Anxiety, Anxiety, Somatoform, Somatoform,
Dissociative and Dissociative and Stress DisordersStress Disorders
Anxiety Anxiety DisordersDisorders
Anxiety DisordersAnxiety Disorders AnxietyAnxiety is a general feeling of is a general feeling of
apprehension characterized by a apprehension characterized by a behavioral, cognitive, or behavioral, cognitive, or psychological symptom.psychological symptom. Most people find anxiety to be an Most people find anxiety to be an
uncomfortable state uncomfortable state People will attempt to relieve or People will attempt to relieve or
lessen anxietylessen anxiety Due to operant conditioning’s Due to operant conditioning’s
effects, people associate strange effects, people associate strange behaviors with lowering their behaviors with lowering their anxietyanxiety
PhobiasPhobias.. AA Phobia Phobia is an intense, excessive is an intense, excessive
fear of an activity, object or situationfear of an activity, object or situation– Some phobias have an obvious Some phobias have an obvious
connection to a traumatic experienceconnection to a traumatic experience– Other phobias are generalized from Other phobias are generalized from
a traumatic experience like a fear of a traumatic experience like a fear of cotton balls after an attack by white cotton balls after an attack by white chickenschickens
– Most phobias do not have a specific Most phobias do not have a specific triggering event and most likely triggering event and most likely result from an operant conditioning result from an operant conditioning reinforcement of an anxiety reinforcement of an anxiety producing or reducing eventproducing or reducing event
PhobiasPhobias AgoraphobiaAgoraphobia is avoidance of public places is avoidance of public places
where the individual may develop symptoms of where the individual may develop symptoms of panic panic – People can end up confining themselves in their People can end up confining themselves in their
houses or even a single roomhouses or even a single room Social PhobiaSocial Phobia is a fear of being seen or is a fear of being seen or
observed, and perhaps judged, by othersobserved, and perhaps judged, by others– Social AnxietySocial Anxiety is an increase in anxiety when in a is an increase in anxiety when in a
social situationsocial situation Specific phobia Specific phobia is any phobia other than is any phobia other than
Agoraphobia or social phobia.Agoraphobia or social phobia.
Panic DisorderPanic Disorder Panic DisorderPanic Disorder is a disorder in is a disorder in
which one may experience racing which one may experience racing pulse or difficulty breathing. Heart pulse or difficulty breathing. Heart rate can accelerate up to 180 rate can accelerate up to 180 beats per minute and can last from beats per minute and can last from a few minutes to an hour. Victims a few minutes to an hour. Victims may believe they are going crazy may believe they are going crazy or having a heart attack.or having a heart attack.– This collection of symptoms is This collection of symptoms is
called a Panic Attackcalled a Panic Attack
Panic AttacksPanic Attacks Panic attacks are not unusual. 15 Panic attacks are not unusual. 15
to 30% of individuals report to 30% of individuals report experiencing at least one attack experiencing at least one attack in their lifetime. in their lifetime. – Frequent attacks are diagnosed Frequent attacks are diagnosed
as panic disorderas panic disorder– People can associate a panic People can associate a panic
attack with specific activities or attack with specific activities or places causing them to places causing them to associate the attack and the associate the attack and the event or activity leading to a event or activity leading to a phobia or avoidance behaviorphobia or avoidance behavior
Generalized Anxiety Generalized Anxiety DisorderDisorder
Generalized Anxiety DisorderGeneralized Anxiety Disorder is a chronically is a chronically high level of anxiety that is not attached to a high level of anxiety that is not attached to a specific stimulation.specific stimulation.– Can be progressiveCan be progressive– Can be triggered by steroid useCan be triggered by steroid use– Can be triggered by Marijuana useCan be triggered by Marijuana use– Found in both men and women often with Found in both men and women often with
different resultsdifferent results Men often use violent out bursts to decrease Men often use violent out bursts to decrease
anxiety to a comfortable or socially anxiety to a comfortable or socially acceptable levelacceptable level
Women often resort to substance abuse to Women often resort to substance abuse to return to a socially acceptable level of anxietyreturn to a socially acceptable level of anxiety
Abuse/Cycle of ViolenceAbuse/Cycle of Violence
Men often use violent outbursts to Men often use violent outbursts to increase their feelings of control over increase their feelings of control over anxiety by blaming or attempting to anxiety by blaming or attempting to control their partner.control their partner.
This is a dangerous cycle and usually This is a dangerous cycle and usually continues to get worse until continues to get worse until intervention jail or deathintervention jail or death
. . Obsessive Compulsive Obsessive Compulsive DisorderDisorder
Obsessive Compulsive DisorderObsessive Compulsive Disorder is is an anxiety disorder characterized by an anxiety disorder characterized by repetitive, irrational thoughts and repetitive, irrational thoughts and irresistible impulses such as washing irresistible impulses such as washing hands. hands. – The lifetime prevalence of OCD is about The lifetime prevalence of OCD is about
2.5 percent and the rate is higher 2.5 percent and the rate is higher among women.among women.
