Ch.18 Anxiety Disorder, Autistic Disorder, and Stress Disorders
Anxiety & Stress-Related Disorders
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Transcript of Anxiety & Stress-Related Disorders
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ANXIETY &
STRESS-RELATED
DISORDERS
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Anxiety-related disorders are the most common of all psychiatricdisorders.
Three quarters of those with anxiety disorders have their first episode by age
21.5 years.
Symptoms of anxiety that negatively affect the persons ability tofunction in work or interpersonal relationships are consideredsymptomatic of anxiety disorders.
Anxiety disorders may be associated with other mental & physicalillnesses such as respiratory, cardiac, and mood disorders
Panic attacks occur in many of the Anxiety Disorders.
Patients with Panic Disorders are often seen in a number ofhealth care settings.
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ETIOLOGY
Research points to a combination of biologic
and psychosocial factors that cause persistent
anxiety.
Other research demonstrates that personality
traits may predispose an individual to anxiety.Low self-esteem and some negative family
influences may contribute to development of
anxiety disorders.
In some cases, there may be a traumatic or
stressful precipitating event.
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ANXIETY DISORDERS
Panic Disorder
Acute Stress Disorder
Post Traumatic Stress Disorder
Obsessive-Compulsive Disorder
Generalized Anxiety Disorder
Phobias
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PANIC DISORDER
Characterized by the appearance of disabling attacks of
panic. Physical and psychological symptoms include:
Palpitations
Sweating
Shaking
Shortness of breath or smothering sensation
Sensation of choking
Chest pain
Nausea & vomiting of abdominal distress
Dizziness
Derealization or depersonalization
Fear of going crazy or fear of dying
Chills or hot flashes
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OBSESSIVE-COMPULSIVE DISORDER
Obsessions are excessive, unwanted, intrusiveand persistent thoughts, impulses or images that
cause anxiety and distress.
Compulsions are behaviors that are performed
repeatedly in a ritualistic fashion with the goal of
preventing or relieving anxiety & distress caused
by obsessions.
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GENERALIZED ANXIETY DISORDER
Excessive worry and anxiety that is unwarranted
more days than not.
Symptoms include uneasiness, irritability, muscle
tension, fatigue, difficulty thinking and sleep
alteration.
Adults with GAD often worry about matters such
as their job, household finances, health of familyor simple matters such as household chores or
being late for appointments.
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ACUTE & POSTTRAUMATIC STRESS DISORDERS
Develops after a traumatic event involving a personal
experience of threatened death, injury or perceived
threat to physical integrity.
They are hypervigilent, they re-experience the event
through images, thoughts or nightmares and try to
avoid people, places or things that are reminders of
the event.
Examples of events are violent personal assault, rape,
military combat, natural disasters, terrorist attacks,
incarceration as POW, torture, automobile accidents or
being diagnosed with a life-threatening illness.
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PHOBIAS
An Illogical, intense, persistent fear of a specific object or
social situation that causes extreme distress andinterferes with normal life functioning.
Agoraphobia- fear of open spaces
Specific Phobia an irrational fear of an object or
situation
Social Phobia- anxiety provoked by certain social or
performance situations.
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TREATMENT
Usually involves a combination ofmedication(anxiolytics & antidepressants) & therapy.
CognitiveBehavioral Therapy:Positive reframing
Decatastrophizing
Assertiveness trainingDesensitization
Psychoeducation:
Relaxation techniquesMedication
Education to understand disorders
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PHARMACOLOGIC INTERVENTIONS
Selective Serotonin Reuptake Inhibitors (SSRIS) &
Tricyclic Antidepressants(TCAS) are the most effective
treatment for clients with Anxiety Disorders.
Benzodiazepines are utilized short-term.
ToleranceSedation
Withdrawal
Buspirone (BuSpar) must be taken 3-4 weeks beforeanxiolytic effects are experienced.
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WORKING WITH ANXIOUS CLIENTS
Be aware of nurses own anxiety
Assess the persons anxiety levelSpeak in short, simple, easy-to-understand
sentences
Lower the persons anxiety level to moderate or mild
before proceeding with anything elseSpeak to the client in a low, calm, and soothing voice
Walk while talking, if the client cant sit still
Ensure safety during panic level of anxiety
Remain with the client until panic recedes
Use Cue Cards to help client restructure thoughtpatterns
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SOMATIC
SYMPTOM
DISORDERS
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DEFINITIONS
Somatization is the transference of mentalexperiences and states into bodily
symptoms.
Somatic Symptom Disorders are the
presence of physical symptoms that
suggest a medical condition without ademonstrable organic basis to account
fully for them.
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ESSENTIAL FEATURES
Physical complaints suggest major medicalillness but have no demonstrable organicbasis.
Psychological factors and conflicts seemimportant in initiating, exacerbating andmaintaining the symptoms.
Symptoms or magnified health concerns arenot under the clients conscious control.
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COMPLEX SOMATIC SYMPTOM DISORDER
Is a reconfiguration of Somatization, Hypochondriasis
and Pain Disorder.Clients perceive themselves as being very sick and
aspects of healthcare as poor.
Common features of somatization and cognitive
distortions.Nurses in Primary Care and MedicalSurgical settings
more likely to encounter these persons.
Symptoms tend to change, are diffuse and complex
and move from one body system to another.Clients tend to move from one practitioner to the next.
It is a chronic relapsing condition
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TREATMENT
Provide health teachingAssist client to express emotion
Teach coping strategies; emotion
focused & problem focusedUse of antidepressants for depression
Referral to pain clinic for Pain Disorder
Family Education