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Which of the following are anxiety disorders?
Which of the following are anxiety disorders?
Anxiety is typically future-oriented.
Anxiety is typically future-oriented.
True
What percentage of the general population is affected by an anxiety disorder?
What percentage of the general population is affected by an anxiety disorder?
What are some risk factors for anxiety disorders?
What are some risk factors for anxiety disorders?
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What is the most common mental health diagnosis in adults?
What is the most common mental health diagnosis in adults?
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What is the difference between fear and anxiety?
What is the difference between fear and anxiety?
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Which of the following is NOT a commonly reported physical symptom of anxiety?
Which of the following is NOT a commonly reported physical symptom of anxiety?
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The body's ______ response is responsible for the physical symptoms of anxiety.
The body's ______ response is responsible for the physical symptoms of anxiety.
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Mild anxiety can be beneficial to problem-solving.
Mild anxiety can be beneficial to problem-solving.
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Which level of anxiety is characterized by a complete lack of focus?
Which level of anxiety is characterized by a complete lack of focus?
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Match the following physical symptoms with the level of anxiety they are most likely associated with.
Match the following physical symptoms with the level of anxiety they are most likely associated with.
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A parent is shopping with their 5-year-old child in a large, busy mall. The parent suddenly realizes that the child is missing. What level of anxiety would likely result?
A parent is shopping with their 5-year-old child in a large, busy mall. The parent suddenly realizes that the child is missing. What level of anxiety would likely result?
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What are some appropriate interventions for a parent experiencing panic-level anxiety due to a missing child?
What are some appropriate interventions for a parent experiencing panic-level anxiety due to a missing child?
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What are some behaviors and physical signs that might indicate panic-level anxiety?
What are some behaviors and physical signs that might indicate panic-level anxiety?
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What does GAD stand for?
What does GAD stand for?
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GAD is more common in men.
GAD is more common in men.
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What percentage of the population is diagnosed with GAD?
What percentage of the population is diagnosed with GAD?
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To be diagnosed with GAD, an individual needs to experience excessive worry and anxiety for more days than not, over a period of at least 6 months
To be diagnosed with GAD, an individual needs to experience excessive worry and anxiety for more days than not, over a period of at least 6 months
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Excessive worry in GAD can be explained by drug abuse or medication.
Excessive worry in GAD can be explained by drug abuse or medication.
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Individuals with GAD are able to effectively self-soothe.
Individuals with GAD are able to effectively self-soothe.
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Children with GAD might only exhibit one symptom, while adults need three or more symptoms to be diagnosed with GAD.
Children with GAD might only exhibit one symptom, while adults need three or more symptoms to be diagnosed with GAD.
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Which of the following are symptoms of GAD listed by the DSM-V?
Which of the following are symptoms of GAD listed by the DSM-V?
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Individuals with GAD generally have good problem-solving skills.
Individuals with GAD generally have good problem-solving skills.
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What medication classification is generally used to treat GAD?
What medication classification is generally used to treat GAD?
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Panic attacks can be triggered by the unexpected.
Panic attacks can be triggered by the unexpected.
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What are some common symptoms of PTSD?
What are some common symptoms of PTSD?
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The symptoms of PTSD are always immediately apparent following trauma.
The symptoms of PTSD are always immediately apparent following trauma.
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Which of the following is NOT a risk factor for PTSD?
Which of the following is NOT a risk factor for PTSD?
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Children with PTSD often express their memory about the traumatic event through play.
Children with PTSD often express their memory about the traumatic event through play.
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Denial is considered a healthy coping mechanism for PTSD.
Denial is considered a healthy coping mechanism for PTSD.
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What is the key element of a patient interview for individuals suspected of having PTSD?
What is the key element of a patient interview for individuals suspected of having PTSD?
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Exposure therapy is considered a beneficial treatment for PTSD.
Exposure therapy is considered a beneficial treatment for PTSD.
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Individuals with PTSD are often open and receptive to discussing traumatic experiences.
Individuals with PTSD are often open and receptive to discussing traumatic experiences.
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What is the purpose of using medications like SSRI/SNRI for PTSD?
What is the purpose of using medications like SSRI/SNRI for PTSD?
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Survivors' guilt is a common concern for individuals with PTSD.
Survivors' guilt is a common concern for individuals with PTSD.
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Somatic symptoms are often intentional
Somatic symptoms are often intentional
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Somatic symptoms are associated with anxiety disorders, but not depression.
Somatic symptoms are associated with anxiety disorders, but not depression.
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Somatic symptoms can increase an individual's quality of life.
Somatic symptoms can increase an individual's quality of life.
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Which of the following is NOT a type of Somatic Symptom Disorder?
Which of the following is NOT a type of Somatic Symptom Disorder?
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Conversion Disorder is characterized by what?
Conversion Disorder is characterized by what?
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The term “secondary gain” refers to the relief of unconscious psychological conflict.
The term “secondary gain” refers to the relief of unconscious psychological conflict.
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Somatic symptoms are more common in individuals with lower socioeconomic status.
Somatic symptoms are more common in individuals with lower socioeconomic status.
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A client has been admitted to a medical unit with acute blindness. After extensive testing, no medical reason for the blindness can be found. The client reports experiencing this blindness after witnessing a hit-and-run accident. What condition might the nurse suspect?
A client has been admitted to a medical unit with acute blindness. After extensive testing, no medical reason for the blindness can be found. The client reports experiencing this blindness after witnessing a hit-and-run accident. What condition might the nurse suspect?
