Psych Study Guide Test 2
Chapter 12 – Anxiety and Anxiety Disorders
Anxiety – is a universal human experience and is the most basic of emotions. Can be defined as a feeling
of apprehension, uneasiness, uncertainty, or dread resulting from a real or perceived threat.
Fear – is a reaction to a specific danger, whereas anxiety is a vague sense of dread related to an unspecific
or unknown danger.
Normal anxiety – necessary for survival.
Levels of Anxiety –
1. Mild Anxiety – occurs in the normal experiences of everyday living. A person sees, hears, and grasps
more information, and problem solving becomes more effective.
2. Moderate Anxiety – person sees, hears and grasps less information and may demonstrate selective
inattention, in which only certain things in the environment are seen or heard unless they are pointed
out. Ability to think clearly is altered along with problem solving.
3. Severe Anxiety – person may focus on one particular detail or many scattered details and have
difficulty noticing what is going on in the environment. Somatic symptoms (headache, nausea,
dizziness, and insomnia) often increase; trembling and a pounding heart are common along with
hyperventilation and sense of impending doom.
4. Panic – most extreme level and the behavior that results may be manifested as pacing, running,
shouting, screaming, or withdrawal. Hallucinations, or false sensory perceptions (seeing people or
objects) may be experienced.
Defense Against Anxiety – defense mechanisms are automatic coping styles that protect people from
anxiety and maintain self-image by blocking feelings, conflicts and memories. Can be healthy and
unhealthy (adaptive vs. maladaptive).
Anxiety Disorders – the term refers to a number of disorders including:
Panic Disorders (PD) –
o Panic attack – is the sudden onset of extreme apprehension or fear, usually associated
with feelings of impending doom.
o Panic disorder with agoraphobia – is a combination of panic-attack symptoms and
agoraphobia. Agoraphobia is intense, excessive anxiety or fear about being in places or
situations from which escape might be difficult or embarrassing or in which help might
not be available if a panic attack occurred.
o Simple Agoraphobia – agoraphobia without a history of PD (unaccompanied by panic
attacks) occurs only rarely and early in the patient’s history. Over time, agoraphobia with
panic attacks usually develops.
Phobias – is a persistent, irrational fear of a specific object, activity, or situation that leads to a
desire for avoidance, or actual avoidance, of the object, activity, or situation.
o Social phobia – also called social anxiety disorder (SAD), is characterized by severe anxiety
or fear provoked by exposure to a social or a performance situation (fear of saying
something that sounds foolish in public, not being able to answer questions, etc), fear of
public speaking is most common.
Obsessive-Compulsive Disorder (OCD) –
o Obsessions – thoughts, impulses, or images that persist and recur, so that they cannot be
dismissed from the mind.
o Compulsions – ritualistic behaviors an individual feels driven to perform in an attempt to
reduce anxiety.
, Generalized Anxiety Disorder (GAD) – characterized by excessive anxiety or worry about
numerous things, lasting for 6 months or longer. Also display many of the following symptoms:
o Restlessness
o Fatigue
o Poor concentration
o Irritability
o Tension
o Sleep disturbance
Posttraumatic Stress Disorder (PTSD) – characterized by persistent re-experiencing of a highly
traumatic event that involved actual or threatened death or serious injury to self or others, to
which the individual responded with intense fear, helplessness, or horror. Major features of
PTSD:
o Flashbacks
o Avoidance of stimuli associated with trauma
o Experiences of persistent numbing or responses
o Persistent symptoms of increased arousal
Acute Stress Disorder – occurs within 1 month after exposure to a highly traumatic event, such as
those listed in the section on PTSD. Must display at least 3 dissociative symptoms – during or
after the event, and resolve within four weeks.
Substance-Induced Anxiety Disorder – characterized by symptoms of anxiety, panic attacks,
obsessions, and compulsions that develop with the use of a substance or within a month of
stopping use of the substance.
Anxiety Due to Medical Conditions – the individual’s symptoms of anxiety are a direct
physiological result of a medical condition, such as hyperthyroidism, pulmonary embolism.
