Post Traumatic Stress Disorder (PTSD)

PTSD is an anxiety disorder that can develop after exposure to a terrifying event

or ordeal in which grave physical harm occurred or was threatened. Anxiety, re-

experiencing of the event, and avoidance of stimuli related to the event are symptoms of PTSD. These symptoms must last for more a

month.

PTSD affects about 7.7 million American adults

More common in women than men

Most common in veterans

Diagnostic Criteria

1. Exposed to a traumatic event

2. Traumatic event is persistently re-experienced

3. Persistent avoidance of stimuli associated with the trauma

4. Persistent symptoms of increased arousal

Symptoms last fore more than

4 weeks.

ExampleTraumatic event

Reoccurring thoughts

avoidance

Insomnia

Cognitive Approach

certain personality profiles, attitudes, and coping styles are

more likely to develop stress disorders.

Cognitive Behavior Therapy

Exposure therapy

Cognitive restructuring

Stress inoculation training

Cognitive Behavior Therapy

• Teach about trauma and its effects.

• Focus on changing how people react to their PTSD symptoms.

• Usually 6 weeks long, but can be longer

• Can be one-on-one or in group

Behavioral Approach

• Emotions/behaviors are acquired through conditioning

• Reinforcement maintains fear and anxiety

• People with a weak support system are more likely to develop a stress disorder after a traumatic event.

• undesirable behavior can be unlearned or changed

• identifying objectionable, maladaptive behaviors and replacing them with healthier actions.

Behavioral Therapy

Humans problems are due to social and emotional immaturity.

Humanistic ApproachHumanistic Approach

Immaturity causes them to be in pain and inflict pain upon others.

Humanistic Treatment• Hopeful view of human beings and

individual’s ability to reach self-actualization & self- empowerment

Psychoanalytic Approach the unconscious influences conscious behavior

The client with the therapist help will make repressed conflicts conscious, making the unconscious conscious.

•Dream analysis•Free association 

Psychoanalytic Treatment

Physiological Causes

• While the brain is storing these traumatic memories information processing may be incomplete (because strong negative feelings or dissociation) and they interfere with information processing.

• This prevents the forging of connections with more adaptive information that is held in other memory networks.

Physiological Treatment: Information Processing Treatment

• Eye Movement Desensitization and Reprocessing (EMDR)– move eyes in a rhythmic manner from side

to side– information processing, new learning,

elimination of emotional distress, and development of cognitive insights.

• Tapas Acupressure Technique (TAT). – placing hands on a few key points near your

eyes and at the back of your head– designed to rewire the brain

Physiological Treatment: Information Processing Treatment

• Emotional Freedom Technique (EFT)– release negative

emotions surrounding an incident or issue

• Thought Field Therapy (TFT)– moving the body’s

energies in specific ways

• Genetic predisposition to high anxiety and fear

• Psychological disorders run in family

• Experiencing frequent fearful events can create fear circuits in the amygdala

• traumatic events trigger physical chances in the brain.– Abnormal activity of

the cortisol and the norepinephrine in the urine and blood people with PTSD.

Biological Treatment: Medication

• Selective serotonin reuptake inhibitors (SSRIs)

• These can help you feel less sad and worried.

• citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).

Group Therapy

Helps to talk about issues with people who have had a similar experience

Works Cited• "Posttraumatic Stress Disorder." PSYweb complete

mental health site. Web. 27 Dec. 2009. <http://psyweb.com/Mdisord/AnxietyDis/posttraumatic.jsp>.

• "Post-traumatic stress disorder (PTSD): Tests and diagnosis - MayoClinic.com." Mayo Clinic medical information and tools for healthy living - MayoClinic.com. Web. 27 Dec. 2009. <http://www.mayoclinic.com/health/post-traumatic-stress-disorder/DS00246/DSECTION=tests-and-diagnosis>.

• Psychological Disorders. Web. 27 Dec. 2009. <http://psychological-disorders.blogspot.com/>.

• "PTSD Treatment Programs." PTSD Support and Information. Web. 27 Dec. 2009. <http://www.ptsdsupport.net/ptsd_treatments.html>.

