Explain the difference between an adjustment disorder and anxiety disorder.. Anxiety Disorders, PTSD, and Related
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.
Assignment
· 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. Which is “Generalized Anxiety Disorder”
· Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned anxiety disorder. Which is “Generalized Anxiety Disorder”
· Compare differential diagnostic features of anxiety disorder
· Support your rationale with recent references (<5yrs) to the Learning Resources or other academic resource.
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.
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
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-Informed-Care-in-Behavioral-Health-Services/SMA14-4816
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Explain the difference between an adjustment disorder and anxiety disorder.
