ANXIETY AND

STRESS-RELATED
DISORDERS
 DEFINITION OF TERMS
 ANXIETY: VAGUE FEELING OF DREAD OR
APPREHENSION

 FEAR: FEELING OF THREAT BY A CLEARLY

IDENTIFIABLE EXTERNAL STIMULUS THAT
REPRESENTS A DANGER TO THE PERSON

 STRESS: WEAR AND TEAR THAT LIFE CAUSES

ON THE BODY
 GENERAL ADAPTATION
SYNDROME

 ALARM REACTION
STAGE

 RESISTANCE
STAGE

 EXHAUSTION
STAGE
 LEVELS OF ANXIETY
LEVEL PSYCHOLOGICAL PHYSIOLOGIC
RESPONSES RESPONSES
MILD WIDE PERCEPTUAL FIELD RESTLESSNES
SHARPENED SENSES GI DISTURBANCES
INCREASED MOTIVATION DIFFICULTY SLEEPING
MODERATE NARROWED PERCEPTION MUSCLE TENSION
SELECTIVE ATTENTION DIAPHORESIS
HEADACHE, DRY MOUTH
SEVERE REDUCED PERCEPTION SEVERE HEADACHE
FEELS AWE, DREAD TREMBLING, RIGID STANCE,
CRIES CHEST PAIN

PANIC DISTORTED PERCEPTION MAY BOLT AND RUN

LOSS OF REASON TOTALLY IMMOBILE AND
CAN’T COMMUNICATE MUTE
 ANXIETY DISORDERS

 GROUP OF CONDITIONS THAT SHARE A KEY FEATURE OF

EXCESSIVE ANXIETY WITH ENSURING BEHAVIORAL,
EMOTIONAL, COGNITIVE AND PHYSIOLOGIC RESPONSES

 AGORAPHOBIA
 PANIC DISORDER
 SPECIFIC PHOBIA
 GENERALIZED ANXIETY DISORDER
 OBESESSIVE COMPULSIVE DISORDER
POSSIBLE ETIOLOGIES

 GENETICS
 NEUROCHEMICAL
IMBALANCES
 INTRAPSYCHIC
CONFLICT
 INTERPERSONAL
FACTORS
 AGORAPHOBIA
 DEFINITION: ANXIETY ABOUT OR
AVOIDANCE OF SITUATIONS FROM
WHICH ESCAPE MIGHT BE DIFFICULT OR
HELP MIGHT NE UNAVAILABLE.

 SYMPTOMS: AVOIDS BEING OUTSIDE

ALONE; AVOIDS TRAVELING IN
VEHICLES; DIFFICULTY MEETING DAILY
RESPONMSIBILITIES
 PANIC DISORDER
 DEFINITION: DISCRETE EPISODE OF PANIC LASTING
15-30 MINUTES ACCOMPANIED BY EXTREME FEAR
OR DISCOMFORT

 SYMPTOMS: AUTOMATIC HYPERSENSITIVITY,

CHEST PAIN OR DISCOMFORT, A CHOKING
FEELING, FEAR OF DYING OR GOING CRAZY,
DEPERSONALIZATION, NUMBNESS OR TINGLING,
LOSS OF CONTROL OVER ONESELF, IMMOBILITY
 NURSING INTERVENTIONS
 PROVIDE A SAFE ENVIRONMENT AND ENSURE
CLIENT’S PRIVACY
 REMAIN WITH THE CLIENT
 HELP THE CLIENT TO FOCUS ON DEEP BREATHING
 TALK TO THE CLIENT IN A CALM, REASSURING
VOICE
 TEACH THE CLIENT TO USE RELAXATION
TECHNIQUES
 ENGAGE THE CLIENT TO EXPLORE HOE TO
DECREASE STRESSORS AND ANXIETY-PROVOKING
SITUATIONS
 SPECIFIC PHOBIA
 DEFINITION: CHARACTERIZED BY SIGNIFICANT
ANXIETY PROVOKED BY SPECIFIC FEARED
OBJECT OR SITUATION WHICH LEADS TO
AVOIDANCE BEHAVIOR.

 SYMPTOMS: MARKED ANXIETY IN RESPONSE

TO OBJECT OR SITUATION; SIGNIFICANT
DISTRESS OR IMPAIRMENT IN RELATIONSHIPS,
WORK, OR SOCIAL LIFE
 SUBTYPES OF MOST COMMON
PHOBIAS
 ANIMAL TYPE
 NATURAL ENVIRONMENT TYPE
 BLOOD-INJECTION-INJURY TYPE
 SITUATIONAL TYPE
 OTHER TYPE

 TREATMENT: BEHAVIOR THERAPY

 GENERALIZED ANXIETY
DISORDER

 CHARACTERIZED BY AT LEAST SIX MONTHS OF

EXCESSIVE WORRY AND ANXIETY.