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An intervention to reduce somatic symptoms is to reduce the focus on illness and symptoms.
An intervention to reduce somatic symptoms is to reduce the focus on illness and symptoms.
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Study Notes
Anxiety
- Anxiety is a universal human experience and a basic emotion.
- It's a feeling of uneasiness, apprehension, uncertainty, or dread stemming from a real or perceived threat.
- Anxiety is typically future-oriented.
- Fear is a distinct emotion, distinguished from anxiety by being a reaction to a specific danger or circumstance.
- Anxiety disorders affect 20% of the general population and are the most common mental health diagnosis in adults.
- Approximately 3-5% of children and adolescents have a diagnosed anxiety disorder.
Risk Factors for Anxiety
- Female sex (2:1 ratio)
- Stressful/traumatic life events
- Family history of anxiety disorders
- Childhood adversity
- Support systems
- Alcohol or illicit drug use
- Other psychiatric or chronic health issues
- Personality factors
- Traumatic brain injury
Anxiety Disorders Spectrum
- Mild: Increased motivation, effective work, heightened awareness, optimal functioning.
- Moderate: Decreased concentration, decreased problem-solving, muscular tension, restlessness.
- Severe: Progressively narrowed focus, severe cognitive impairment, physical and emotional symptoms
- Panic: Complete lack of focus, marked change in baseline behavior, functional impairment.
Fight or Flight Symptoms
- Increased vital signs
- Dilated pupils
- Hyperglycemia
- Dilated bronchioles
- Peripheral vasoconstriction
Case Study Examples
- A parent realizing a 5-year-old child is missing in a busy mall would likely experience severe anxiety.
- Interventions for someone experiencing panic-level anxiety during a child-missing crisis may include providing a safe space, calm, simple words, and delaying the visit if that would help.
Generalized Anxiety Disorder (GAD)
- GAD is characterized by persistent and exaggerated apprehension and tension leading to dysfunction.
- Worry is a central feature, with events often misrepresented due to worry.
- GAD is more prevalent in women.
- Approximately 5% of the population experiences GAD.
GAD Diagnosis (DSM-V Criteria)
- Excessive anxiety for most days over 6 months
- Causes significant impairment in daily life
- Hard to control anxiety, unable to self-soothe
- Not explained by medication, drug abuse, or another medical condition
- Not better explained by another mental disorder.
Symptoms (DSM-V)
- Restlessness
- Sleep disturbances
- Muscle tension
- Easily fatigued
- Difficulty concentrating
Additional GAD Symptoms
- Excessive physiologic arousal (e.g., sweating, palpitations, SOB)
- Distorted cognitive processing (e.g., poor concentration, unrealistic assessments, excessive worry)
- Poor coping mechanisms (e.g., avoidance, procrastination, poor problem-solving)
- Sleep disturbances (e.g., rumination, difficulties falling asleep)
PTSD (Post-Traumatic Stress Disorder)
- PTSD is a complex response to traumatic events.
- Symptoms typically emerge within 3 months of the traumatic event, but sometimes the onset is delayed.
- The diagnosis of PTSD is not possible until four weeks or more after the event.
- Risk factors for PTSD include female sex, those under 25 years old, lower education levels, prior history of adverse life events or trauma, family history.
PTSD Risk Factors
- Female sex
- Under 25
- Low education level
- Childhood adversity
- Adverse life events
- Psychiatric disorders
- Genetic factors
- Perceived severity of trauma
- Nature of trauma
- HPA axis dysfunction.
PTSD Diagnosis Criteria
- Exposure to or threat of trauma
- Intrusion symptoms (e.g., flashbacks)
- Recurrent avoidance
- Negative changes in mood and cognition
- Trauma-related alterations in arousal and reactivity
- Functional significance
- Elimination of alternative explanations
PTSD Main Features
- Re-experiencing (flashbacks)
- Avoidance
- Increased arousal
- Numbing of general responsiveness or negative changes.
PTSD in Children
- Children may show less distress than adults but may still experience PTSD.
- PTSD in children can be expressed through acting it out.
Negative Coping Mechanisms in PTSD
- Denial
- Repression
Patient Interview with PTSD
- A sensitive approach to interviewing is crucial for someone with chronic PTSD.
- Obtaining trauma history should occur at a tolerable pace for the patient.
PTSD Treatment
- Exposure therapy and group therapy may be beneficial
- Medications such as SSRIs and SNRIs may help minimize flashbacks and nightmares.
- Anxiolytics and sleep aids may help treat physiological arousal and sleep issues.
Risk Factors for PTSD (cont'd)
Risk Associated with Substance Abuse in Anxiety/PTSD
- Substance abuse can occur as a form of self-medication in an effort to cope with the symptoms of anxiety or PTSD.
Somatic Symptom Disorders
- These involve physical symptoms that are not intentionally caused, but are very real.
- Often co-occur with anxiety, depression, or other psychological issues.
- Characterized by a high level of functional impairment focused on symptoms
- Symptoms can significantly diminish quality of life.
- Symptoms vary (Examples: GI issues, pain, sexual dysfunction, persistent anxiety)
Risk Factors for Somatic Symptom Disorders
- Lower socioeconomic status
- Fewer years of education
- Family history of chronic illness
- Existing psychiatric conditions
- Female sex
- Prior history of chronic childhood illness
Psychological factors contributing to Somatic Disorders
- Psychological factors are frequently a part of somatic symptom disorders, and are a significant contributor to the emergence.
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