3 JENIS GANGGUAN

CEMAS/ANXIETY
DISORDER

SOPHIE DWIYANTI
MODUL KEPERAWATAN JIWA 1
11102018
BEBERAPA ISTILAH YANG
BERKAITAN DG GANGGUAN CEMAS
Psychophysiological disorder = psychosomatic
 some physical or medical problems can be strongly
influenced by psychological factors such as stress,
emotion, or personality.
 psychophysiological disorders are defined as any medical
conditions which are adversely affected by psychological
factors such as stress, behavior, or mood
 types of psychophysiological disorders are: migraine
headache, tension headache, peptic ulcer, irritable bowel
syndrome, insomnia,and essential hypertension.
 essential hypertension has been postulated to result from
an inherently overactive cardiovascular system such that
stress ultimately results in chronically elevated blood
pressure.
Dissosiative disorder = split personaity
 dissociation is a common defense/reaction to stressful or traumatic
situations.
 severe isolated traumas or repeated traumas may result in a person
developing a dissociative disorder.
 a dissociative disorder impairs the normal state of awareness and
limits or alters one’s sense of identity, memory, or consciousness.
 dissociation is a mental process where a person disconnects from
their thoughts, feelings, memories or sense of identity.
 dissociative disorders include dissociative amnesia, dissociative
fugue, depersonalisation disorder and dissociative identity disorder
 dissociative symptoms are as common as anxiety and depression,
but are frequently misdiagnosed for many years, delaying effective
treatment
 undetected or untreated simply because they were unable to identify
their problem, dissociative symptoms are typically hidden
Somatoform = somatic symptom disorder = somatization
disorder
 a form of mental illness that causes one or more bodily
symptoms, including pain.
 Many people who have SSD will also have an anxiety
disorder.
 the distress they experience from pain and other problems
they experience are real, regardless of whether or not a
physical explanation can be found.
ANXIETY ??
Normal human emotion
Many people feel anxious, nervous when faced problem with
job, interview, final exam, public speaking, etc.

But Anxiety Disorder is

different!
ANXIETY DISORDER:
Perasaan yang tidak menyenangkan

Merupakan gangguan yang simptom utamanya bersifat

eksesif/berlebihan atau penuh kecemasan dan ketakutan yang
tidak realistik

Menyebabkan stres/distres yang mengganggu kemampuan

seseorang untuk berfungsi secara normal

Serious mental illness

BEBERAPA JENIS
GANGGUAN
CEMAS:
1. Phobic disorder
2. Panic disorder
3. Obsessive-compulsive disorder
 PENYEBAB GANGGUAN CEMAS:
Pandangan behaviorist
Reaksi perilaku cemas terjadi karena dipelajari

Pandangan psikolog kognitif

Cemas terjadi karena proses pemikiran yang tdk logis, irasional

Biologis
Ketakseimbangan neurotransmiter, aktivasi otak yang berbeda,
herediter

Budaya
Terdapat dalam budaya tertentu
ASPEK BUDAYA DALAM
SOCIAL ANXIETY/SAD
Asian cultures typically show the lowest rates, whereas
Russian and US samples show the highest rates, of SAD
The defining feature of social anxiety disorder (SAD) is the
fear of negative evaluation by others.
SAD is directly linked to social standards and role
expectations, which are culture dependent.
DSM-IV-TR criteria for social anxiety disorder (SAD) as it
relates to culture, race, and ethnicity.
 AKAR KATA BAHASA YUNANI,
YAITU PHOBOS = FEAR
 AN IRRATIONAL, PERSISTENT
FEAR OF AN OBJECT,
SITUATION, OR SOCIAL
ACTIVITY
PHOBIC DISORDER:
• Ketakutan yang kuat dan tidak rasional terhadap sesuatu
• Penderita menghindarinya dalam jangka waktu lama, penilaian
tidak proporsional dari situasi bahaya sesungguhnya/aktual
dibandingkan dengan yang dipersepsikan (pikiran)
• Feeling dreadfull
• Jika konfrontasi dengan sumber ketakutan, ia akan distress
yang mengganggu fungsi normal sampai serangan panik
• Sesuatu: obyek/benda, makhluk hidup, tempat, situasi atau
situasi sosial
Contoh:
menghindari ular (rasional)
menghindari foto/gambar ular (irasional)
BEBERAPA JENIS PHOBIA:
Social phobia (social anxiety disorder)  ketakutan untuk
berinteraksi dengan orang lain atau berada dalam situasi sosial,
sangat pemalu
- Contoh: takut berbicara di depan umum, takut
menggunakan toilet umum, takut bicara telpon umum

