NLE Psychiatric Disorders — Anxiety, Obsessive-Compulsive, and Trauma-Related DisordersConcept Map

Concept

Understanding Anxiety

Sub Concepts

• Anxiety vs. Fear distinction
• Anxiety continuum (mild, moderate, severe, panic)
• Defense mechanisms
• Perceptual field narrowing
• Physiological and psychological responses

Relationship To Central

Foundation for all anxiety-spectrum disorders; defines anxiety levels and mechanisms

Concept

Generalized Anxiety Disorder (GAD)

Sub Concepts

• Diagnostic criteria (6+ months excessive worry)
• Associated symptoms (restlessness, fatigue, concentration difficulty)
• Nursing assessment and management
• Relaxation techniques and CBT
• Environmental modifications

Relationship To Central

Primary anxiety disorder characterized by excessive, uncontrollable worry

Concept

Panic Disorder

Sub Concepts

• Panic attack presentation and duration
• Physical symptoms mimicking cardiac events
• Agoraphobia as complication
• Emergency nursing interventions
• Crisis management strategies

Relationship To Central

Severe anxiety manifestation with sudden, intense panic attacks

Concept

Phobic Disorders

Sub Concepts

• Specific phobia
• Social anxiety disorder (social phobia)
• Agoraphobia
• Systematic desensitization treatment
• Exposure hierarchy and flooding

Relationship To Central

Persistent, irrational fears leading to avoidance behaviors

Concept

Obsessive-Compulsive Disorder (OCD)

Sub Concepts

• Obsessions definition and characteristics
• Compulsions and rituals
• Common presentations (contamination, checking, doubt)
• Key nursing principle: allow ritual time initially
• Gradual response prevention and exposure therapy
• Time-limiting rituals appropriately

Relationship To Central

Disorder combining intrusive thoughts and repetitive behaviors to reduce anxiety

Concept

Post-Traumatic Stress Disorder (PTSD)

Sub Concepts

• Trauma exposure criteria
• Intrusion symptoms (flashbacks, nightmares)
• Avoidance behaviors
• Negative mood and cognition alterations
• Hyperarousal manifestations
• Differentiation from Acute Stress Disorder
• Philippine context and RA 11036

Relationship To Central

Severe stress reaction following trauma exposure lasting >1 month

Concept

Acute Stress Disorder

Sub Concepts

• Similar symptom clusters to PTSD
• Timeframe distinction
• Progression to PTSD if symptoms persist
• Early intervention importance

Relationship To Central

Trauma response occurring within 3 days to 1 month; precursor to PTSD

Concept

Dissociative Disorders

Sub Concepts

• Dissociative amnesia
• Dissociative fugue
• Dissociative identity disorder
• Depersonalization/derealization disorder
• Safety as primary nursing concern
• Trust-building strategies

Relationship To Central

Disruption of consciousness, memory, identity in response to overwhelming trauma

Concept

Pharmacological Interventions

Sub Concepts

• Selective Serotonin Reuptake Inhibitors (SSRIs)
• Benzodiazepines
• Buspirone
• Adverse effects and monitoring
• Drug interactions and contraindications
• Patient teaching and adherence

Relationship To Central

Medication management supporting therapy for anxiety and trauma disorders

Concept

SSRIs: First-Line Pharmacotherapy

Sub Concepts

• Examples: fluoxetine, sertraline, paroxetine, escitalopram, fluvoxamine
• 2-4 week therapeutic onset
• Common early side effects (nausea, insomnia, sexual dysfunction)
• Discontinuation syndrome prevention
• Serotonin syndrome risk
• Suicidal ideation monitoring in young adults
• MAOI washout periods

Relationship To Central

Gold standard medication for most anxiety, OCD, PTSD disorders

Concept

Benzodiazepines: Short-Term Anxiety Relief

Sub Concepts

• Examples: lorazepam, diazepam, alprazolam, clonazepam
• Rapid onset and CNS depression
• Fall and safety risks
• Dependence, tolerance, withdrawal potential
• Tapered discontinuation mandatory
• Withdrawal seizure risk
• Flumazenil as reversal agent
• Alcohol and CNS depressant interactions

Relationship To Central

Rapid-acting agents for acute anxiety and panic; dependence risk with prolonged use

Concept

Nursing Management Principles

Sub Concepts

• Therapeutic nurse-patient relationship
• Anxiety level assessment and response adaptation
• Environmental modifications
• Safety prioritization
• Trust and acceptance communication
• Grounding and relaxation techniques
• Psychoeducation and coping skills
• Suicide and self-harm risk assessment

Relationship To Central

Core interventions applied across all anxiety and trauma disorders

Concept

Philippine Legal and Ethical Framework

Sub Concepts

• Republic Act 11036 (Mental Health Act)
• Client rights to humane, non-discriminatory care
• Community-based mental health services
• Informed consent requirements
• RA 9173 (Philippine Nursing Act)
• Disaster and trauma response obligations

Relationship To Central

Regulatory and rights-based context for nursing practice in mental health

To

Nursing Interventions

From

Anxiety Continuum

Strength

strong

Relationship

Severity level determines what nursing actions are appropriate; teaching is contraindicated in severe anxiety/panic