Application of the Nursing Process – p. 227
Basic Level Nursing Interventions –
o Counseling – used to reduce anxiety, enhance coping and communication skills, and intervene in
crisis.
o Milieu Therapy
o Promotion of self-care activities
o Health teaching
Pharmacological Interventions – p. 234-236
o Antidepressants – for example SSRI’s, tricyclic antidepressants, MAOI’s, SNRI’s.
o Antianxiety drugs – benzodiazepines
o Other classes of medication –
o Beta-Blockers
o Antihistamines (Atarax, and Vistaril (hydroxyzine))
Advanced Practice Interventions –
o Cognitive Therapy – based on the belief that patients make errors in thinking that lead to
mistaken negative beliefs about self and others. Cognitive restructuring is used to correct.
o Cognitive-Behavioral Therapy – combines cognitive therapy with specific behavioral therapies to
reduce the anxiety response. Includes relaxation techniques, modeling, systematic
desensitization, flooding, response prevention and thought stopping.
, Chapter 19 – Personality Disorders
Common Characteristics of Personality Disorder (PD) – difficulty in three areas of day-to-day functioning in
thoughts and emotions, participation in interpersonal relationships, and managing impulses. Frequently
occur with disorders of mood, anxiety, eating, and substance abuse.
Cluster A Personality Disorders – (p. 435) are usually eccentric and display odd behavior, have an unusual
level of suspiciousness, are magical thinkers, and may display some cognitive impairment. Examples
include:
o Paranoid PD – a pervasive distrust and suspiciousness of other such that their motives are
interpreted as malevolent, beginning by early adulthood and present in a variety of contexts.
o Schizoid PD –primary feature of emotional detachment. The person with this disorder does not
seek out or enjoy close relationships, may be able to function in a solitary occupation but shows
indifference to praise or criticism from others. Do not put these individuals in group therapy.
o Schizotypal PD – a pervasive pattern of social and interpersonal deficits marked by acute
discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual
distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of
contexts.
Cluster B Personality Disorders – (p. 437) show patterns of responding to life demands with dramatic,
emotional, or erratic behavior processing and regulation, and interpersonal difficulties. Examples include:
o Antisocial PD – main feature is consistent disregard for others through exploitation and repeated
unlawful actions. Repeatedly neglect responsibilities, tell lies, and perform destructive or illegal
acts without developing any insight into predictable consequences. Show no remorse for hurting
others.
o Borderline PD – characterized by severe impairments in functioning, a high mortality rate of
nearly 10%, and extensive utilization of services from the health care system. Major features of
this disorder are patterns of marked instability in emotion regulation, interpersonal relationships,
impulsivity, identity or self-image distortions, and unstable mood.
o Histrionic PD – marked by emotional attention-seeking behavior, in which the person needs to be
the center of attention, is impulsive and melodramatic and may act flirtatious or provocative.
Relationships do not last, because the partner often feels smothered or reacts to the insensitivity
of the histrionic person.
o Narcissistic PD – primary feature of arrogance with grandiose view of self-importance. Has a need
for constant admiration, along with a lack of empathy for others, which strains most relationships.
These individuals experience a feeling of personal entitlement; when paired with their lack of
social empathy, it may result in the exploitation of other people.
Cluster C Personality Disorders – (p. 440) show patterns of anxious and fearful behaviors, rigid patterns of
social shyness, hypersensitivity, need for orderliness, and relationship dependency. Examples include:
o Avoidant PD – characterized by an extreme sensitivity to rejection and robust avoidance of
interpersonal situations. Demonstrate poor self-confidence and are prone to misinterpreting
others’ feedback because they are overly sensitive to rejection.
o Dependent PD – have a pattern of establishing relationships in which they are submissive, passive,
self-doubting, and avoid self-responsibility. Find it difficult to sustain autonomy and often seek
out relationships in which they can be taken care of.
o Obsessive-Compulsive PD – characterized by perfectionism with a focus on orderliness and
control. Often become preoccupied with details and rules that may not be able to accomplish a
given task. Often lack insight about their own difficult behavior.