. . Obsessive Compulsive DisorderObsessive Compulsive Disorder
Obsessive compulsive disorder is not a Obsessive compulsive disorder is not a personality trait. It is a coping mechanism personality trait. It is a coping mechanism for dealing with the obsessive thoughts for dealing with the obsessive thoughts people experience that has been reinforced people experience that has been reinforced over time because it decreases or avoids over time because it decreases or avoids the feelings of anxiety and panic people the feelings of anxiety and panic people feel. During the movie you will be trying to feel. During the movie you will be trying to identify what behaviors Mr. Udall identify what behaviors Mr. Udall shows that are part of his obsessive shows that are part of his obsessive compulsive disorder and which compulsive disorder and which behaviors are part of his personality behaviors are part of his personality and if there are any other behaviors and if there are any other behaviors which might indicate another disorder.which might indicate another disorder.
As Good As It Gets
Put Mr. Udall’s behaviors on a T ChartPut Mr. Udall’s behaviors on a T Chart
OCD BehaviorsOCD Behaviors PersonalityPersonality
As Good As It Gets
Blind Man TagBlind Man Tag
A great warm up activity low key A great warm up activity low key tag gametag game– Safety concerns Safety concerns
Leaders must maintain contact w/ blind Leaders must maintain contact w/ blind at all timesat all times
Walk onlyWalk only Must have a consistent, flat field of Must have a consistent, flat field of
play. Make it small grass if possibleplay. Make it small grass if possible
RulesRules
Played just like tagPlayed just like tag
Somatoform DisordersSomatoform Disorders
Somatoform Disorders Somatoform Disorders involves involves complaints of bodily symptoms that complaints of bodily symptoms that do not have a medical causedo not have a medical cause
Notice that it does not say “Identifiable medical cause.” This is because Many physical symptoms have a medical cause that Doctors just haven’t figured out yet
HypochondriasHypochondrias
HypochondriasHypochondrias is a preoccupation is a preoccupation with physical symptoms that are with physical symptoms that are believed to indicate a serious illness.believed to indicate a serious illness.
Usually the physical symptoms are common, and benignlike heart burn or headache, but the diagnosisThey come up with for themselves is uncommon and disastrous
Somatization DisorderSomatization Disorder
SomatoformSomatoform disorderdisorder involving involving multiple symptoms that are vague multiple symptoms that are vague and unrelated, have no medical and unrelated, have no medical cause and are interfering with an cause and are interfering with an individuals ability to functionindividuals ability to function
A person will have physical complaints that help them have a legitimate excuse for altering their behavior or help them deal with anxiety
Conversion DisorderConversion Disorder
Conversion Disorder Conversion Disorder is when an is when an individual presents sensory or motor individual presents sensory or motor symptoms that do not have a symptoms that do not have a medical reason.medical reason.
Anxiety, fear, guilt and stress are expressedas physical symptoms
Journal EntryJournal Entry What is your earliest childhood What is your earliest childhood
memory? How old were you?memory? How old were you? How much of your childhood (ages How much of your childhood (ages
1-10) do you recall? 1-10) do you recall? Of the things you recall about your Of the things you recall about your
childhood, what percent are childhood, what percent are positive memories and what % are positive memories and what % are negative?negative?
DO you have any memories that are DO you have any memories that are missing or incomplete because they missing or incomplete because they are scary or sad?are scary or sad?
Dissociative DisordersDissociative Disorders
Dissociative Disorders Dissociative Disorders affect the affect the function of the mind, such as function of the mind, such as memory for events, knowledge of memory for events, knowledge of one’s identityone’s identity
Dissociative DisordersDissociative Disorders
Dissociative disorders develop as Dissociative disorders develop as a coping mechanism for dealing a coping mechanism for dealing with stressful situations. with stressful situations. – People who are more sensitive to People who are more sensitive to
dissociation will use it initially to dissociation will use it initially to cope with very serious situations cope with very serious situations and it can easily become a way of and it can easily become a way of life.life.
Dissociative AmnesiaDissociative Amnesia
Dissociative Amnesia Dissociative Amnesia involves a involves a sudden inability to recall important sudden inability to recall important personal information and other facts personal information and other facts often occurs after emotional trauma. often occurs after emotional trauma.
Journal EntryJournal Entry :A week has :A week has passedpassed
How would you feel if you How would you feel if you woke up far away from home woke up far away from home with no recollection of how with no recollection of how you got there, only to find you got there, only to find out that a week has passed out that a week has passed and you have no idea what and you have no idea what has happened? What would has happened? What would your concerns be?your concerns be?
Dissociative FugueDissociative Fugue
DissociativeDissociative Fugue Fugue involving involving amnesia and flight from the amnesia and flight from the workplace or home; may involve workplace or home; may involve establishing a new identity in a new establishing a new identity in a new location. location.
