Anxiety and Related Disorders Overview
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Questions and Answers

Which medication is particularly known for its delayed onset of action in treating Generalized Anxiety Disorder?

  • Buspirone (correct)
  • Venlafaxine
  • Escitalopram
  • Imipramine

    • What is a common characteristic of agoraphobia?

  • Fear of social evaluations
  • Fear of public speaking
  • Fear of the dark
  • Fear of being in situations where escape might be difficult (correct)

    • Which of the following medications is NOT typically used for treating social anxiety disorder?

  • Fluoxetine
  • Venlafaxine
  • Quetiapine (correct)
  • Clonazepam

    • Which type of antidepressants are specifically mentioned for treating phobias?

    <p>SSRIs and SNRIs</p> Signup and view all the answers

    What symptom is commonly associated with excessive worry in Generalized Anxiety Disorder?

    <p>Irritability</p> Signup and view all the answers

    A patient diagnosed with social anxiety disorder may exhibit which behavior?

    <p>Refusing to eat in public settings</p> Signup and view all the answers

    Which of the following medications is categorized as a benzodiazepine for treating anxiety?

    <p>Diazepam</p> Signup and view all the answers

    What is a common fear expressed by individuals with agoraphobia?

    <p>Fear of being in open spaces</p> Signup and view all the answers

    Which medication is classified as a beta blocker often used for social anxiety disorder?

    <p>Propranolol</p> Signup and view all the answers

    What characterizes obsessive-compulsive disorder (OCD)?

    <p>Recurrent intrusive thoughts causing anxiety</p> Signup and view all the answers

    Which of the following is an example of a specific phobia?

    <p>Fear of needles</p> Signup and view all the answers

    Which medication is typically NOT used to treat OCD?

    <p>Beta blockers</p> Signup and view all the answers

    Which symptom is most associated with anxiety disorder due to another medical condition?

    <p>Physical symptoms due to thyroid issues</p> Signup and view all the answers

    What are compulsions in the context of OCD?

    <p>Repetitive behaviors done to alleviate anxiety</p> Signup and view all the answers

    Which of these is a common symptom of social anxiety disorder?

    <p>Overwhelming panic in social situations</p> Signup and view all the answers

    Which of the following medications is used to treat social phobia?

    <p>Atenolol</p> Signup and view all the answers

    What is an example of a behavioral response to anxiety in specific phobias?

    <p>Panic attacks triggered by certain objects</p> Signup and view all the answers

    Which group of medications includes SSRIs that are used for OCD treatment?

    <p>Antidepressants</p> Signup and view all the answers

    What is a primary characteristic of anxiety disorders?

    <p>Excessive fear or anxiety that affects functioning</p> Signup and view all the answers

    Which neurotransmitter is NOT commonly associated with anxiety disorders?

    <p>Adrenaline</p> Signup and view all the answers

    Which factor is considered a psychosocial influence on anxiety disorders?

    <p>Stressful situations and unmanaged stress</p> Signup and view all the answers

    What defines panic disorder?

    <p>Recurrent panic attacks of unpredictable onset</p> Signup and view all the answers

    Which of the following is a common symptom of a panic attack?

    <p>Shortness of breath and chest pain</p> Signup and view all the answers

    What is a characteristic symptom of generalized anxiety disorder (GAD)?

    <p>Excessive worry that occurs most days for at least 6 months</p> Signup and view all the answers

    Which of the following medications is commonly prescribed for panic disorder?

    <p>Antidepressants such as SSRIs and SNRIs</p> Signup and view all the answers

    What effect do benzodiazepines have when used for panic attacks?

    <p>May cause drowsiness and sedation</p> Signup and view all the answers

    What is one of the main theories explaining predisposition to anxiety and related disorders?

    <p>Cognitive Theory</p> Signup and view all the answers

    Which statement about the prevalence of anxiety disorders is correct?

    <p>They are more common in women than in men.</p> Signup and view all the answers

    What is a characteristic symptom of Body Dysmorphic Disorder?