•Specific phobia  ketakutan pada obyek atau situasi tertentu

•Agoraphobia  lbh kompleks dari social phobia

BEBERAPA JENIS SPECIFIC PHOBIA
(SIMPLE PHOBIA):
Claustrophobia: ketakutan berada dalam tempat tertutup
Trypanophobia: ketakutan terhadap injeksi
Odontophobia: ketakutan pada hal-hal di dokter gigi
Hematophobia: takut pada darah/luka
Acrophobia: takut ketinggian
Cynophobia: takut pada anjing
Ophidiophobia: takut pada ular
Nyctophobia: takut pada gelap/kegelapan
Glossophobia: takut berbicara di depan audiens
Aviatophobia: takut terbang
SIMPTOM
FISIK/FISIOLOGIS FOBIA:
Jantung berdetak kencang, seperti berkejaran
Nafas pendek-pendek, sulit bernafas
Berkeringat, gemetar
Perasaan tidak nyaman/sakit di dada/perut
Merasa pusing, tekanan darah meningkat
Rasa takut yang intens yang bisa memalukan diri penderita
Mulut kering, tersedak
Dada sesak, sakit (chest pain), seperti ditusuk jarum
SIMPTOM
EMOSI/PSIKOLOGIS
FOBIA:
Perasaan panik
Keinginan yang kuat untuk menghindar (escape)
Merasa ‘gila’ , kehilangan kontrol
Merasa seolah-olah akan mati
Overreacting  tidak berdaya mengatasi ketakutan
PENYEBAB FOBIA
Insiden/trauma yang dihadapi
co: turbulensi  takut terbang
Respons yang dipelajari
co: melihat ibu takut anjing  jadi takut anjing
Genetik  tendensi sejak lahir
Respons terhadap situasi panik  makin intens
Stres jangka panjang  coping stress buruk
GANGGUAN APAKAH
INI?
PANIC DISORDER:

Panic attack:
Sudden onset of intense panic in which multiple physical
symptoms of stress occur, often with feelings that one is dying

Panic disorder:
Disorder in which panic attacks occur frequently enough to
cause the person difficultyin adjusting to daily life
PHYSICAL SYMPTOMS:
1. Gemetar, merasa dikocok-kocok
2. Perasaan disorientasi
3. Mual, perut tidak enak
4. Tergesa, bertubi-tubi
5. Irama detak jantung yang tidak teratur,
berkejaran
6. Mulut kering
7. Kesulitan bernafas
8. Berkeringat
9. Pusing
10. Merasa lepas kontrol, merasa gila
YANG DIRASAKAN
ADALAH….

Seperti mendapatkan serangan jantung,

atau perasaan ingin kolaps,
atau perasaan ingin mati/meninggal.
OBSESSIVE-COMPULSIVE
DISORDER:
Obsessive-compulsive disorder
Disorder in which intruding, recurring thoughts or
obsessions create anxiety that is relieved by performing a
repetitive, ritualistic behavior (compulsion)
Obsessions
Obsessions are unwelcome thoughts, images, urges or
doubts that repeatedly appear in your mind; for example,
thinking that you have been contaminated by dirt and germs,
or experiencing a sudden urge to hurt someone.

Compulsions
Compulsions are repetitive activities that you feel you have
to do. This could be something like repeatedly checking a
door to make sure it is locked or repeating a specific phrase
in your head to prevent harm coming to a loved one
SIKLUS OCD

Obsessive
Anxiety
thought

Temporary Compulsive
relief behavior
PENYEBAB OCD
‘Dysfunctional’ beliefs
‘dysfunctional’ beliefs and interpretations.

Personal experience
personal experience. It is thought that if you have had a
painful childhood experience or suffered trauma or abuse,
you might learn to use obsessions and compulsions to cope
with anxiety.

Biological factors
 a lack of the brain chemical serotonin may have a role in
OCD.