Transcript Anxiety, Somatoform, Dissociative Disorders and Stress

Anxiety,
Somatoform,
Dissociative and
Stress Disorders
Anxiety Disorders
Anxiety Disorders

Anxiety is a general feeling of
apprehension characterized by a
behavioral, cognitive, or psychological
symptom.
 Most people find anxiety to be an
uncomfortable state
 People will attempt to relieve or lessen
anxiety
 Due to operant conditioning’s effects,
people associate strange behaviors with
lowering their anxiety
Phobias
. excessive fear of
 A Phobia is an intense,
an activity, object or situation
– Some phobias have an obvious
connection to a traumatic experience
– Other phobias are generalized from a
traumatic experience like a fear of
cotton balls after an attack by white
chickens
– Most phobias do not have a specific
triggering event and most likely result
from an operant conditioning
reinforcement of an anxiety producing
or reducing event
Phobias

Agoraphobia is avoidance of public places where the
individual may develop symptoms of panic
– People can end up confining themselves in their houses or
even a single room

Social Phobia is a fear of being seen or observed,
and perhaps judged, by others
– Social Anxiety is an increase in anxiety when in a social
situation

Specific phobia is any phobia other than
Agoraphobia or social phobia.
Panic Disorder
 Panic
Disorder is a disorder in which
one may experience racing pulse or
difficulty breathing. Heart rate can
accelerate up to 180 beats per minute
and can last from a few minutes to an
hour. Victims may believe they are
going crazy or having a heart attack.
–This collection of symptoms is called a
Panic Attack
 Panic
Panic Attacks
attacks are not unusual. 15 to
30% of individuals report
experiencing at least one attack in
their lifetime.
–Frequent attacks are diagnosed as
panic disorder
–People can associate a panic attack
with specific activities or places
causing them to associate the
attack and the event or activity
leading to a phobia or avoidance
behavior
Generalized Anxiety Disorder

Generalized Anxiety Disorder is a chronically
high level of anxiety that is not attached to a
specific stimulation.
–
–
–
–
Can be progressive
Can be triggered by steroid use
Can be triggered by Marijuana use
Found in both men and women often with
different results
 Men often use violent out bursts to decrease
anxiety to a comfortable or socially acceptable
level
 Women often resort to substance abuse to
return to a socially acceptable level of anxiety
Abuse/Cycle of Violence
Men often use violent outbursts to
increase their feelings of control over
anxiety by blaming or attempting to
control their partner.
 This is a dangerous cycle and usually
continues to get worse until intervention
jail or death

. Obsessive Compulsive
Disorder

Obsessive Compulsive Disorder is an
anxiety disorder characterized by
repetitive, irrational thoughts and
irresistible impulses such as washing
hands.
– The lifetime prevalence of OCD is about 2.5
percent and the rate is higher among women.
.
Obsessive Compulsive Disorder
As Good As It Gets
Obsessive compulsive disorder is not a personality
trait. It is a coping mechanism for dealing with
the obsessive thoughts people experience that
has been reinforced over time because it
decreases or avoids the feelings of anxiety and
panic people feel. During the movie you will be
trying to identify what behaviors Mr. Udall
shows that are part of his obsessive
compulsive disorder and which behaviors
are part of his personality and if there are
any other behaviors which might indicate
another disorder.
As Good As It Gets
Put Mr. Udall’s behaviors on a T Chart
OCD Behaviors
Personality
Blind Man Tag

A great warm up activity low key tag
game
– Safety concerns
 Leaders must maintain contact w/ blind at
all times
 Walk only
 Must have a consistent, flat field of play.
Make it small grass if possible
Rules
Played just like tag
Somatoform Disorders

Somatoform Disorders involves
complaints of bodily symptoms that do 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
Hypochondrias

Hypochondrias is a preoccupation with
physical symptoms that are believed to
indicate a serious illness.
Usually the physical symptoms are common, and benign
like heart burn or headache, but the diagnosis
They come up with for themselves is uncommon
and disastrous
Somatization Disorder

Somatoform disorder involving multiple
symptoms that are vague and unrelated,
have no medical cause and are interfering
with an individuals 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 Disorder

Conversion Disorder is when an
individual presents sensory or motor
symptoms that do not have a medical
reason.
Anxiety, fear, guilt and stress are expressed
as physical symptoms
Journal Entry
What is your earliest childhood
memory? How old were you?
 How much of your childhood (ages 110) do you recall?
 Of the things you recall about your
childhood, what percent are positive
memories and what % are negative?
 DO you have any memories that are
missing or incomplete because they
are scary or sad?