 SYMPTOMS: UNCONTROLLABLE WORRYING; AT

LEAST THREE OF THE FOLLOWING SYMPTOMS:
RESTLESSNESS, EASY FATIGABILITY,
DIFFICULTYCONCENTRATING, IRRITABILITY,
MUSCLE TENSION, SLEEP DISTURBANCE
 OBSESSIVE COMPULSIVE
DISORDER

 OBSESSION: UNWANTED, INTRUSIVE,

PERSISTENT IDEAS, THOUGHTS, IMPULSES, OR
IMAGES THAT CAUSE MARKED ANXIETY OR
DISTRESS.
 COMPULSION: UNWANTED REPITITIVE
BEHAVIOR PATTERNS OR MENTAL ACTYSTHAT
ARE INTENDED TO REDUCE ANXIETY, NOT TO
PROVIDE PLEASURE OR GRATIFICATION.
OBSESSIVE COMPULSIVE DISORDER
 DIAGNOSED ONLY WHEN THOUGHTS, IMAGES
AND IMPULSES CONSUME THE PERSON OR HE
IS COMPELLED TO ACT OUT THE BEHAVIORS TO
A POINT AT WHICH THEY INTERFERE WITH
PERSONAL, SOCIAL AND OCCUPATIONAL
FUNCTION.

 TREATMENT: MEDICATION AND BEHAVIOR

THERAPY
SCHIZOPHRENIA
 HOW SERIOUS IS SCHIZOPHRENIA?
 ONSET: GRADUAL OR SUDDEN
 INTELLIGENCE AND SCHIZOPHRENIA
 SOCIOECONOMIC FACTORS
 AGE AND GENDER
 PREDISPOSING FACTORS
 BIOLOGICAL INFLUENCES
GENETICS
BIOCHEMICAL INFLUENCES

 PHYSIOLOGICAL INFLUENCES
VIRAL INFECTION
ANATOMICAL ABNORMAILITIES

 PSYCHOLOGICAL INFLUENCES
 ENVIRONMENTAL INFLUENCES
CLINICAL COURSE
 PHASE 1: THE
SCHIZOID
PERSONALITY
 PHASE 2: THE
PRODROMAL PHASE
 PHASE 3:
SCHIZOPHRENIA
 PHASE 4: RESIDUAL
PHASE
 TYPES OF SCHIZOPHRENIA

 DISORGANIZED
 CATATONIC
CATATONIC STUPOR
CATATONIC
EXCITEMENT
 PARANOID
 UNDIFFERENTIATED
 RESIDUAL
 SIGNS AND SYMPTOMS
 POSITIVE OR HARD SYMPTOMS
AMBIVALENCE
ASSOCIATIVE LOOSENESS
DELUSIONS
ECHOPRAXIA
FLIGHT OF IDEAS
HALLUCINATION
IDEAS OF REFERENCE
PERSEVERATION
 SIGNS AND SYMPTOMS
 NEGATIVE OR SOFT
SYMPTOMS
ALOGIA
ANHEDONIA
APATHY
BLUNTED AFFECT
CATATONIA
FLAT AFFECT
LACK OF VOLITION
 RELATED DISORDERS
 SCHIZOPHRENIFORM DISORDER
 SCHIZOAFFECTIVE DISORDER
 BRIEF PSYCHOTIC DISORDER
 DELUSIONAL DISORDER
EROTOMANIC TYPE
GRANDIOSE TYPE
JEALOUS TYPE
PERSECUTORY
SOMATIC TYPE
 SHARED PSYCHOTIC DISORDER
 TREATMENT MODALITIES
 PSYCHOLOGICAL TREATME
 \NTS
INDIVIDUAL
PSYCHOTHERAPY
GROUP THERAPY
BEHAVIOR THERAPY
SOCIAL SKILLS
TRAINING

 SOCIAL TREATMENT
MILIEU THERAPY
FAMILY THERAPY

 ORGANIC TREATMENT
Typical Antipsychotic (or
Neuroleptic) Drugs
 chlorpromazine (Thorazine).
 haloperidol (Haldol)
 mesoridazine (Serentil),
 fluphenazine (Prolixin).
Side Effects of Neuroleptics.

 Sexual dysfunction
 neuroleptic malignant syndrome
 extrapyramidal symptoms
 acute dystonia
 tardive dyskinesia
Atypical Drugs
 Clozapine (Clozaril) was the first of
these drugs;
 risperidone,
 olanzapine,
 quetiapine