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

Discussion: GENERALIZED ANXIETY DISORDER 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. 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. Assigned Anxiety Disorder : GENERALIZED ANXIETY DISORDER 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. Rubric Detail Select Grid View or List View to change the rubric's layout. Name: NRNP_6670_Week6_Discussion_Rubric • Grid View • List View Show Descriptions Main Posting: Response to the discusion question is reflecive with critical analysis and synthesis representive of knowledg gained from the course readings for the module and current credible sources.-- Outstanding Performance 44 (44%) - 44 (44%) * Thoroughly responds to the discusion question(s) *is reflecive with critical analysis and synthesis representive of knowledg gained from the course readings for the module and current credible sources. * supported by at least 3 current, credible sources Excellent Performance 40 (40%) - 43 (43%) * Responds to the discusion question(s) *is reflecive with critical analysis and synthesis representive of knowledg gained from the course readings for the module. * 75% of post has exceptional depth and breadth * supported by at least 3 credible references Competent Performance 35 (35%) - 39 (39%) * Responds to most of the discusion question(s) *is somewhat reflecive with critical analysis and synthesis representive of knowledg gained from the course readings for the module. * 50% of post has exceptional depth and breadth * supported by at least 3 credible references Proficient Performance 31 (31%) - 34 (34%) * Responds to some of the discusion question(s) * one to two criteria are not addressed or are superficially addresed *is somewhat lacking reflection and critical analysis and synthesis *somewhat represents knowledge gained from the course readings for the module. * post is cited with fewer than 2 credible references Room for Improvement 0 (0%) - 30 (30%) * Does not respond to the discusion question(s) * lacks depth or superficially addresses criteria *lacks reflection and critical analysis and synthesis *does not represent knowledge gained from the course readings for the module. * contains only 1 or no credible references Main Posting: Writing-- Outstanding Performance 6 (6%) - 6 (6%) * Written clearly and concisely * Contains no grammatical or spelling errors * Fully adheres to current APA manual writing rules and style Excellent Performance 5.5 (5.5%) - 5.5 (5.5%) * Written clearly and concisely * May contain one or no grammatical or spelling error * Adheres to current APA manual writing rules and style Competent Performance 5 (5%) - 5 (5%) * Written concisely * May contain one to two grammatical or spelling error * Adheres to current APA manual writing rules and style Proficient Performance 4 (4%) - 5 (5%) *Writtten somewhat concisely * May contain more than two2 spelling or grammatical errors * Contains some APA formatting erros Room for Improvement 0 (0%) - 4 (4%) * Not written clearly or concisely * Contains more than two spelling or grammatical errors * Does not adhere to current APA manual writing rules and style Main Posting: Timely and full participation-- Outstanding Performance 10 (10%) - 10 (10%) * meets requirements for timely and full participation * posts main discussion by due date Excellent Performance 0 (0%) - 0 (0%) Competent Performance 0 (0%) - 0 (0%) Proficient Performance 0 (0%) - 0 (0%) Room for Improvement 0 (0%) - 6 (6%) * does not meet requirement for full participation First Reponse Post to colleague's main post that is reflective and justified with credible sources.-- Outstanding Performance 9 (9%) - 9 (9%) * response exhibits critical thinking and application to practice settings * responds to questions posed by faculty * the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives Excellent Performance 8.5 (8.5%) - 8.5 (8.5%) * response exhibits critical thinking and application to practice settings Competent Performance 7.5 (7.5%) - 8 (8%) * response has some depth and may exhibit critical thinking or application to practice setting Proficient Performance 6.5 (6.5%) - 7 (7%) * response is on topic, may have some depth Room for Improvement 0 (0%) - 6 (6%) * reponse may not be on topic, lacks depth First Reponse: Writing-- Outstanding Performance 6 (6%) - 6 (6%) * Communication is professional and respectful to colleagues * Response to faculty questions are fully answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in Standard Edited English Excellent Performance 5.5 (5.5%) - 5.5 (5.5%) * Communication is professional and respectful to colleagues * Response to faculty questions are answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in