• "Treatment of PTSD - National Center for PTSD." National Center for PTSD Home. Web. 27 Dec. 2009. <http://www.ptsd.va.gov/public/pages/treatment-ptsd.asp>.

• "Treatment of PTSD - (National Center for PTSD)." Web. 27 Dec. 2009. <http://ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_treatmentforptsd.html>.

Panic DisorderJulia Solecki

January 6, 2009AP Psychology- 3rd Hour

Panic Disorder• Panic attacks

usually produce a sense of unreality, a fear of impending doom, or a fear of losing control.

Diagnostic Criteria• A. Both (1) and (2): 

– (1) recurrent unexpected panic attacks– (2) at least one of the attacks has been followed by 1 month (or

more) of one (or more) of the following: – (a) persistent concern about having additional attacks 

(b) worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, "going crazy") (c) a significant change in behavior related to the attacks 

• B. Absence of Agoraphobia. • C. The Panic Attacks are not due to the direct

physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism). 

Causes• Psychoanalytic:

– The generation of panic attacks goes back to infancy and childhood

– attacks occur in response to cues associated with long past psychological and biological threats to one's existence

• Both conscious and unconscious panic triggers as representations of intense early life wishes and fears

Causes• Behavioral/ Learning: • Example: if one gets positively

reinforced, or loved, they feel comforted and have a panic attack to get attention

Causes• Cognitive:

– A panic attack is a manifestation of an intense feeling of helplessness in the face of intense danger

– The vicious cycle of panic is generated by combining the terror of vulnerability with one's traditional distorted thought and feeling responses

Causes• Biological/Somatic:

– Irregularities in the synthesis and release of norepinephrine (NE)

– Stimulants (cocaine) that alter NE can precipitate panic attacks

– Genetic pre-disposition to panic

– Brain region: amygdala

About 25 percent of people with panic have close relatives with panic disorder

Treatment• Exposure:

– Exposed to the physical sensations of panic in a safe environment,giving you the opportunity to learn healthier ways of coping

• Bio Medical: – Medication can be used to control or reduce some

of the symptoms of panic disorder – Antidepressants– Benzodiazepines

Treatments• Cognitive Behavioral Therapy:

– Most effective method of treatment– Focuses on thinking patterns and behaviors

sustaining or triggering the attacks– 1. Identifying and changing the distorted

thinking patterns that maintain anxiety (cognitive therapy)

– 2. Desensitizing anxiety through exposure to feared situations (behavioral therapy)

Bibliography • "NIMH." NIMH. Web. 03 Jan. 2010. <http://www.nimh.nih.gov/health/topics/panic-disorder/index.shtml>.

• "Panic disorder -." Wikipedia, the free encyclopedia. Web. 03 Jan. 2010. <http://en.wikipedia.org/wiki/Panic_disorder>.

• "Panic disorder, an anxiety disorder associated with agoraphobia, panic attacks." Anxiety Disorders Association of America, ADAA, Triumph Over Anxiety, Find a Therapist. Web. 03 Jan. 2010. http://www.adaa.org/gettingHelp/AnxietyDisorders/Panicattack.asp

• "Panic Attacks (Panic Disorders) Symptoms, Causes, Treatment and Types on MedicineNet.com." Web. 03 Jan. 2010. <http://www.medicinenet.com/panic_disorder/article.htm>.

Katharine Schmidt, 3rd hour

Diagnosis (DSM-IV)

Obsessions

• Reoccurring and intrusive thoughts, impulses or images that cause distress

• Person tries to ignore thoughts

• Recognition that obsessive thoughts, are a product of their own mind (unrealistic)

Compulsions

• Repetitive behaviors (washing, ordering, checking) or mental acts (praying, counting) that one feels driven to perform.

• Behaviors are aimed to prevent anxiety or a dreaded situation

• Not realistically connected to the feared outcome

Diagnosis (DSM-IV)• The person has recognized that their

obsessions or compulsions are excessive and unreasonable (does not apply to children)

• Obsessions/compulsions take more than 1 hour a day & interfere with normal daily functioning. (work, school, social, relationships)

• If another disorder present (anorexia), obsessions are not limited to that disease.

