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.
Example
Traumatic
event
Reoccurring
thoughts
Insomnia
avoidance
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.
Behavioral Therapy
• undesirable behavior can be unlearned
or changed
• identifying objectionable, maladaptive
behaviors and replacing them with
healthier actions.
Humanistic Approach
Humans problems
are due to social and
emotional
immaturity.
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 & selfempowerment
Psychoanalytic Approach
the unconscious influences conscious behavior
Psychoanalytic Treatment
The client with the therapist help will
make repressed conflicts
conscious, making the unconscious
conscious.
•Dream analysis
•Free association
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/posttrau
matic.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/posttraumatic-stressdisorder/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.htm
l>.
"Treatment of PTSD - National Center for PTSD."
National Center for PTSD Home. Web. 27 Dec. 2009.
<http://www.ptsd.va.gov/public/pages/treatmentptsd.asp>.
"Treatment of PTSD - (National Center for PTSD)."
Web. 27 Dec. 2009.
<http://ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_
treatmentforptsd.html>.
Panic Disorder
Julia Solecki
January 6, 2009
AP 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
• Behavioral/ Learning:
•
Example: if one gets positively
reinforced, or loved, they feel
comforted and have a panic
attack to get attention
Causes
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
• Exposure:
Treatment
– 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/panicdisorder/index.shtml>.
•
"Panic disorder -." Wikipedia, the
free encyclopedia. Web. 03 Jan.
2010.
<http://en.wikipedia.org/wiki/Pani
c_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/pa
nic_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)
Fear of
contamination
Obsessive Hand
washing
Counting Steps
Obsessive sexual
thoughts
Constant checking
of locks, doors
and appliances
No stepping on
cracks
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/ Learning
Causes:
• 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=Rn1OYlYzgm
8
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/obsessivecompulsive-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.ht
m>.
"OCD: Symptoms of Obsessive-Compulsive Disorder." Online Therapy,
Counselling & Mental Health Resources. Web. 07 Jan. 2010.
<http://counsellingresource.com/distress/anxiety-disorders/obsessivecompulsive.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
Parenting styles –
overly
demanding/critical
(Authoritarian)
Child “can’t measure
up”, can bring about
anxious feelings
• Low self esteem + Poor coping skills=more
prone to GAD
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 Criteria
Excessive 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 & Symptoms
A 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.
Recognition that the fear goes beyond the realistic threat of danger.
Reactions are automatic and uncontrollable, most likely taking over the person’s
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 Indiana
Jones had Ophidiophobia, or
an 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 Woody
Allen is supposedly afraid of
insects, sunshine, dogs, deer,
bright colors, children, heights,
small rooms, crowds, cancer and
anywhere except 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>.