Post Traumatic Stress Disorder

1. Post Traumatic Stress Disorder

2. 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

3. PTSD Stressors

4. Diagnostic Criteria • Exposed to a traumatic event • Traumatic event is persistently re-experienced • Persistent avoidance of stimuli associated with the trauma • Persistent symptoms of increased arousal Symptoms last fore more than 4 weeks.

5. Example Traumatic event Reoccurring thoughts Insomnia avoidance

6. Cognitive Approach certain personality profiles, attitudes, and coping styles are more likely to develop stress disorders.

7. Cognitive Behavior Therapy Exposure therapy Cognitive restructuring Stress inoculation training

8. 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

9. 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.

10. Behavioral Therapy • undesirable behavior can be unlearned or changed • identifying objectionable, maladaptive behaviors and replacing them with healthier actions.

11. Humanistic Approach Humans problems are due to social and emotional immaturity. Immaturity causes them to be in pain and inflict pain upon others.

12. Humanistic Treatment • Hopeful view of human beings and individual’s ability to reach self-actualization & self- empowerment

13. 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 

14. 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.

15. 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

16. 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

17. Biological Causes • 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 cortisoland the norepinephrine in the urine and blood people with PTSD.

18. 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).

19. Group Therapy Helps to talk about issues with people who have had a similar experience

20. 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>.

21. Panic Disorder Julia Solecki January 6, 2009 AP Psychology- 3rd Hour

22. Panic Disorder • Panic attacks usually produce a sense of unreality, a fear of impending doom, or a fear of losing control.

23. 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). 

24. 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

25. Causes • Behavioral/ Learning: • Example: if one gets positively reinforced, or loved, they feel comforted and have a panic attack to get attention

26. 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

27. 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 Causes About 25 percent of people with panic have close relatives with panic disorder

28. 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

29. 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)

30. 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>.

32. OCD Katharine Schmidt, 3rd hour

33. An anxiety disorder characterized by unwanted repetitive thoughts (obsessions) or actions (compulsions)

34. 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)

35. 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)

36. Fear of contamination Obsessive Hand washing Counting Steps Obsessive sexual thoughts Constant checking of locks, doors and appliances No stepping on cracks Turning lights on and off Touching specific objects hoarding

37. TYPES 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%

38. Biological Causes: • 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)

39. Behavioral/ Learning Causes: modeling parents that have obsessive tendencies Cognitive Causes: Stressful or abusive environments may lead to the development of O.C.D

40. 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

41. Therapy • 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

42. Selective Serotonin inhibitors (SSRI) (paraoxetine, sertraline, tricyclic antidepressants) Antidepressants (prozac, zoloft, paxil) Tranquilizers Brain Surgery Deep Brain Stimulation Other Treatments

43. 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. Facts & Figures

44. Fear of Contamination Video http://www.youtube.com/watch?v=Rn1OYlYzgm8

45. 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>.

46. Generalized Anxiety Disorder By Amanda Rapacchietta

47. Generalized Anxiety Disorder • Excessive worrying and anxiety that is intense enough to interfere with his/her daily life

48. 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.

49. Symptoms • Excessive and unrelenting worrying • Sweating • Irritability • Headaches • Problems paying attention • Problems falling/staying asleep • Nausea • “Edginess” • Muscle tension

50. 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.