• Not due to the direct effects of a substance (drug abuse)

Obsessive Hand washing

Fear of contamination Counting Steps

No stepping on cracks

Obsessive sexual thoughts

Constant checking of locks, doors and appliances

Touching specific objects

Turning lights on and off hoarding

Obsessions (repetitive thoughts):

Concern with dirt, germs, or toxins 40%

Something terrible happening (fire, death, illness) 24%

Symmetry, order, exactness 17%

Compulsions (repetitive behavior)

Excessive hand washing, bathing, grooming 85%

Repeating rituals (in/out of door, up/down from chair) 51%

Checking locks, doors, appliances 46%

• Imbalance/ abnormalities with neurotransmitter serotonin - receptors under stimulated

• Genetic Mutation

• Abnormal brain development-miscommunicated between orbitofrontal cortex, caudate nucleus and thalamus

• Genetic (runs in families)

Behavioral/ LearningCauses:• modeling parents that

have obsessive tendencies

Cognitive Causes:• Stressful or abusive

environments may lead to the development of O.C.D

Strep Throat & OCD• Some kids develop OCD

symptoms after a strep throat infection (must be genetically predisposed)

• PANDAS (Pediatric Autoimmune Neuropychiatric Disorders Associated with a Strep Infection)

• 1 in 1,000 (very rare)• Cause by antibodies

created to fight strep

1. Psychoanalysis Therapy-helps gain insight to problems

2. Cognitive Behavior Therapy (CBT)-most effective-1 in 4 refuse to participate- Informed about disease- Exposure and Response Prevention

*face fears in a safe way little by little without compulsions.

3. Family/ Group Therapy

• Selective Serotonin inhibitors (SSRI)

(paraoxetine, sertraline, tricyclic antidepressants)

• Antidepressants (prozac, zoloft, paxil)

• Tranquilizers

• Brain Surgery

• Deep Brain Stimulation

• Affects 2-3% of population.• In U.S about 3.3 million

people have OCD. • Found equally in all ethnic

groups and genders (in children, boy are more common)

• Males develop disease around 6- 15years old.

• Onset for females: 20- 29 years

• Symptoms worsen with fatigue, stress and illness.

• Symptoms progress throughout adulthood.

• People with OCD often develop depression, panic disorder, general anxiety disorder, bipolar disorder and eating disorders.

• No specific cure.

Fear of Contamination Video

http://www.youtube.com/watch?v=Rn1OYlYzgm8

Bibliography Black, Donald W. "Obsessive Compulsive

Disorder." World book. 2000. Print Obsessive-compulsive disorder (OCD): Symptoms - MayoClinic.com." Mayo

Clinic medical information and tools for healthy living - MayoClinic.com. Web. 06 Jan. 2010. <http://www.mayoclinic.com/health/obsessive-compulsive-disorder/DS00189/DSECTION=symptoms>.

"Obsessive-Compulsive Disorder (OCD): Symptoms, Behavior, and Treatment." Helpguide.org: Understand, Prevent and Resolve Life's Challenges. Web. 05 Jan. 2010. <http://www.helpguide.org/mental/obsessive_compulsive_disorder_ocd.htm>.

"OCD: Symptoms of Obsessive-Compulsive Disorder." Online Therapy, Counselling & Mental Health Resources. Web. 07 Jan. 2010. <http://counsellingresource.com/distress/anxiety-disorders/obsessive-compulsive.html>.

Science Daily: News & Articles in Science, Health, Environment & Technology. 26 Nov. 2007. Web. 05 Jan. 2010. <http://www.sciencedaily.com>.

Generalized Anxiety Disorder

By Amanda Rapacchietta

Generalized Anxiety Disorder• Excessive worrying and anxiety that is intense enough to

interfere with his/her daily life

Diagnostic Criteria

• Patients suffer from excessive feelings of anxiety and worrying that occur most days for at least a six month period of time.

• The patients have a hard time controlling their worrying.