Chapter 12 – Anxiety and Anxiety Disorders
Anxiety – is a universal human experience and is the most basic of emotions. Can be defined as a feeling
of apprehension, uneasiness, uncertainty, or dread resulting from a real or perceived threat.
Fear – is a reaction to a specific danger, whereas anxiety is a vague sense of dread related to an unspecific
or unknown danger.
Normal anxiety – necessary for survival.
Levels of Anxiety –
1. Mild Anxiety – occurs in the normal experiences of everyday living. A person sees, hears, and grasps
more information, and problem solving becomes more effective.
2. Moderate Anxiety – person sees, hears and grasps less information and may demonstrate selective
inattention, in which only certain things in the environment are seen or heard unless they are pointed
out. Ability to think clearly is altered along with problem solving.
3. Severe Anxiety – person may focus on one particular detail or many scattered details and have
difficulty noticing what is going on in the environment. Somatic symptoms (headache, nausea,
dizziness, and insomnia) often increase; trembling and a pounding heart are common along with
hyperventilation and sense of impending doom.
4. Panic – most extreme level and the behavior that results may be manifested as pacing, running,
shouting, screaming, or withdrawal. Hallucinations, or false sensory perceptions (seeing people or
objects) may be experienced.
Defense Against Anxiety – defense mechanisms are automatic coping styles that protect people from
anxiety and maintain self-image by blocking feelings, conflicts and memories. Can be healthy and
unhealthy (adaptive vs. maladaptive).
Anxiety Disorders – the term refers to a number of disorders including:
Panic Disorders (PD) –
o Panic attack – is the sudden onset of extreme apprehension or fear, usually associated
with feelings of impending doom.
o Panic disorder with agoraphobia – is a combination of panic-attack symptoms and
agoraphobia. Agoraphobia is intense, excessive anxiety or fear about being in places or
situations from which escape might be difficult or embarrassing or in which help might
not be available if a panic attack occurred.
o Simple Agoraphobia – agoraphobia without a history of PD (unaccompanied by panic
attacks) occurs only rarely and early in the patient’s history. Over time, agoraphobia with
panic attacks usually develops.
Phobias – is a persistent, irrational fear of a specific object, activity, or situation that leads to a
desire for avoidance, or actual avoidance, of the object, activity, or situation.
o Social phobia – also called social anxiety disorder (SAD), is characterized by severe anxiety
or fear provoked by exposure to a social or a performance situation (fear of saying
something that sounds foolish in public, not being able to answer questions, etc), fear of
public speaking is most common.
Obsessive-Compulsive Disorder (OCD) –
o Obsessions – thoughts, impulses, or images that persist and recur, so that they cannot be
dismissed from the mind.
o Compulsions – ritualistic behaviors an individual feels driven to perform in an attempt to
reduce anxiety.
, Generalized Anxiety Disorder (GAD) – characterized by excessive anxiety or worry about
numerous things, lasting for 6 months or longer. Also display many of the following symptoms:
o Restlessness
o Fatigue
o Poor concentration
o Irritability
o Tension
o Sleep disturbance
Posttraumatic Stress Disorder (PTSD) – characterized by persistent re-experiencing of a highly
traumatic event that involved actual or threatened death or serious injury to self or others, to
which the individual responded with intense fear, helplessness, or horror. Major features of
PTSD:
o Flashbacks
o Avoidance of stimuli associated with trauma
o Experiences of persistent numbing or responses
o Persistent symptoms of increased arousal
Acute Stress Disorder – occurs within 1 month after exposure to a highly traumatic event, such as
those listed in the section on PTSD. Must display at least 3 dissociative symptoms – during or
after the event, and resolve within four weeks.
Substance-Induced Anxiety Disorder – characterized by symptoms of anxiety, panic attacks,
obsessions, and compulsions that develop with the use of a substance or within a month of
stopping use of the substance.
Anxiety Due to Medical Conditions – the individual’s symptoms of anxiety are a direct
physiological result of a medical condition, such as hyperthyroidism, pulmonary embolism.
