use normal language to show interest
Encourage pt. to talk about feelings
Avoid closing off avenues of communication important to pt.
Ask questions to clarify what is being said
Encourage problem solving with the pt.
Explore behaviors that have worked in the past to release anxiety
Provide outlets for working off excess energy
Assist in developing alternative solutions to a problem through role play or modeling
Ask Open-ended questions
Give broad openings
Provide calm presence

Mild-Moderate Anxiety Intervention

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Maintain calm manner
Remain with the person
Minimize environmental stimuli
Use low pitch voice &amp; speak slowly
Clear, simple statement; repetition
Reinforce reality if distortion occurs
Listen for themes in communication
Attend to physical &amp; safety needs
Provide opportunities for exercise
When pacing, offer high calorie fluids
Assess need for seclusion

Severe-Panic Anxiety Intervention

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denying that you have a problem after being confronted with factual info

psychotic denial

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automatic coping styles that protect people from anxiety

defense mechanisms

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shelfing it

supression

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releasing tension

sublimation

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helping others

altruism

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finding humor

humor

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won’t accept

denial

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cheaters

projection

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verbal or physical

acting out

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covert aggression

passive-aggression

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love/hate, teenage

splitting

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others are worse

devaluation

idol

idealization

removal from environment

dissociation

short-man syndrome

compensation

physical impairment

conversion

taking it out on someone else

displacement

mimicking

identification

"voices"

introjection

excuses

rationalization

behaving opposite of true feelings

reaction formation

reverting

regression

burying deep

repression

making amends

undoing

pt. inability to realize that they are ill which is caused by the illness itself

anosognosia

difficulty in experiencing, expressing & describing emotional responses

alexithymia

developmentally inappropriate levels of concern over being away from significant other Harm avoidance, worry, shyness, uncertainty, fatigability & lack of self-direction, headaches & GI disturbances

Separation Anxiety | Anxiety Disorders

persistent, irrational fear of something that leads to avoidance Overwhelming & crippling anxiety when faced with object of fear

Specific Phobia | Anxiety Disorders

Fear of open space Intense, excessive anxiety or fear about being in a place/situation where there may be no escape

Agoraphobia | Anxiety Disorders

Excessive Worry Anticipates disaster, restless, irritable & muscle tension, puts things off & avoidance, lateness & absence, seeks continual reassurance, sleep disturbance, fatigue, and perseverates about meaningless details

GAD | Anxiety Disorders

Sudden onset of extreme apprehension/fear Palpitations, chest pain, breathing difficulties, nausea, feelings of choking, shills & hot flashes

Panic Disorder | Anxiety Disorders

Symptoms that occur on a daily basis & may involve issues of sexuality, violence, contamination, illness or death Marked distress, often feels humiliation & shame regarding behaviors Onset around 19 years

OCD | Obsessive-Compulsive & related disorders

Preoccupation with an imagined defective body part results in obsessional things & compulsive behaviors Mirror checking, camouflaging; frequent concerns with skin, hair, nose, stomach, teeth, weight, & breast/chest Men- body building & genitals Women- skin, stomach, weight, breast, butt, thighs, legs, hips & toes more frequent in women

Body Dysmorphic Disorder | Obsessive-Compulsive & related disorders

Accumulation of belonging that have little or no value Men slightly more likely; may/may not be aware of the problem tend to begin early in adolescence

Hoarding Disorder | Obsessive-Compulsive & related disorders

One of the oldest recorded psychiatric problems; pain results in anxiety production Typically head, but can be body, eyebrows, eyelashes, pubic area, axilla & limbs

Trichotillomania (Hair-pulling) | Obsessive-Compulsive & related disorders

Typically the face, damaging their skin Common areas- face, head, cuticles, back, arms & legs

Excoriation Disorder (Skin-picking) | Obessive-Compulsive & related disorders

symptoms of anxiety are direct physiological result of a medical condition Hyperthyroidism, PE, or cardiac dyrhythmias

anxiety D/T a medical condition

characterized by symptoms of anxiety, panic attacks, obsessions & compulsions that develop with the use of a substance alcohol, cocaine, heroin, hallucinogens

Substance-induced anxiety disorder

obsessions & compulsions that develop with the use of a substance or within a month of stopping the use of a substance Parkinson's disease meds- gambling, sex urges, out of control spending

substance induced obsessive-compulsive & related disorders

individual's symptoms of obsessions & compulsions are direct physiological result of a medical condition postencephalatic syndrome, postanoxic events, traumatic brain injury, Huntington's, seizures, & cerebral infarctions

Obsessive-compulsive or related disorder due to a medical condition

results in OCD after going through a strep infection with pediatric patients

PANS | Pediatric Acute-Onset Neuropsychiatric Syndrome

Hispanic people exhibit sudden trembling, faintness, palpitations, out-of-control shouting, heat that moves from the chest to head, & seizure like activity

ataque de nervios "attack of the nerves"

Determine if anxiety is primary, secondary, medical or substance induced through thorough exam Detemine current level of anxiety Assess for potential of self-harm or danger to others Perform psychosocial assessment

Anxiety & OCD assessment

often used to treat the somatic & psychological symptoms of anxiety disorders Nurses- monitor for side effects of benzos, including ataxia, sedation & decreased cognitive functioning

Antianxiety (anxiolytic) drugs

cognitive restructuring 1. ID automatic negative beliefs that cause anxiety 2. explore the basis of these thoughts 3. reevaluate the situation realistically 4. replace negative self-talk with supportive ideas

Cognitive Therapy Thought process

exercises for breathing or muscle groups

relaxation training

role model demonstrates appropriate behavior in a feared situation

modeling

gradually introduce to fear object or experience through a series of steps

systematic desensitization

exposure of large amounts of an undesirable stimiulus

flooding

therapist does not allow the pt. to preform the compulsive ritual

response prevention

yell "stop" or snap a rubberband to stop negative thoughts or impulses

thought stopping

cognitive restructuring psychoeducation breath restraining muscle relaxation

cognitive-behavioral therapy | CBT

unconscious childhood conflicts; breakthrough or repressed emotions or thoughts

Freud

unmet needs (emotional distress) disapproval, or transmitted anxiety (via empathy)

Sullivan

classical conditioning; modeling of parent or peers

leaning theory

distortions in perceiving & thinking; a mistake is catastrophic

Cognitive theorists

Ch 15 Anxiety & OCD Flashcards

(69 cards)