• Anxiety/worrying interferes with daily life and distresses you

• There are at least three of the following symptoms reported: fatigue, trouble sleeping, irritability, restlessness etc.

Symptoms

• Excessive and unrelenting worrying

• Sweating• Irritability• Headaches• Problems paying attention• Problems falling/staying

asleep• Nausea• “Edginess”• Muscle tension

Risk Factors For GAD

• The following are some variables that could increase your risk for developing GAD.– Having a bad childhood – ex. Neglectful parents, drugs etc.– Stress – obviously– Genetics – GAD may be in your family genetics– Being a Female – twice as many women are diagnosed with

GAD than men– Substance Abuse – Nicotine and Caffeine have a negative

effect on anxiety. Drugs can make GAD worse.

How Common?• Around 4 million adults suffer from GAD in the U.S. currently• More commonly seen in women than men• Typically begins from childhood

Behavioral/Learning Causes

• Low self esteem + Poor coping skills=more prone to GAD

Parenting styles – overly demanding/critical (Authoritarian)

Child “can’t measure up”, can bring about anxious feelings

Cognitive Causes• Environmental

– Stress – loosing a job or loved one, moving, divorce etc.– Trauma – violence, natural disasters, attacks: often

triggering flashbacks

Biological/Somatic Causes

• Heredity – can be genetically linked

• Chemical imbalances in the brain– Neurotransmitters

Cognitive Behavioral Therapy• Therapy for GAD helps people

change their thinking patterns that help support their fears

• teaches the patient learn to change the way they react to situations that trigger anxiety.

• If you have an appointment it is recommended to:– Write down a list of all

medications you are taking and medical problems you are experiencing.

– Any symptoms you are or have experienced

– What in particular is causing you stress

Bio Medical Therapy

• Drugs used to combat GAD:– Antidepressants – influence

neurotransmitters that are associated with anxiety disorders.

• Prozac• Paxil• Lexapro• Zoloft

Bio Medical Therapy Cont.• Buspirone – an anti-anxiety medication that

can be used on a regular basis• Benzodiazepines – sedatives, typically not

prescribed because they are short term relief, and can be habit forming.– Valium– Xanax– Klonopin– Librium

Group/Family Therapy• Talking about problems with

groups can benefit patients who are suffering from an anxiety disorder

• Family should support a family member with an anxiety disorder, and try not to aggravate their symptoms

The End

Bibliography• DeviantArt.com. N.p., n.d. Web. 3 Jan. 2010. <http://www.deviantart.com/#>.

• Mayo Clinic. N.p., n.d. Web. 6 Jan. 2010. <http://www.mayoclinic.com/health/ generalized-anxiety-disorder/DS00502/DSECTION=causes>.

• Helpguide.org. N.p., n.d. Web. 3 Jan. 2010. <http://helpguide.org/mental/ generalized_anxiety_disorder.htm>.

• University of Maryland Medical Center. N.p., n.d. Web. 3 Jan. 2010. <http://www.umm.edu/ mentalhealth/ancauses.htm>.

• National Institute of Mental Health. N.p., n.d. Web. 3 Jan. 2010. <http://www.nimh.nih.gov/health/ topics/generalized-anxiety-disorder-gad/index.shtml>.

Phobias

• By: Matt Hughes

Diagnostic CriteriaExcessive or unreasonable fear of a place, thing, or situation(s).

Recognize this fear is excessive or unreasonable, children may not recognize this.

Exposure to this phobic stimulus ( place, thing, or situation(s) ) can lead to embarrassment and a anxiety response in the form of a situationally bound or a situationally predisposed Panic Attack. In children the anxiety may be expressed it the form of crying, tantrums, freezing up, or clinging.

The phobic situation(s) may be avoid or endured with intense distress and interferes significantly with a persons normal daily routine. ( E.g., school, work, social activities, relationships )

If under 18 symptoms present of at least 6 months.

