Discussion: Treatment of Anxiety Disorders

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• Explain the difference between an adjustment disorder and anxiety disorder. Provide examples to illustrate your rationale.
• Explain the diagnostic criteria for social anxiety disorder.
• Explain the evidenced-based psychotherapy and psychopharmacologic treatment for social anxiety anxiety disorder.
• Support your rationale with references to the Learning Resources or other academic resource.

Week 6: Anxiety Disorders, PTSD, and Related Disorders

Oh no! It is happening again. I am having a heart attack… I know it. My heart is racing, I can’t breathe, and I am shaking all over. I can’t go to the ER again. They will say what they always say… I am not having a heart attack. It is all in my head.
Barbara, age 68

The anxiety disorders provide us a good opportunity to take a close look at the nature/nurture debate as well as the gene/environment interactions that influence the nervous system and neurochemistry. A significant part of most of Sigmund Freud’s theories, the concept of anxiety has been debated and discussed over many years in the psychiatric literature. While Freud’s theories focused on the “mind” and the unconscious, another way to look at anxiety is with Hans Selye’s concept of “fight or flight” in which the sympathetic nervous system is activated as a response to stress. As you explore the concept of anxiety, you will notice that no two cases of anxiety are the same.

This week, you will explore evidence-based treatment methods for clients with anxiety disorders. You will complete a midterm exam and analyze reimbursement rates for treatment of mental health disorders.

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Learning Resources

REQUIRED READINGS

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 9, “Anxiety Disorders” (pp. 387–417)
• Chapter 11, “Trauma- and Stressor-Related Disorders” (pp. 437–451)

 

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

• Chapter 16, “Panic Disorder”
• Chapter 18, “Social Anxiety Disorder (Social Phobia)”
• Chapter 19, “Generalized Anxiety Disorder”
• Chapter 20, “Specific Phobia”

 

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

• “Anxiety Disorders”
• “Trauma- and Stressor-Related Disorders”

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.
Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear. http://ezp.waldenulibrary.org/login?url=http://sta…
To access information on specific medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Anxiety	Generalized anxiety disorder	Panic disorder
alprazolam amitriptyline amoxapine buspirone chlordiazepoxide citalopram clomipramine clonazepam clonidine clorazepate cyamemazine desipramine diazepam dothiepin doxepin duloxetine escitalopram fluoxetine fluvoxamine gabapentin (adjunct) hydroxyzine imipramine isocarboxazid lofepramine	loflazepate lorazepam maprotiline mianserin mirtazapine moclobemide nefazodone nortriptyline oxazepam paroxetine phenelzine pregabalin reboxetine sertraline tiagabine tianeptine tranylcypromine trazodone trifluoperazine trimipramine venlafaxine vilazodone	alprazolam citalopram desvenlafaxine duloxetine escitalopram fluoxetine fluvoxamine mirtazapine paroxetine pregabalin sertraline tiagabine (adjunct) venlafaxine	alprazolam citalopram clonazepam desvenlafaxine escitalopram fluoxetine fluvoxamine isocarboxazid lorazepam mirtazapine nefazodone paroxetine phenelzine pregabalin reboxetine sertraline tranylcypromine venlafaxine

Posttraumatic stress disorder	Reversal of benzodiazepine effects	Social anxiety disorder
citalopram clonidine desvenlafaxine escitalopram fluoxetine fluvoxamine mirtazapine nefazodone paroxetine prazosin (nightmares) propranolol (prophylactic) sertraline venlafaxine	flumazenil	citalopram clonidine desvenlafaxine escitalopram fluoxetine fluvoxamine isocarboxazid moclobemide paroxetine phenelzine pregabalin sertraline tranylcypromine venlafaxine

 

Maples-Keller, J. L., Price, M., Rauch, S., Gerardi, M., & Rothbaum, B. O. (2017). Investigating relationships between PTSD symptom clusters within virtual reality exposure therapy for OEF/OIF veterans. Behavior Therapy, 48(2), 147–155. doi:10.1016/j.beth.2016.02.011

 

Hayes, J. P., Logue, M. W., Reagan, A., Salat, D., Wolf, E. J., Sadeh, N., & … Miller, M. W. (2017). COMT Val158Met polymorphism moderates the association between PTSD symptom severity and hippocampal volume. Journal of Psychiatry & Neuroscience: JPN, 42(2), 95–102. doi:10.1503/jpn.150339

 

Quinn, B. L., & Peters, A. (2017). Strategies to reduce nursing student test anxiety: A literature review. Journal of Nursing Education, 56(3), 145–151. doi:10.3928/01484834-20170222-05

Document: Reimbursement Rate Template (Word document)

REQUIRED MEDIA

 

Wolpe, J. (Producer). (n.d.). Joseph Wolpe on systematic desensitization [Video file]. Mill Valley, CA: Psychotherapy.net.

OPTIONAL RESOURCES

Acosta, M. C., Possemato, K., Maisto, S. A., Marsch, L. A., Barrie, K., Lantinga, L., . . . Rosenblum, A. (2017). Web-delivered CBT reduces heavy drinking in OEF-OIF veterans in primary care with symptomatic substance use and PTSD. Behavior Therapy, 48(2), 262-–276. doi:10.1016/j.beth.2016.09.001

Substance Abuse and Mental Health Services Association (SAMHSA). (2014). TIP 57: Trauma-informed care in behavioral health services. Retrieved from: http://store.samhsa.gov/product/TIP-57-Trauma-Info…
Note: This document is available as a free download. Treatment of Anxiety Disorders Discussion

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Discussion: Treatment of Anxiety Disorders

Anxiety disorders are common in both primary care and psychiatric practice. Clients with anxiety disorders including generalized anxiety disorders, agoraphobia, and other specific phobias will present to the PMHNP’s office with a significant level of distress. Successful recognition and treatment of anxiety disorders includes an accurate diagnostic assessment with a treatment plan that includes a combination of psychopharmacology and psychotherapy. Although psychoanalytic theories are based on the concept of anxiety, the more recent standard of care is with the cognitive-behavioral therapies. Treatment of Anxiety Disorders Discussion

In this Discussion, you will analyze evidence-based treatment plans for clients with anxiety disorders.

Learning Objectives

Students will:

• Analyze differences between adjustments disorders and anxiety disorders
• Analyze diagnostic criteria for anxiety disorders
• Analyze evidence-based psychotherapy and psychopharmacologic treatment for anxiety disorders
• Compare differential diagnostic features of anxiety disorders

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking Submit!

To prepare for this Discussion:

• By Day 5 of Week 5, your Instructor will have assigned you an anxiety disorder, which will be your focus for your initial post for this Discussion.
• Review the Learning Resources.

BY DAY 3

Post:

• Explain the difference between an adjustment disorder and anxiety disorder. Provide examples to illustrate your rationale.
• Explain the diagnostic criteria for your assigned anxiety disorder.
• Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned anxiety disorder.
• Support your rationale with references to the Learning Resources or other academic resource.