    <p>Exaggerated belief that one's body is deformed or defective.</p> Signup and view all the answers

    Which medication is commonly used for Body Dysmorphic Disorder?

    <p>Clomipramine</p> Signup and view all the answers

    What behavior often precedes episodes of hair-pulling in trichotillomania?

    <p>Increasing tension or anxiety.</p> Signup and view all the answers

    What is a common consequence of interruptions in routine for someone like Helen?

    <p>She becomes frustrated and starts over.</p> Signup and view all the answers

    Which of the following is a common comorbidity associated with Body Dysmorphic Disorder?

    <p>Depression</p> Signup and view all the answers

    Which statement is true regarding the medications for hair-pulling disorder?

    <p>No medications have shown consistent benefits.</p> Signup and view all the answers

    What is one example of a specific behavior displayed by someone with Body Dysmorphic Disorder?

    <p>Constantly seeking dermatologists for cosmetic fixes.</p> Signup and view all the answers

    What is the primary concern of individuals with Body Dysmorphic Disorder regarding their appearance?

    <p>Unrealistically exaggerated concerns about minor defects.</p> Signup and view all the answers

    What is a characteristic behavior of hoarding disorder?

    <p>Excessive purchasing of items</p> Signup and view all the answers

    Which nursing diagnosis is commonly associated with anxiety disorders?

    <p>Social isolation</p> Signup and view all the answers

    What is a key intervention for managing panic anxiety?

    <p>Remain calm and use simple words</p> Signup and view all the answers

    Which outcome reflects effective coping in a patient with anxiety?

    <p>Recognizing signs of escalating anxiety</p> Signup and view all the answers

    How should a nurse respond to a patient experiencing panic anxiety?

    <p>Assist the patient to breathe into a small paper bag</p> Signup and view all the answers

    What is NOT an expected outcome for a patient with anxiety disorder?

    <p>Experiencing panic anxiety constantly</p> Signup and view all the answers

    Which of the following is a maladaptive behavior in managing anxiety?

    <p>Resorting to ritualistic actions</p> Signup and view all the answers

    Why is it important to keep the immediate surroundings low in stimuli for a patient with panic anxiety?

    <p>To avoid overwhelming the patient</p> Signup and view all the answers

    Study Notes

    Anxiety

    • Subjective response to a stressor
    • Normal reaction to stress
    • Different levels
    • Exists a relationship between anxiety and dysfunctional behaviors
    • Involve excessive fear or anxiety
    • Are amongst the most common psychiatric disorders
    • Frequently co-occur with other psychiatric disorders
    • Lifetime prevalence is 30% +
    • More common in females
    • Genetic factors
    • Dysfunction within limbic system & prefrontal cortex
    • Neurotransmitter dysfunction: serotonin, norepinephrine, GABA, dopamine, glutamate
    • Psychoanalytic/Psychodynamic Theories
      • Ego development is delayed and lacks ability to modulate anxiety
      • Unconscious fears may be expressed symbolically as phobias
      • Underdeveloped ego leads to regression
    • Psychosocial Influences
      • Stressful situations and unmanaged stress
    • Learning Theory
      • Classic conditioning
      • Learned behaviors, modeling
      • Passive and active avoidance
    • Cognitive Theory
      • Faulty, distorted thinking patterns precede maladaptive behaviors
      • Negative self-statement and irrational beliefs

    Panic Disorder

    • Characterized by recurrent panic attacks
      • The onset is unpredictable
      • Manifested by intense apprehension, fear, or terror
      • Often associated with feelings of impending doom
      • Accompanied by intense physical discomfort
    • May or may not be accompanied by agoraphobia

    Panic Attack Symptoms

    • Shortness of breath, chest pain, or discomfort, palpitations, pounding heart rate, accelerated HR, intense apprehension, fear of terror, Fear of losing control or "going crazy" and Fear of dying
    • Sweating, trembling, shaking
    • Nausea or abdominal distress
    • Dizziness, chills, or hot flashes
    • Numbness or tingling sensations
    • Derealization or depersonalization