Definition & SymptomsSymptomsA lasting, irrational fear of an object, situation, or activity that one feels compelled to avoid. Phobias tend to interfere with one’s ability to work, socialize, and execute a daily routine.Feelings of panic, dread, or terror.Feelings of panic, dread, or terror.Recognition that the fear goes beyond the realistic threat of danger.Recognition that the fear goes beyond the realistic threat of danger.Reactions are automatic and uncontrollable, most likely taking over the person’s Reactions are automatic and uncontrollable, most likely taking over the person’s thoughts.thoughts.

CAUSES

Behavioral Causes

People can be classically conditioned, either naturally or purposefully, to be afraid of stimulants. If pushed to far, the fear can escalate into a phobia.It is possible to gain phobias through observational learning. This usually would happen at a young age. (12 & younger)Learned helplessness is a strong factor in developing phobias of stimulants that we cannot control.

Fictional Character Fictional Character Indiana Jones had Indiana Jones had Ophidiophobia, or an Ophidiophobia, or an extreme fear of snakes.extreme fear of snakes.

Biological Causes

Neurotransmitter-receptor abnormalities in the brain are suspected to play a major roll in the development of phobias.

Specifically, the deficiency of the neurotransmitters norepinephrine, dopamine, and serotonin, among others, seem to have a significant influence.

These abnormalities in the brain are believed to be caused by genetic predispositions, which have the most prominent influence on the development of phobias.

As proof, research with identical twins has been conducted. Although separated at birth, identical twins in the experiment often had the same phobias.

Cognitive Causes

Traumatic events can easily lead to the development of phobias.Examples: fires, car accidents, etc. Actor and film director Actor and film director

Woody Allen is supposedly Woody Allen is supposedly afraid of insects, sunshine, afraid of insects, sunshine, dogs, deer, bright colors, dogs, deer, bright colors, children, heights, small children, heights, small rooms, crowds, cancer and rooms, crowds, cancer and anywhere except anywhere except Manhattan.Manhattan.

Evolutionary Causes

Over time, humans have had to become fearful of certain things in order to survive. Thus, certain phobias could be caused and triggered randomly by our instincts, according to the evolutionary perspective.

Treatments

Psychodynamic Therapy

In mild cases, posthypnotic suggestions can help to control reactions to stimulants (breathing, heart rate, etc.) and achieve a relaxed state of mind. This permits them to deal with the problem in a rational manner and possibly extinguish the fear.In more severe cases, if the phobia is a result of a traumatic event, hypnotherapists will utilize age regression to guide the person back in time, and help them reexamine the event that initially triggered the fear from an objective point of view. Once the cause is identified, the fear of losing control is often eliminated.

Behavioral Therapy

Exposure Treatment- Slowly forcing the patient to be exposed to the phobic stimulus using classical conditioning techniques in a safe way in order to eventually extinguish the phobia.

Flooding- The patient is exposed to the stimulus in a safe way for as long as it takes for them to realize there is no danger and the phobia is extinguished

Desensitization- Training the patient to relax, establishing an anxiety hierarchy, then conditioning the patient to respond with relaxation instead of fear when presented with stimuli on their anxiety hierarchy.

Bio Medical Treatment

Medication is used to help with the symptoms, not for curing phobias. No medications can cure phobias.

Anti-anxiety- Xanax and Valium

Beta-blockers for high blood pressure- Inderal and Tenormin

Anti-depressants- Nardil, Parnate, Prozac, Paxil, Zoloft, and Luvox.

Bibliography

Culbertson, Fredd. The Phobia List. 17 July 1995. Web. 05 Jan. 2010. <http://www.phobialist.com>.

Fritscher, Lisa. "Mental Health Research - Mental Health Research on the Genetics of Phobias." Phobias - An In-Depth Guide to Managing Phobias. 10 July 2008. Web. 05 Jan. 2010. <http://phobias.about.com/od/research/a/geneticsphobias.htm>.

Gersley, Erin. "Phobias: Causes and Treatment in AllPsych Journal." Psychology Classroom at AllPsych Online. 17 Nov. 2001. Web. 06 Jan. 2010. <http://allpsych.com/journal/phobias.html>.

"Specific Phobia." PSYweb complete mental health site. Web. 06 Jan. 2010. <http://psyweb.com/Mdisord/AnxietyDis/specphobia.jsp>.