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Anxiety, Somatoform, Dissociative and Stress Disorders Anxiety Disorders Journal Reflection Write about a time you were really nervous. What did it feel like? 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 and anxiety people experience. The behavior 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. . Obsessive Compulsive Disorder As Good As It Gets 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 Movie Notes: Sybil During the movie, you will be keeping track of Sybil’s personalities and their functions. See if you can figure out why/how each one developed. Name Behaviors Function 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