Definition

A feeling of uneasiness that activates the autonomic nervous system in response to a vague, nonspecific threat

Differs from fear because fear is a response to a known threat.

4 Degrees of Anxiety

MILD Perceptual field widens slightly.

Increased ability to see relationships among data.

Person is alert, more perceptive, able to recognize the anxiety.

MODERATE Perceptual field narrows slightly. Can

change attention if directed.

Person is able to sustain attention on a focal point. May talk faster, V/S begin to increase, able to recognize and express anxiety.

SEVERE Perceptual field is greatly reduced.

Does not notice external events. Unable to redirect attention even with direction.

Attention is focused on a small part of a specific area. May be unaware of anxiety, V/S increasing, coping relief measures are used.

PANIC Perception is distorted, may jump

from one detail to another (flight of ideas) Person feels dread or terror.

Feeling of unreality, confusion, terror, self-absorption. Mat be expressed with violence toward self or others. Loss of control. Can result in exhaustion if prolonged.

Signs & Symptoms

Increased heart rate

Increased blood pressure

Dilated pupils

Cool skin

Piloerection (hair “standing on end”)

Decreased GI motility

Coping with anxiety

Coping behaviors are:

ADAPTIVE ~ A student receives a bad grade on an

exam. The student goes to the instructor to see what her faults are (problem solving).

MALADAPTIVE~ A student receives a bad grade on an exam.

The student does not seek advice or help, keeps studying the way he always does, hoping it will pay off (avoidance)

Task Oriented Reactions

Reactions to anxiety that are conscious ways to cope with problems or to meet needs.

Attack Behavior~ actively removing obstacles through problem solving while considering the rights of others

Withdrawal Behavior~ removing self either physically or emotionally from a stressful situation

Compromise~ changing the usual ways of behaving, substituting goals, or giving up aspects of person needs.

Attack Behavior

Adaptive attack behavior: Example~ A nurse asking another nurse to

help figure out why a client’s condition is changing

Maladaptive attack behavior: Example~ A nurse shouting at a nursing

assistant that made a mistake.

Withdrawal Behavior

Adaptive Withdrawal behavior: Example~ Person with asthma leaves a

smoke-filled room

Maladaptive Withdrawal behavior: Example~ Avoiding visiting family or

friends to avoid arguments

Compromise

Compromise is usually adaptive

Example~ Nursing student wanted to go on vacation to Disney World a week during school but would be penalized for it. She compromised by still going to Disney World, but on break from school.

Types of Anxiety Disorders

Generalized Anxiety Disorder

Panic Disorder (with or without Agoraphobia)

Agoraphobia (with out Panic Disorder)

Obsessive-Compulsive Disorder (OCD)

Acute Stress Disorder

Posttraumatic Stress Disorder (PTSD)

Generalized Anxiety Disorder

Characterized by excessive anxiety and worry occurring on most days for at least 6 months. Anxiety can be for a number of different events or activities, and the individual finds it difficult to control.

Must have at least 3 of the following: Restlessness Fatigue Difficulty Concentrating Irritability Muscle Tension Disturbed Sleep

Generalized Anxiety Disorder

Persons with GAD report they feel:

Significant stress

Difficulty controlling the worry

Impairment in social occupational functioning

Physical Symptoms of GAD

Fatigue

Headaches

Muscle tension

Muscle pain

Irritability

Sweating

Nausea/Vomiting

Difficulty breathing/swallowing

Trembling

Hot flashes

Panic Disorder

Panic Attack: Characterized by an episode of intense fear or

discomfort

People with Panic Disorder have recurrent, unexpected panic attacks followed by at least one month of persistent concern about having another one.

May occur without warning, or are associated with stressor(s)

Can occur at anytime (even sleep)

Peaks in severity within 10 minutes

Can severely limit an individual’s ability to function

Panic Disorder

During a panic attack, four or more of the following are present: Palpitations, pounding heart, or increased heart rate Sweating Trembling/shaking Sensations of shortness of breath or smothering Feeling of choking Chest pain or discomfort Nausea of abdominal distress Feeling dizzy, unsteady, lightheaded or faint Derealization (feeling of unreality) o depersonalization

(feeling detached from oneself) Fear of losing control or going crazy Fear of dying Paresthesias (numbness or tingling) Chills or hot flashes

Agoraphobia

Agoraphobia: Characterized by anxiety about being in places or

situations where escape may be difficult (or embarrassing) or when help might not be available in the case of a panic attack

Commonly associated with Panic Disorder More likely to occur in females than in

males Often include situation that involve being

alone away from home in a crowd or standing in line; on a bridge; or traveling in a plane, train, bus, or automobile.

Post-traumatic Stress Disorder (PTSD)

PTSD: Debilitating condition that follows an extreme

traumatic stressor

Stressor may be and even that threatens the individual’s life, serious injury, or personal integrity.

Characteristics of PTSD

Persistent re-experiencing the traumatic event

Increased arousal (difficulty sleeping, nightmares, exaggerated startle response, and hypervigilance or alertness for danger)

Numbing of general responsiveness (“psychic numbing” or “emotional anesthesia”)

Avoidance of stimuli associated with the trauma

Types of Phobias

Acrophobia Agoraphobia Ailurophobia Apiphobia Aviophobia Claustrophobia Cynophobia Entomophobia Hematophobia

Iatrophobia Hydrophobia Microphobia Monophobia

(autophobia) Mysophobia Nyctophobia Pyrophobia Xenophobia