Standard Edited English Competent Performance 5 (5%) - 5 (5%) * Communication is mostly professional and respectful to colleagues * Response to faculty questions are mostly answered if posed * Provides opinions and ideas that are supported by few credible sources * Response is written in Standard Edited English Proficient Performance 4.5 (4.5%) - 4.5 (4.5%) * Responses posted in the discussion may lack effective professional communication * Response to faculty questions are somewhat answered if posed * Few or no credible sources are cited Room for Improvement 0 (0%) - 4 (4%) * Responses posted in the discussion lack effective * Response to faculty questions are missing * No credible sources are cited First Reponse: Timely and full participation-- Outstanding Performance 5 (5%) - 5 (5%) * meets requirements for timely and full participation * posts by due date Excellent Performance 0 (0%) - 0 (0%) Competent Performance 0 (0%) - 0 (0%) Proficient Performance 0 (0%) - 0 (0%) Room for Improvement 0 (0%) - 0 (0%) * does not meet requirement for full participation Second Reponse: Post to colleague's main post that is reflective and justified with credible sources.-- Outstanding Performance 9 (9%) - 9 (9%) * response exhibits critical thinking and application to practice settings * responds to questions posed by faculty * the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives Excellent Performance 8.5 (8.5%) - 8.5 (8.5%) * response exhibits critical thinking and application to practice settings Competent Performance 7.5 (7.5%) - 8 (8%) * response has some depth and may exhibit critical thinking or application to practice setting Proficient Performance 6.5 (6.5%) - 7 (7%) * response is on topic, may have some depth Room for Improvement 0 (0%) - 6 (6%) * reponse may not be on topic, lacks depth Second Reponse: Writing-- Outstanding Performance 6 (6%) - 6 (6%) * Communication is professional and respectful to colleagues * Response to faculty questions are fully answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in Standard Edited English Excellent Performance 5.5 (5.5%) - 5.5 (5.5%) * Communication is professional and respectful to colleagues * Response to faculty questions are answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in Standard Edited English Competent Performance 5 (5%) - 5 (5%) * Communication is mostly professional and respectful to colleagues * Response to faculty questions are mostly answered if posed * Provides opinions and ideas that are supported by few credible sources * Response is written in Standard Edited English Proficient Performance 4.5 (4.5%) - 4.5 (4.5%) * Responses posted in the discussion may lack effective professional communication * Response to faculty questions are somewhat answered if posed * Few or no credible sources are cited Room for Improvement 0 (0%) - 4 (4%) * Responses posted in the discussion lack effective * Response to faculty questions are missing * No credible sources are cited Second Reponse: Timely and full participation-- Outstanding Performance 5 (5%) - 5 (5%) * meets requirements for timely and full participation * posts by due date Excellent Performance 0 (0%) - 0 (0%) Competent Performance 0 (0%) - 0 (0%) Proficient Performance 0 (0%) - 0 (0%) Room for Improvement 0 (0%) - 0 (0%) * does not meet requirement for full participation Total Points: 100 Name: NRNP_6670_Week6_Discussion_Rubric 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 also will complete a midterm exam. Learning Resources Required Readings American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. • “Anxiety Disorders” • “Trauma- and Stressor-Related Disorders” 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” 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 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 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 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) Stahl, S. M. (2017). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (6th ed.). New York, NY: Cambridge University Press. To access information on specific medications, click on The Prescriber’s Guide, 6th 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 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. Note: The approximate length of this media piece is 59 minutes. 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 Note: This document is available as a free download. Read: Assessing and Treating Patients With Psychosis and Schizophrenia

ANSWER. PAPER DETAILS
Academic Level	Masters
Subject Area	Nursing
Paper Type	Discussion Post
Number of Pages	2 Page(s)/550 words
Sources	5
Format	APA 6
Spacing	Double Spacing

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