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Part II
Fun Facts
The phrase “mad as a hatter” became widely used
because hatmakers suffered from tremors, slurred
speech, and confusion. Scientists discovered that this
condition was caused by mercury-laden vapors
inhaled by the hatmakers while they worked on felt
In the United States, one person in seven will seek
help for a psychological disorder at some time
during his or her lifetime.
Fun Facts
In ancient times, Egyptians and Babylonians
believed that mental illness was due primarily to
evil spirits. Archaeologists frequently find evidence
of a practice known as terphining, which involved
drilling an opening in the skull to let evil spirits
Anxiety Disorders: post-traumatic stress
disorder (PTSD)
Post-traumatic stress
disorder is a type of
anxiety disorder. It can
occur after you've seen
or experienced a
traumatic event that
involved the threat of
injury or death.
Anxiety Disorders: post-traumatic stress
disorder (PTSD)
Post-traumatic stress disorder
(PTSD) may occur soon after a
major trauma, or it can be
delayed for more than 6
months after the event.
When it occurs soon after the
trauma, it usually gets better
after 3 months. However,
some people have a longerterm form of PTSD, which can
last for many years.
Anxiety Disorders: post-traumatic stress
disorder (PTSD)
PTSD can occur at any age and can
follow a natural disaster such as a flood
or fire, or events such as war, a prison
stay, assault, domestic abuse, or rape.
The terrorist attacks of September 11,
2001, in the United States may have
caused PTSD in some people who were
involved, in people who saw the disaster,
and in people who lost relatives and
These kinds of events can produce stress
in anyone, but not everyone develops
Anxiety Disorders: post-traumatic stress
disorder (PTSD)
The cause of PTSD is unknown, but
psychological, genetic, physical, and
social factors are involved.
PTSD changes the body’s response to
stress. It affects the stress hormones and
chemicals that carry information
between the nerves (neurotransmitters).
Having been exposed to trauma in the
past may increase the risk of PTSD.
Having good social support helps to
protect against PTSD.
In studies of Vietnam veterans, those
with strong support systems were less
likely to get PTSD than those without
social support.
Anxiety Disorders: post-traumatic stress
disorder (PTSD)
People with PTSD re-experience
the event again and again in at
least one of several ways.
They may have frightening dreams
and memories of the event, feel as
though they are going through the
experience again (flashbacks), or
become upset during anniversaries
of the event.
Symptoms of PTSD
Affective: anhedonia (inability to feel
positive emotions), emotional numbing
Behavioral: hypervigilance, passivity,
nightmares, flashbacks, exaggerated
startled response
Cognitive: Intrusive memories, inability
to concentrate, hyperarousal
Somatic: lower back pain, headaches,
stomach ache and digestion problems,
insomnia, regression in some children,
losing already acquired developmental
skills, such as speech or toilet training.
PTSD in a post-genocidal societies: the
case of Rwanda
In 1995, UNICEF conducted a survey of
3000 Rwandan children, aged 8-19
years. Of these:
95% had witnessed violence
80% had suffered a death in their
immediate family
62% had been threatened with death
Des Forges (1999) has argued that
eliminating Tutsi children was seen as a
critical dimension in eliminating the Tutsi
presence in Rwanda. Perhaps because
of this direct assault on children, one of
the key symptoms in Rwandan
adolescents is diminished expectations.
PTSD in a post-genocidal societies: the
case of Rwanda
Geltman and Stover (1997) have argued that
trauma occurs when a child cannot give
meaning to the dangerous experiences in the
presence of overwhelming arousal.
UNICEF Survey (1999) 60% of children
surveyed did not care if they grew up.
Dyregrov (2000) argues that the extent of loss
and trauma which affected all levels of society
throughout Rwanda may have rendered the
traditional coping mechanisms and collective
support less viable, and the whole adult
community less receptive to children’s needs, as
adults coped with their own traumas and grief.
According to UNICEF, in 1997 there were
65.000 families headed by children aged 12
years or younger. Over 300,000 children were
growing up in households without adults.
