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PANIC DISORDER_PHOBIAS - PANIC DISORDER/PHOBIAS DSM-IV...

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PANIC DISORDER/PHOBIAS DSM-IV PANIC DISORDER/PHOBIAS 300.01 Panic disorder without agoraphobia 300.21 Panic disorder with agoraphobia 300.22 Agoraphobia without history of panic disorder 300.23 Social phobia 300.29 Specific phobia Panic attack is a discrete period of intense fear or discomfort with onset spontaneous/unpredictable or  situationally bound, peaking within 10 minutes. ETIOLOGICAL THEORIES Psychodynamics Phobic object may symbolize the underlying conflict, although there is not always a clear connection.  Personal perceptions, life experiences, and cultural values color the meaning of the symbol for the client. The freudian view is that anxiety feelings stem from loss of love and support from the mothering  figure, which increases the client’s dependency needs. The client combats the diffuse intolerable anxiety by  an exaggerated use of displacement on a particular object or situation, which makes the anxiety more  manageable. Phobic partners may develop in the family; these are “helpers” who stand by and participate in  maintaining phobic behavior, protecting phobic client from acute panic and anxiety. Participation of  partner furthers the unconscious wish of phobic client to be taken care of and to be in control. Biological (Refer to CP: Generalized Anxiety Disorder.) Temperament may be a factor in that some fears are innate. These fears represent a part of the overall  characteristics with which one is born that influence how the individual responds to specific situations  throughout his or her life. Research suggests irregularities in the synthesis and release of norepinephrine  and/or hypersensitivity of receptors for neurotransmitters (including serotonin and gamma-aminobutyric  acid [GABA]), or an interaction between norepinephrine transmitters. The trigger may lie in the locus  coeruleus located in the brainstem. There also may be a genetic susceptibility to either an excess or  deficiency of CO 2  levels and a sensitivity to lactate associated with the panic attack. Family Dynamics (Refer to CP: Generalized Anxiety Disorder.) CLIENT ASSESSMENT DATA BASE Circulation Palpitations or tachycardia Sweating, hot flashes, or chills Ego Integrity A persistent fear of some object/situation that poses no actual danger or in which the danger is magnified  out of proportion to its seriousness; tries to avoid or escape contact with the feared object or situation Degree of discomfort may vary from mild anxiety to incapacitation; may be unable to move, speak, or  identify ways of decreasing anxiety or may begin running about aimlessly and shouting
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