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Chapter 12

Chapter 12. Anxiety and Anxiety Disorders. Anxiety. Anxiety – apprehension, uneasiness, uncertainty, or dread from real or perceived threat Fear – reaction to specific danger Normal anxiety – necessary for survival. Levels of Anxiety. Mild anxiety Moderate anxiety Severe anxiety Panic.

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Chapter 12

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  1. Chapter 12 Anxiety and Anxiety Disorders

  2. Anxiety • Anxiety – apprehension, uneasiness, uncertainty, or dread from real or perceived threat • Fear – reaction to specific danger • Normal anxiety– necessary for survival

  3. Levels of Anxiety Mild anxiety Moderate anxiety Severe anxiety Panic

  4. A parent is shopping with a 5-year-old child in a large, busy urban mall. The parent suddenly realizes the child is missing. Which level of anxiety would likely result?

  5. Mild Moderate Severe Panic

  6. Defenses Against Anxiety • Defense mechanisms • Automatic coping styles • Protect people from anxiety • Maintain self-image by blocking • feelings • conflicts and • memories • Can be healthy or unhealthy

  7. Anxiety Disorders • Clinical picture • Epidemiology • Comorbidity • Etiology • Biological • Genetics • Neurobiological

  8. Psychological Theories • Psychodynamic theories • Sigmund Freud • Harry Stack Sullivan • Behavior theories • Cognitive theories • Cultural considerations

  9. Panic Disorders (PD) • Panic attack • Panic disorder without agoraphobia • Panic disorder with agoraphobia • Simple agoraphobia

  10. Phobias • Specific phobias • Social phobia or social anxiety disorder (SAD)

  11. Obsessive-Compulsive Disorder (OCD) • Obsessions • Thoughts, impulses, or images that persist and recur, so that they cannot be dismissed from the mind • Compulsions • Ritualistic behaviors an individual feels driven to perform in an attempt to reduce anxiety

  12. Generalized Anxiety Disorder (GAD) • Excessive anxiety or worry about numerous things • Lasts for 6 months or longer

  13. Posttraumatic Stress Disorder (PTSD) • Flashbacks • Avoidance of stimuli associated with trauma • Experience of persistent numbing of responses • Persistent symptoms of increased arousal

  14. Acute Stress Disorder Occurs within 1 month after exposure to highly traumatic event Must display at least 3 dissociative symptoms – during or after event Resolves within 4 weeks

  15. Substance-InducedAnxiety Disorder • Symptoms of anxiety, panic attacks, obsessions, and compulsions • Develop with the use of a substance or within a month of stopping use of the substance

  16. Anxiety Due toMedical Conditions Symptoms of anxiety are direct physiological result of a medical condition

  17. Application of the Nursing Process • Assessment • General assessment of symptoms • Self-assessment • Assessment guidelines: anxiety disorders • Nursing Diagnosis • Outcomes Identification • Planning

  18. Application of the Nursing Process Continued • Implementation • Mild to moderate levels of anxiety • Severe to panic levels of anxiety

  19. Basic Level Nursing Interventions • Counseling • Milieu therapy • Promotion of self-care activities • Pharmacological interventions • Health teaching

  20. Advanced Practice Interventions • Cognitive therapy • Behavioral therapy • Relaxation training • Modeling • Systematic desensitization

  21. Advanced Practice Interventions Continued • Behavioral therapy, continued • Flooding • Response prevention • Thought stopping • Cognitive-behavioral therapy

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