CLP 3144 Chapter 5: Chapter 5 Textbook Notes: Trauma, Anxiety, Obsessive-Compulsive and Related Disorders

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Chapter 5 Textbook Notes: Trauma, Anxiety,
Obsessive-Compulsive and Related Disorders
Fear is adaptive when it is realistic, when it is in proportion to the threat, if it subsides when the
threat has passed, and if it leads to appropriate behaviors to overcome that threat.
Fear becomes anxiety when it persists long after the threat has subsided and when a person
engages in maladaptive behaviors in response to a threat
Over evolutionary history, humans have developed fight-or-flight response: a set of physical
and psychological responses that help us fight a threat or flee from it
Physiological response of fight or flight (aka anxiety):
The hypothalamus activates the sympathetic division of the autonomic nervous system
Heart rate, blood pressure, and breathing rate increase
The body secretes endorphins
The hypothalamus activates the adrenal-cortical system by releasing corticotropin
release factor, which signals the pituitary gland to secrete ACTH which then leads to the
secretion of cortisol
After the threat has passed, the hippocampus turns off this physiological cascade
Cortisol: hormone related to stress; released by adrenal glands
Anxiety is the vague sense of danger that you are unable to pinpoint; shares some of the same
features as fear
Anxiety is useful when there is a real danger (driving during a storm) but other times it is
maladaptive and interferes with how you are able to function in society
Anxiety disorder: people whose fear tends to persist longer than what is natural
Other responses to a threat:
Emotionally, experience terror and dread; often restless and irritable
cognitively , we are on the lookout for danger
Behaviorally, we seek to confront the threat or escape from it
In anxiety disorders, these responses persist in the absence of any objective threat
Anxiety is part of many disorders; most people with serious depression report bouts of anxiety
Many people who abuse alcohol and other drugs do so to dampen their anxiety
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Posttraumatic Stress Disorder and Acute Stress Disorder
Posttraumatic stress disorder (PTSD) and acute stress disorder are by definition the
consequences of experiencing extreme stressors (aka traumas) that persist to long after the
event
Trauma: events in which the individuals are exposed to actual or threatened death, serious
injury, or sexual violation
DSM requires that individuals either directly experience or witness the event, learn that the
event happened to someone they are close to, or experience repeated/ extreme exposure to
trauma
For some, the symptoms can be mild to moderate, permitting normal functioning but for others,
the symptoms can be immobilizing
A diagnosis of PTSD requires the presence of four types of symptoms:
Repeated re experiencing of the traumatic event (such as recurring nightmares,
flashbacks, intrusive images or thoughts)
Persistent avoidance of situations, thoughts, or memories associated with the trauma
Negative changes in thought and mood associated with the event; may have survivor
guilt about having lived through the event
Ex. reduced responsiveness to environment (detached from environment; can be
social or emotional)
Hypervigilance and chronic arousal
Constantly being on edge, which could cause a flashback; constantly being
aware of their surroundings
Survivor guilt: often associated with acts of terrorism or war; people begin to question why they
survived instead of the other people
Many people with PTSD experience some symptoms of dissociation: a process in which
different facets of their sense of self, memories, or consciousness become disconnected from
one another
Those with prominent dissociative symptoms can be diagnosed with a subtype PTSD with
prominent dissociative symptoms
Dissociation: feeling disconnected from yourself, environment or other people
Derealization: don't feel like they are part of their environment
Acute stress disorder: occurs in response to traumas similar to those involved in PTSD but is
diagnosed when symptoms arise within 1 month of exposure to the stressor and lasts no longer
than 4 weeks; sort of a segway into PTSD usually comes before full blown PTSD
Short term response to trauma but more likely to continue to experience symptoms over time
Similar to PTSD; people can have these symptoms
Numbing or detachment
Reduced awareness of surroundings
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Derealization
Depersonalization
An inability to recall important aspects of the trauma
At high risk for experiencing posttraumatic stress symptoms for many months
Adjustment disorder: consists of emotional and behavioral symptoms (depressive or anxiety
symptoms, and/or antisocial behaviors) that arise within 3 months of the experience of a
stressor
Stressors that lead to this disorder can be of any severity; people who are experiencing
emotional and behavioral symptoms following a stressor who do not meet the criteria for PTSD
or any other anxiety disorder
Typically anxiety or depressive symptoms
No bar for severity of stressor
Less severe than acute stress disorder and PTSD; can be found in college student (home
sickness)
Traumas Leading to PTSD
Are usually common things:
Natural disasters (floods, earthquakes, tsunamis, fires, hurricanes, and tornadoes)
Human made disasters (war, terrorist attacks, and torture)
Ex. BP oil spill;
Sexual assault is the trauma most commonly associated with PTSD
One of the leading causes of PTSD
Traumatic events
War? WWI: combat fatigue WWII: shell shock
Search and rescue personnel who responded in the hours and days just after the disaster are at
a significant risk for PTSD
PTSD became widely recognized after the Vietnam War
Women are more likely than men to develop PTSD (almost 2xs as likely maybe)
Theories of PTSD
Environmental and Social Factors
Strong predictors of people’s reactions to trauma include its severity and duration and the
individual's proximity to it
Ex. people who experience more severe and longer-lasting traumas & are directly affected by a
traumatic event are more prone to developing PTSD
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