    Medications for Panic Disorder

    • Antidepressants: SSRIs (fluoxetine, paroxetine, sertraline) & SNRIs (venlafaxine)

    • Benzodiazepines: Lorazepam, diazepam, clonazepam

      • Used for panic attacks
      • Drowsiness and sedation
      • Increases risk of respiratory depression (especially when paired with opioids and ETOH)
      • Potential for dependence
      • Educated to take medication as prescribed

    Generalized Anxiety Disorder (GAD)

    • Characterized by persistent/chronic, unrealistic, and excessive anxiety and worry
      • Causes impairment in social, occupational, or other important areas of functioning
      • Avoidance and procrastination behaviors
      • Most occur more days than not for at least 6 months
    • May avoid activities/events that may result in negative outcomes
    • Irritability, muscle tension, sleep disturbance, feeling keyed up or on edge, and excessive anxiety and worry for at least 6 months

    GAD Treatment Modalities

    • Antidepressants
      • SSRIs (escitalopram, paroxetine) or SNRIs (duloxetine, venlafaxine)
      • TCAs (imipramine)
      • Other antidepressants
    • Other medications
      • Buspirone (takes 1 week or so to take w/ consistent use)
      • Diphenhydramine or Hydroxyzine (antihistamines)
      • Anticonvulsants (pregabalin, valproic acid, gabapentin)
      • Antipsychotics (quetiapine)

    Phobias

    • Agoraphobia
      • Fear of being in places or situations from which escape might be difficult or in which help might not be available
        • Using public transportation (e.g., automobiles, buses, trains, ships, planes)
        • Being in open spaces (e.g., parking lots, marketplaces, bridges)
        • Being in enclosed places (e.g., shops, theaters, cinemas)
        • Standing in line or being in a crowd
        • Being outside of the home alone
    • Antidepressants: SSRIs (fluoxetine, paroxetine, sertraline) & SNRIs (venlafaxine)
    • Benzodiazepines: Lorazepam, diazepam, clonazepam

    Social Anxiety Disorder (Social Phobia)

    • Excessive fear of situations in which the affected person might do something embarrassing or be evaluated negatively by others
    • Extreme concerns about being exposed to scrutiny in social or performance situations

    Medications for Social Anxiety Disorder/Social Phobia

    • SSRIs (sertraline, paroxetine)/SNRIs (venlafaxine)
    • Beta blockers (propranolol, atenolol)
    • Antihypertensive (clonidine)
    • Antihistamines (diphenhydramine, hydroxyzine)
    • Benzodiazepines (diazepam, clonazepam, lorazepam)

    Specific Phobia

    • Fear of specific objects or situations that could conceivably cause harm, but the person's reaction to them is excessive, unreasonable, and inappropriate - Exposure to the phobic object produces overwhelming symptoms of panic
      • Examples: claustrophobia, arachnophobia, belonephobia
      • Usually don't require medication

    Anxiety Disorder Due to Another Medical Condition or Substance or Medication Induced

    • Medical conditions that may produce anxiety s/s
      • Cardiac, endocrine, thyroid, respiratory, & neurological conditions; Common with COPD
    • Substance or Medication Induced Anxiety Disorder
      • May be associated with intoxication or withdrawal from any of the following substances:
        • Alcohol, sedatives, hypnotics, or anxiolytics
        • Amphetamines or cocaine, Hallucinogens, Caffeine, Cannabis, Others

    Obsessive-Compulsive Disorder (OCD)

    • Recurrent intrusive thoughts that cause anxiety
    • Individual attempts to ignore or suppress thoughts
    • Repetitive behaviors are done in response to obsession
    • Behaviors or mental acts are done to prevent or reduce anxiety

    OCD Assessment Data

    • Recurrent obsessions and/or compulsions that are severe enough to be time-consuming or to cause marked distress or significant impairment