Application of the Nursing Process – p. 227
Basic Level Nursing Interventions –
o Counseling – used to reduce anxiety, enhance coping and communication skills, and intervene in
crisis.
o Milieu Therapy
o Promotion of self-care activities
o Health teaching
Pharmacological Interventions – p. 234-236
o Antidepressants – for example SSRI’s, tricyclic antidepressants, MAOI’s, SNRI’s.
o Antianxiety drugs – benzodiazepines
o Other classes of medication –
o Beta-Blockers
o Antihistamines (Atarax, and Vistaril (hydroxyzine))
Advanced Practice Interventions –
o Cognitive Therapy – based on the belief that patients make errors in thinking that lead to
mistaken negative beliefs about self and others. Cognitive restructuring is used to correct.
o Cognitive-Behavioral Therapy – combines cognitive therapy with specific behavioral therapies to
reduce the anxiety response. Includes relaxation techniques, modeling, systematic
desensitization, flooding, response prevention and thought stopping.
, Chapter 19 – Personality Disorders
Common Characteristics of Personality Disorder (PD) – difficulty in three areas of day-to-day functioning in
thoughts and emotions, participation in interpersonal relationships, and managing impulses. Frequently
occur with disorders of mood, anxiety, eating, and substance abuse.
Cluster A Personality Disorders – (p. 435) are usually eccentric and display odd behavior, have an unusual
level of suspiciousness, are magical thinkers, and may display some cognitive impairment. Examples
include:
o Paranoid PD – a pervasive distrust and suspiciousness of other such that their motives are
interpreted as malevolent, beginning by early adulthood and present in a variety of contexts.
o Schizoid PD –primary feature of emotional detachment. The person with this disorder does not
seek out or enjoy close relationships, may be able to function in a solitary occupation but shows
indifference to praise or criticism from others. Do not put these individuals in group therapy.
o Schizotypal PD – a pervasive pattern of social and interpersonal deficits marked by acute
discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual
distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of
contexts.
Cluster B Personality Disorders – (p. 437) show patterns of responding to life demands with dramatic,
emotional, or erratic behavior processing and regulation, and interpersonal difficulties. Examples include:
o Antisocial PD – main feature is consistent disregard for others through exploitation and repeated
unlawful actions. Repeatedly neglect responsibilities, tell lies, and perform destructive or illegal
acts without developing any insight into predictable consequences. Show no remorse for hurting
others.
o Borderline PD – characterized by severe impairments in functioning, a high mortality rate of
nearly 10%, and extensive utilization of services from the health care system. Major features of
this disorder are patterns of marked instability in emotion regulation, interpersonal relationships,
impulsivity, identity or self-image distortions, and unstable mood.
o Histrionic PD – marked by emotional attention-seeking behavior, in which the person needs to be
the center of attention, is impulsive and melodramatic and may act flirtatious or provocative.
Relationships do not last, because the partner often feels smothered or reacts to the insensitivity
of the histrionic person.
o Narcissistic PD – primary feature of arrogance with grandiose view of self-importance. Has a need
for constant admiration, along with a lack of empathy for others, which strains most relationships.
These individuals experience a feeling of personal entitlement; when paired with their lack of
social empathy, it may result in the exploitation of other people.
Cluster C Personality Disorders – (p. 440) show patterns of anxious and fearful behaviors, rigid patterns of
social shyness, hypersensitivity, need for orderliness, and relationship dependency. Examples include:
o Avoidant PD – characterized by an extreme sensitivity to rejection and robust avoidance of
interpersonal situations. Demonstrate poor self-confidence and are prone to misinterpreting
others’ feedback because they are overly sensitive to rejection.
o Dependent PD – have a pattern of establishing relationships in which they are submissive, passive,
self-doubting, and avoid self-responsibility. Find it difficult to sustain autonomy and often seek
out relationships in which they can be taken care of.
o Obsessive-Compulsive PD – characterized by perfectionism with a focus on orderliness and
control. Often become preoccupied with details and rules that may not be able to accomplish a
given task. Often lack insight about their own difficult behavior.