To

SSRI Pharmacotherapy

From

Generalized Anxiety Disorder

Strength

strong

Relationship

SSRIs are first-line medication treatment for GAD, providing sustained anxiety reduction

To

Panic Attack Interventions

From

Panic Disorder

Strength

strong

Relationship

Specific nursing protocols apply during acute panic episodes: stay present, slow breathing, reduce stimulation

To

Benzodiazepines

From

Panic Attack Interventions

Strength

strong

Relationship

Benzodiazepines provide rapid relief during acute panic but are only for short-term use

To

Systematic Desensitization

From

Phobic Disorders

Strength

strong

Relationship

Primary behavioral treatment: gradual exposure to feared stimulus paired with relaxation techniques

To

Ritual Management

From

Obsessive-Compulsive Disorder

Strength

strong

Relationship

Core nursing principle: do NOT abruptly interrupt rituals; allow time and gradually set limits as client improves

To

Response Prevention

From

OCD Rituals

Strength

strong

Relationship

Behavioral therapy technique: gradually prevent client from performing compulsions while managing resulting anxiety

To

Trust and Safety

From

Post-Traumatic Stress Disorder

Strength

strong

Relationship

Foundation of PTSD nursing care; client must feel safe before processing trauma or learning coping skills

To

Grounding Techniques

From

PTSD Hyperarousal

Strength

moderate

Relationship

Nursing intervention for flashbacks and dissociative episodes; helps client stay present and oriented

To

Suicide Risk Assessment

From

PTSD

Strength

strong

Relationship

Depression, hopelessness, and substance use frequently accompany PTSD; suicide risk screening is mandatory

To

PTSD

From

Acute Stress Disorder

Strength

strong

Relationship

ASD occurs within 1 month of trauma; if symptoms persist beyond 1 month, diagnosis becomes PTSD

To

Trauma Response

From

Dissociative Disorders

Strength

strong

Relationship

Dissociation is an unconscious ego defense mechanism against overwhelming trauma and anxiety

To

Safety Priority

From

Dissociative Disorders

Strength

strong

Relationship

Clients with dissociative disorders have high risk for self-harm; safety assessment is first nursing action

To

2-4 Week Onset

From

SSRIs

Strength

strong

Relationship

SSRIs require 2-4 weeks for therapeutic effect; early side effects may occur before benefit is felt

To

Serotonin Syndrome

From

SSRIs

Strength

strong

Relationship

Serious drug interaction risk when combined with MAOIs, triptans, tramadol, or St. John's Wort

To

Dependence Risk

From

Benzodiazepines

Strength

strong

Relationship

Benzodiazepines carry high risk of tolerance, physical dependence, and withdrawal seizures with regular use

To

CNS Depression

From

Benzodiazepines

Strength

strong

Relationship

Additive effects with alcohol and other CNS depressants can cause respiratory depression and death

To

Tapered Withdrawal

From

Benzodiazepine Discontinuation

Strength

strong

Relationship

Must taper gradually to prevent rebound anxiety, tremors, and potentially fatal withdrawal seizures

To

Anxiety Management

From

Defense Mechanisms

Strength

moderate

Relationship

Unconscious mechanisms (repression, denial, displacement) help manage anxiety but become maladaptive when overused

To

Client Teaching

From

Perceptual Field Narrowing

Strength

strong

Relationship

As anxiety increases, perceptual field narrows; teaching effectiveness decreases and must be deferred

To

Nursing Care Approach

From

Philippine Mental Health Act

Strength

moderate

Relationship

RA 11036 mandates humane, non-discriminatory, community-based mental health care and informed consent

To

SSRI Pharmacotherapy

From

OCD

Strength

strong

Relationship

SSRIs (especially fluoxetine, sertraline, fluvoxamine) are first-line medication for OCD in addition to behavioral therapy

To

Trauma-Focused CBT

From

PTSD

Strength

strong

Relationship

Cognitive-behavioral therapy is evidence-based treatment; helps process trauma memories and modify unhelpful thoughts

To

Eye Movement Desensitization

From

PTSD

Strength

moderate

Relationship

Alternative evidence-based therapy for PTSD; uses bilateral eye movements during trauma processing

To

Sexual Dysfunction

From

Early Side Effects SSRIs

Strength

strong

Relationship

Sexual side effects are common with SSRIs and a major reason for medication nonadherence; must be discussed openly

To

Suicidal Ideation

From

Young Adults SSRIs

Strength

strong

Relationship

Increased suicide risk in adolescents and young adults during first weeks of SSRI use as energy improves before mood

To

Anxiety Reduction

From

Relaxation Techniques

Strength

strong

Relationship

Deep breathing, progressive muscle relaxation, and guided imagery are core nursing interventions for all anxiety disorders

To

Anxiety Disorders

From

Cognitive-Behavioral Therapy

Strength

strong

Relationship

CBT is gold standard psychotherapy for anxiety, panic, phobias, and OCD; addresses thoughts and behaviors