    OCD Obsessions

    • Recurrent thoughts, impulses, or images experienced as intrusive and stressful, and unable to be removed by logic or reasoning
    • Cause anxiety and the compulsions are an attempt to alleviate the anxiety

    OCD Compulsions

    • Repetitive ritualistic behavior or thoughts, the purpose of which is to prevent or reduce distress or to prevent some dreaded event or situation

    OCD Medications

    • Antidepressants
      • SSRIs (fluoxetine, paroxetine, sertraline, fluvoxamine)
      • TCAs (clomipramine)
    • Other medications
      • Atypical antipsychotics (risperidone, aripiprazole)
      • Buspirone

    Body Dysmorphic Disorder

    • Characterized by the exaggerated belief that the body is deformed or defective in some specific way
    • If true defect is present, the person's concern is unrealistically exaggerated and grossly excessive
    • Often has another comorbid mental disorder (depression, psychotic disorders)
    • Plastic surgeons screen for this disorder prior to surgeries

    Medications for Body Dysmorphic Disorder

    • No FDA approved mediation
    • Antidepressants
      • SSRIs (citalopram, escitalopram, sertraline, fluoxetine, fluvoxamine)
      • TCAs (clomipramine)
    • Other medications
      • Atypical antipsychotics (olanzapine, quetiapine, risperidone, aripiprazole)

    Hair-Pulling Disorder (Trichotillomania)

    • The recurrent pulling out of one's own hair that results in noticeable hair loss
    • Preceded by increasing tension and results in sense of release or gratification
    • No medications have demonstrated consistent benefits, may try SSRIs, TCA-clomipramine, mood stabilizers, antipsychotics, N-Acetylcysteine, inositol, naltrexone, memantine

    Hoarding Disorder

    • The persistent difficulty discarding possessions regardless of their value
      • There can be a need for excessive acquiring of items (by purchasing or other means)
    • No FDA approved medications for this disorder, may try SSRIs/SNRIs, addition of an antipsychotic

    Diagnosis/Outcome Identification

    • Nursing diagnoses commonly associated with anxiety, OCD, and related disorders
      • Panic anxiety
      • Powerlessness
      • Fear
      • Social isolation
      • Ineffective coping
      • Ineffective role performance
      • Disturbed body image
      • Ineffective impulse control

    Outcomes: The Patient

    • Is able to recognize signs of escalating anxiety and intervene before reaching panic level
    • Is able to maintain anxiety at manageable level and make independent decisions about life situation
    • Functions adaptively in the presence of the phobic object or situation without experiencing panic anxiety
    • Verbalizes a future plan of action for responding in the presence of the phobic object or situation without developing panic anxiety
    • Is able to maintain anxiety at a manageable level without resorting to the use of ritualistic behavior
    • Demonstrates more adaptive coping strategies for dealing with anxiety than ritualistic behaviors
    • Verbalizes a realistic perception of his or her appearance and expresses feelings that reflect a positive body image
    • Verbalizes and demonstrates more adaptive strategies for coping with stressful situations

    Planning/Implementation

    • Remain calm, nonthreatening approach
    • Assist the patient to breathe into a small paper bag
    • Stay with patient
    • Give benzo PRN
    • Use simple words and brief messages
    • Keep the immediate surroundings low in stimuli.
    • Teach the client signs of escalating anxiety
    • Include the client in making decisions
    • Encourage the client to explore underlying feelings
    • Initially meet the client's dependency needs
    • Provide a structured schedule of activities

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    Anxiety, Obsessive-Compulsive, and Related Disorders PDF

    Description

    This quiz covers the fundamental concepts of anxiety, including its subjective responses to stressors and the relationship between anxiety and dysfunctional behaviors. Additionally, it explores anxiety, OCD, and their predisposing factors, including genetic and psychosocial influences. Test your knowledge on these common psychiatric disorders and their prevalence.

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