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PHOBIC ANXIETY DISORDER
PHOBIC ANXIETY DISORDER
 Anxiety is a normal phenomenon, which is
characterized by a state of apprehension or
uneasiness arising out of anticipation of danger.
Normal anxiety becomes pathological when it causes
significant subject distress and impairment of
functioning of the individual.
 A phobia is an unreasonable fear of a specific object,
activity or situation.
CLASSIFICATION
F40.0:- AGORAPHOBIA
F40.1 :-SOCIAL PHOBIA
F40.2:- SPECIFIC PHOBIA
F40.8 :-OTHER PHOBIC
ANXIETY DISORDER
F40.9 :- PHOBIC ANXIETY
DISORDER,UNSPECIFIED
TYPES OF PHOBIA
SIMPLE PHOBIA
SOCIAL PHOBIA
AGORAPHOBIA
SIMPLE PHOBIA (SPECIFIC PHOBIA)
IRRATIONAL FEAR OF A
SPECIFIC OBJECT OR
STIMULUS. SIMPLE PHOBIAS
ARE COMMON IN CHILDHOOD.
BY EARLY TEENAGE,MOST OF
THESE FEARS ARE LOST,BUT A
FEW PERSIST TILL ADULTS
LIFE.
SIGNS AND SYMPTOMS OF SPECIFIC PHOBIA
 IRRATIONAL AND PERSISTENT FEAR OF
OBJECT OR SITUATION.
 IMMEDIATE ANXIETY ON CONTACT WITH
FEARED OBJECT OR SITUATION
 LOSS OF CONTROL,FAINTING OR PANIC
RESPONSE
 AVOIDANCE OF ACTIVITIES INVOLVING FEAR
STIMULUS.
ANXIETY WHEN THINKING
ABOUT STIMULUS
WORRY ABOUT ANTICIPATORY
ANXIETY
POSSIBLE IMPAIRED SOCIAL OR
WORK FUNCTIONING.
SOCIAL PHOBIA
It is an irrational fear of performing
activities in the presence of other
people or interacting with others.
The patient is afraid of his own
actions being viewed by others
critically, resulting
Signs and symptoms
 Hyperventilation
 Sweating ,cold and clammy hands
 Blushing
 Palpitation
 Confusion
 Gastrointestinal symptoms
 Trembling hands and voices
 Urinary urgency
 Muscle tension
 Anticipatory anxiety
AGORAPHOBIA
 It is characterized by an irrational fear of being in
places away from the familiar setting of in crows,
or in situation that the patient cannot leave easily
SIGNS AND SYMPTOMS
 OVERRIDING FEAR OF OPEN OR PUBLIC
SPACES
 AVOIDANCE OF PUBLIC PLACES AND
CONFINEMENT TO HOME
 WHEN ACCOMPAINED BY PANIC
DISORDER,FEAR THAT HAVING PANIC ATTACK
IN PUBLIC WILL LEAD TO EMBARRASSMENT OR
INABILITY TO ESCAPE(FOR SYMPTOMS OF
PANIC ATTACK).
ETIOLOGY
 PSYCHODYNAMIC THEORY :- According to this
theory, anxiety is usually dealt with repression.
When repression fails to function adequately. other
secondary defense mechanisms of ego come in to
action. In phobia this secondary defense
mechanism is displacement.by displacement
anxiety is transferred from a really dangerous or
frightening object to the neutral object.
 The neutral objectives chosen unconsciously is the
one that can be easily avoided in day to day activities,
 Learning objectives :- according to classical
conditioning a stressful stimulus produces an
unconditioned response-fear when the stressful
stimulus is repeatedly paired with a harmless object,
the harmless object alone produces the fear.which is
now a conditioned response,if the person avoid the
harmless object to avoid fear,the fear becomes a
phobia
 Cognitive theory :- Anxiety is the product of faulty
cognitions or anxiety inducing self instruction.
Cognitive theorists believe that some individual
engage in negative and irrational thinking that
produce anxiety reactions.
DIAGNOSIS
 NO SPECIFIC DIAGNOSTIC TEST,DIAGNOSIS
CONFIRMED IF ICD 10 CRITERIA MET
 HISTORY OF ANXIETY WHEN EXPOSED TO OR
ANTICIPATING SPECIFIC ENTITY OR SITUATION
TREATMENT
 PHARMACOTHERAPY :-
BENZODIAZEPINES (FOR EXAMPLE :-
ALPRAZOLAM,CLONAZEPAM,LORAZEPAM.)
ANTIDEPRESSANTS (FOR EXAMPLE :-
IMIPRAMINE,)
 BEHAVIOR THERAPY
PSYCHOTHERAPY
NURSING MANAGEMENT
 NURSING ASSESSMENT :-
FOCUS ON physical symptoms, precipitating factors,
avoidance behavior associated with phobia, impact
of anxiety on physical functioning, normal coping
ability ,thought content and social support system.
 HISTORY AND MSE
NURSING DIAGNOSIS
 Fear related to a specific stimulus (simple phobia),or
causing embarrassment to self in front of others as
evidenced by behavior directed towards avoidance of
the feared object/situation.