Dissociative Disorders

Dissociative Disorders affect the
function of the mind, such as memory for
events, knowledge of one’s identity
Dissociative Disorders

Dissociative disorders develop as a
coping mechanism for dealing with
stressful situations.
– People who are more sensitive to
dissociation will use it initially to cope
with very serious situations and it can
easily become a way of life.
Dissociative Amnesia

Dissociative Amnesia involves a sudden
inability to recall important personal
information and other facts often occurs
after emotional trauma.
Journal Entry :A week has passed
 How
would you feel if you woke
up far away from home with no
recollection of how you got
there, only to find out that a
week has passed and you have
no idea what has happened?
What would your concerns be?
Dissociative Fugue

Dissociative Fugue involving amnesia
and flight from the workplace or home;
may involve establishing a new identity in
a new location.
Dissociative Identity
Disorder

Dissociative Identity Disorder
(multiple personality) is the most dramatic
dissociative disorder. Although once
thought rare, many suggest that it is not
rare but under-diagnosed.
http://www.youtube.com/watch?v=d73YSNtdT3o
Stress Disorders

Stress Disorders result from the
brain’s attempt to cope with a
stressful situation. The process of
coping, forces changes in the brain’s
chemistry that create long term
effects.
– Stress disorders can be very debilitating
– The effects can cause permanent
damage to physical and emotional
systems
Acute Stress Disorder (ASD)

Acute Stress Disorder (ASD) Develops
in the first few days after a traumatic
incident.
Involves dissociative symptoms such as
“zoning out”, feeling numb or dazed,
detached or emotionally unresponsive,
recurrent images, thoughts and dreams;
“flashbacks”
2 days to 4 week duration
Post Traumatic Stress Disorder (PTSD)
Post Traumatic Stress Disorder (PTSD) Persists over
a period of time or occurs at least six months after
event.
 Triggers: Internal or external cues that cause
intense reactions or distress often taking the person
back to the original source of the stress and forcing
them to relive it (Flashbacks)

– Ironically the treatment is to talk about and revisit the
source of the stress over and over in one on one or group
therapy until the triggers no longer lead to the intense
reactions and flashbacks. Support groups are an important
part of this type of therapy.
– EMDR a promising new Therapy uses brain biology to
reprogram memories
http://www.youtube.com/watch?v=zBtqWrs2-K0&list=RDWFYeoPqjV28
PTSD in Children







Distancing themselves from physical contact
and relationships
Self-destructive behavior
amnesia or dissociation
Somatization panic=pain
Vivid nightmares and/or flashbacks
Depression/lack of affect
Difficulty in school/ability to concentrate
http://www.youtube.com/watch?v=WFYeoPqjV28&feature=related
PTSD in Children
Notes to Caregivers
 Look for behavioral signs:
–
–
–
–
–
–
–



Bed wetting
promiscuous behavior,
precocious understanding of sex,
pain / preoccupation with genitals
Vivid nightmares and/or flashbacks
Depression or flat affect
Drop in grades, unable to focus
Listen! Support, don’t react. Assure them that it is not
their fault and the adult was wrong. Report!
Be patient w/ physical contact and relationships
Provide alternatives for self-destructive behavior
http://www.youtube.com/watch?v=WFYeoPqjV28
Complex PTSD or Disorders of
Extreme Stress not Otherwise
Specified (DESNOS)






Difficulty with regulation of affect (emotion)
self destructive behavior
amnesia or dissociation
somatization –panic=pain
relationship issues
Depression
http://www.youtube.com/watch?v=zkqibQWCecc
http://www.youtube.com/watch?v=WFYeoPqjV28&feature=related

Sometimes disorders present with complex
combinations of symptoms
– In this example a woman with PTSD is
experience a dissociative response and
heading toward a panic attack as she tries to
cope with a flashback. Her therapist does an
great job of attempting to ground her in the
present and reintegrate her dissociation to
bring her back to the present
http://www.youtube.com/watch?v=k_8SX2GJiyQ&feature=related