Dissociative Identity Dissociative Identity DisorderDisorder
Dissociative Identity Disorder Dissociative Identity Disorder (multiple personality) is the most (multiple personality) is the most dramatic dissociative disorder. dramatic dissociative disorder. Although once thought rare, many Although once thought rare, many suggest that it is not rare but under-suggest that it is not rare but under-diagnosed. diagnosed.
http://www.youtube.com/watch?v=d73YSNtdT3o
Stress Disorders Stress Disorders
Stress Disorders result from the Stress Disorders result from the brain’s attempt to cope with a brain’s attempt to cope with a stressful situation. The process of stressful situation. The process of coping, forces changes in the coping, forces changes in the brain’s chemistry that create long brain’s chemistry that create long term effects.term effects.– Stress disorders can be very Stress disorders can be very
debilitatingdebilitating– The effects can cause permanent The effects can cause permanent
damage to physical and emotional damage to physical and emotional systemssystems
Acute Stress Disorder Acute Stress Disorder (ASD)(ASD)
Acute Stress Disorder (ASD) Acute Stress Disorder (ASD) Develops in the first few days after a Develops in the first few days after a traumatic incident.traumatic incident.Involves dissociative symptoms such Involves dissociative symptoms such as “zoning out”, feeling numb or as “zoning out”, feeling numb or dazed, detached or emotionally dazed, detached or emotionally unresponsive, recurrent images, unresponsive, recurrent images, thoughts and dreams; “flashbacks”thoughts and dreams; “flashbacks”2 days to 4 week duration 2 days to 4 week duration
Post Traumatic Stress Disorder Post Traumatic Stress Disorder (PTSD)(PTSD)
Post Traumatic Stress Disorder (PTSD) Persists over Post Traumatic Stress Disorder (PTSD) Persists over a period of time or occurs at least six months after a period of time or occurs at least six months after event. event.
Triggers: Internal or external cues that cause Triggers: Internal or external cues that cause intense reactions or distress often taking the person intense reactions or distress often taking the person back to the original source of the stress and forcing back to the original source of the stress and forcing them to relive it (Flashbacks)them to relive it (Flashbacks)– Ironically the treatment is to talk about and revisit the Ironically the treatment is to talk about and revisit the
source of the stress over and over in one on one or group source of the stress over and over in one on one or group therapy until the triggers no longer lead to the intense therapy until the triggers no longer lead to the intense reactions and flashbacks. Support groups are an important reactions and flashbacks. Support groups are an important part of this type of therapy.part of this type of therapy.
– EMDR a promising new Therapy uses brain biology to EMDR a promising new Therapy uses brain biology to reprogram memoriesreprogram memories
http://www.youtube.com/watch?v=zBtqWrs2-K0&list=RDWFYeoPqjV28
PTSD in ChildrenPTSD in Children Distancing themselves from physical Distancing themselves from physical
contact and relationshipscontact and relationships Self-destructive behavior Self-destructive behavior amnesia or dissociationamnesia or dissociation Somatization panic=painSomatization panic=pain Vivid nightmares and/or flashbacksVivid nightmares and/or flashbacks Depression/lack of affectDepression/lack of affect Difficulty in school/ability to concentrateDifficulty in school/ability to concentrate
http://www.youtube.com/watch?v=WFYeoPqjV28&feature=related
PTSD in ChildrenPTSD in ChildrenNotes to CaregiversNotes to CaregiversLook for behavioral signs: Look for behavioral signs:
– Bed wetting Bed wetting – promiscuous behavior, promiscuous behavior, – precocious understanding of sex, precocious understanding of sex, – pain / preoccupation with genitals pain / preoccupation with genitals – Vivid nightmares and/or flashbacks Vivid nightmares and/or flashbacks – Depression or flat affect Depression or flat affect – Drop in grades, unable to focusDrop in grades, unable to focus
Listen! Support, don’t react. Assure them that it Listen! Support, don’t react. Assure them that it is not their fault and the adult was wrong. is not their fault and the adult was wrong. Report!Report!
Be patient w/ physical contact and relationshipsBe patient w/ physical contact and relationships Provide alternatives for self-destructive behavior Provide alternatives for self-destructive behavior http://www.youtube.com/watch?v=WFYeoPqjV28
Complex PTSD or Disorders of Complex PTSD or Disorders of Extreme Stress not Otherwise Extreme Stress not Otherwise
Specified (DESNOS)Specified (DESNOS)
Difficulty with regulation of affect Difficulty with regulation of affect (emotion)(emotion)
self destructive behavior self destructive behavior amnesia or dissociationamnesia or dissociation somatization –panic=painsomatization –panic=pain relationship issuesrelationship issues DepressionDepression
http://www.youtube.com/watch?v=zkqibQWCecc
http://www.youtube.com/watch?v=WFYeoPqjV28&feature=related
Sometimes disorders present with Sometimes disorders present with complex combinations of symptomscomplex combinations of symptoms– In this example a woman with PTSD is In this example a woman with PTSD is
experience a dissociative response and experience a dissociative response and heading toward a panic attack as she heading toward a panic attack as she tries to cope with a flashback. Her tries to cope with a flashback. Her therapist does an great job of therapist does an great job of attempting to ground her in the present attempting to ground her in the present and reintegrate her dissociation to bring and reintegrate her dissociation to bring her back to the presenther back to the present
http://www.youtube.com/watch?v=k_8SX2GJiyQ&feature=related
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