 Social isolation related to fear of being in a place
from which one is unable to escape as evidenced by
refusing to leave the room

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Phobic anxiety disorder

  • 2. PHOBIC ANXIETY DISORDER  Anxiety is a normal phenomenon, which is characterized by a state of apprehension or uneasiness arising out of anticipation of danger. Normal anxiety becomes pathological when it causes significant subject distress and impairment of functioning of the individual.  A phobia is an unreasonable fear of a specific object, activity or situation.
  • 3. CLASSIFICATION F40.0:- AGORAPHOBIA F40.1 :-SOCIAL PHOBIA F40.2:- SPECIFIC PHOBIA F40.8 :-OTHER PHOBIC ANXIETY DISORDER F40.9 :- PHOBIC ANXIETY DISORDER,UNSPECIFIED
  • 4. TYPES OF PHOBIA SIMPLE PHOBIA SOCIAL PHOBIA AGORAPHOBIA
  • 5. SIMPLE PHOBIA (SPECIFIC PHOBIA) IRRATIONAL FEAR OF A SPECIFIC OBJECT OR STIMULUS. SIMPLE PHOBIAS ARE COMMON IN CHILDHOOD. BY EARLY TEENAGE,MOST OF THESE FEARS ARE LOST,BUT A FEW PERSIST TILL ADULTS LIFE.
  • 6. SIGNS AND SYMPTOMS OF SPECIFIC PHOBIA  IRRATIONAL AND PERSISTENT FEAR OF OBJECT OR SITUATION.  IMMEDIATE ANXIETY ON CONTACT WITH FEARED OBJECT OR SITUATION  LOSS OF CONTROL,FAINTING OR PANIC RESPONSE  AVOIDANCE OF ACTIVITIES INVOLVING FEAR STIMULUS.
  • 7. ANXIETY WHEN THINKING ABOUT STIMULUS WORRY ABOUT ANTICIPATORY ANXIETY POSSIBLE IMPAIRED SOCIAL OR WORK FUNCTIONING.
  • 8. SOCIAL PHOBIA It is an irrational fear of performing activities in the presence of other people or interacting with others. The patient is afraid of his own actions being viewed by others critically, resulting
  • 9. Signs and symptoms  Hyperventilation  Sweating ,cold and clammy hands  Blushing  Palpitation  Confusion  Gastrointestinal symptoms  Trembling hands and voices  Urinary urgency  Muscle tension  Anticipatory anxiety
  • 10. AGORAPHOBIA  It is characterized by an irrational fear of being in places away from the familiar setting of in crows, or in situation that the patient cannot leave easily
  • 11. SIGNS AND SYMPTOMS  OVERRIDING FEAR OF OPEN OR PUBLIC SPACES  AVOIDANCE OF PUBLIC PLACES AND CONFINEMENT TO HOME  WHEN ACCOMPAINED BY PANIC DISORDER,FEAR THAT HAVING PANIC ATTACK IN PUBLIC WILL LEAD TO EMBARRASSMENT OR INABILITY TO ESCAPE(FOR SYMPTOMS OF PANIC ATTACK).
  • 12. ETIOLOGY  PSYCHODYNAMIC THEORY :- According to this theory, anxiety is usually dealt with repression. When repression fails to function adequately. other secondary defense mechanisms of ego come in to action. In phobia this secondary defense mechanism is displacement.by displacement anxiety is transferred from a really dangerous or frightening object to the neutral object.
  • 13.  The neutral objectives chosen unconsciously is the one that can be easily avoided in day to day activities,
  • 14.  Learning objectives :- according to classical conditioning a stressful stimulus produces an unconditioned response-fear when the stressful stimulus is repeatedly paired with a harmless object, the harmless object alone produces the fear.which is now a conditioned response,if the person avoid the harmless object to avoid fear,the fear becomes a phobia
  • 15.  Cognitive theory :- Anxiety is the product of faulty cognitions or anxiety inducing self instruction. Cognitive theorists believe that some individual engage in negative and irrational thinking that produce anxiety reactions.
  • 16. DIAGNOSIS  NO SPECIFIC DIAGNOSTIC TEST,DIAGNOSIS CONFIRMED IF ICD 10 CRITERIA MET  HISTORY OF ANXIETY WHEN EXPOSED TO OR ANTICIPATING SPECIFIC ENTITY OR SITUATION
  • 17. TREATMENT  PHARMACOTHERAPY :- BENZODIAZEPINES (FOR EXAMPLE :- ALPRAZOLAM,CLONAZEPAM,LORAZEPAM.) ANTIDEPRESSANTS (FOR EXAMPLE :- IMIPRAMINE,)  BEHAVIOR THERAPY PSYCHOTHERAPY
  • 18. NURSING MANAGEMENT  NURSING ASSESSMENT :- FOCUS ON physical symptoms, precipitating factors, avoidance behavior associated with phobia, impact of anxiety on physical functioning, normal coping ability ,thought content and social support system.  HISTORY AND MSE
  • 19. NURSING DIAGNOSIS  Fear related to a specific stimulus (simple phobia),or causing embarrassment to self in front of others as evidenced by behavior directed towards avoidance of the feared object/situation.  Social isolation related to fear of being in a place from which one is unable to escape as evidenced by refusing to leave the room