PTSD in a post-genocidal societies: the
case of Rwanda
Dyregrov found that living in the
community (rather than in centers)
was associated with higher rates
of intrusive memories. In addition
to the fact that living in community
where atrocities took place could
expose children to stimuli which
triggered memories of the
Etiology of PTSD:
Biological level of analysis
Hauff and Vaglum (1994) Twin
research has shown a possible
genetic predisposition for
Most biological research
focuses on the role of
noradrenaline, a
neurotransmitter which plays
an important role in emotional
arousal. High levels of
noradrenaline cause people to
express emotions more openly
than is normal
Etiology of PTSD:
Biological level of analysis
Geracioti (2001) found that
PTSD patients had higher levels
of noradrenaline than the
average. Also stimulating the
adrenal system in PTSD patients
induced a panic attack in 70%
of patients, and flashbacks in
40% of patients. No control
group members experienced
these symptoms.
Etiology of PTSD:
Cognitive level of analysis
Intrusive memories are memories
that come to consciousness
seemingly at random. Often they
are triggered by sounds, sights, or
smells related to the traumatic
Brewin et al. (1996) argue that the
flashbacks occurs as a result of cuedependent memory, where stimuli
similar to the original traumatic
event may trigger sensory and
emotional aspects of the memory,
thus causing panic.
Etiology of PTSD:
Cognitive level of analysis
Albert Rizzo developed a therapeutic
tool using virtual reality to treat PTSD
in veterans. In Virtual Iraq the
traumatized soldiers can reexperience
the horrors of the war and the
therapist can manipulate variables that
are relevant for each individual. This
therapy is based on the concept of
flooding (over-exposure to stressful
events), because the stress reactions
will eventually fade out (habituation).
In this way, the power of the cues that
trigger traumatic memories gradually
Etiology of PTSD:
Cognitive level of analysis
Development of PTSD is associated with a
tendency to take personal responsibility
for failures and to cope with stress by
focusing on the emotion, rather than the
Sutker et at. (1995) found that Gulf War
veterans who had a sense of purpose and
commitment to the military had less chance
of suffering from PTSD than other
Cognitive theorists have also found that
victims of child abuse who are able to see
that the abuse was not their fault, but a
problem within the perpetrator, are able
to overcome symptoms of PTSD.
Etiology of PTSD:
Sociocultural level of analysis
Research suggests that experiences
with racism and oppression are
predisposing factors for PTSD.
Roysircar (2000) cites research that
among Vietnam War veterans,
20.6% of black and 27.6% of
Hispanic veterans met the criteria for
a current diagnosis of PTSD,
compared to 13% of white veterans.
Silva (2000) children may develop
PTSD by observing domestic violence.
Etiology of PTSD:
Cultural considerations in PTSD
Often, non-western survivors
exhibit what are called body
memory symptoms.
 Example:
Hanscom (2001) the
dizziness experienced by a
woman which was found to be
a body memory of her
repeated experience of being
forced to drink large amounts
of alcohol and then being
Etiology of PTSD:
Gender considerations in PTSD
Breslau et al. (1991) study of
1007 young adults who had been
exposed to community violence
and found a prevalence rate of
11.3% in women and 6% in men.
Horowitz et al. (1995) reviewed a
number of studies and found that
women have a risk up to 5 times
greater than males to develop
PTSD after a violent or traumatic
Etiology of PTSD:
Gender considerations in PTSD
Symptoms of PTSD vary in gender.
Men are more likely to suffer form irritability and
impulsiveness. They are also more likely to suffer
from substance abuse disorders.
where women likely suffer from numbing and
avoidance. They also more likely to suffer from
anxiety and affective disorders.
Rape carries one of the highest risks for
producing PTSD. Other forms of sexual abuse
and interpersonal violence are also more often
followed by PTSD than, for example, accidents
or natural disasters.
Achencach (1991) Males are more likely to
externalize symptoms (e.g. delinquency,
aggression) and girls are more likely to
internalize symptoms (e.g. depression, anxiety).