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Panic Disorder / PD With Agoraphobia Agoraphobia Specific Phobias Social Phobia (social anxiety disorder) Generalized Anxiety Disorder Obsessive Compulsive Disorder Trauma and Stressor-Related Disorders– now in own category in DSM-5 Clinical Description Exposure to Traumatic Events War and Combat Rape and Assault Car Accidents Natural Disasters IPV and child neglect/abuse Symptom Clusters 1. Persistent re-experiencing/intrusions of event A. Intrusive memories of the event Ex.______________________ B. Recurrent, distressing dreams/nightmares C. Dissociative states; flashbacks D. Psychological distress at exposure to events that symbolize or resemble an aspect of the trauma. Ex. Anniversary dates. Symptom Clusters 2. Avoidance of stimuli associated with event or numbing of responsiveness A. Deliberate efforts to avoid thoughts or feelings B. Deliberate efforts to avoid activities/ situations that are reminders about event C. Psychogenic amnesia (all or part of event) D. Feeling detached from others; “numbing”; unable to have loving feelings Symptom Clusters 3. Symptoms of increased arousal A. Sleep problems B. Irritability or outbursts of anger C. Problems concentrating D. Hypervigilence E. Exaggerated startle response F. Physical reactivity to events similar to trauma Ex. person sexually assaulted in an elevator sweats when entering elevator * survivor guilt Subtypes Acute Stress Disorder < 1 month PTSD > 1 month Delayed Onset Symptoms Begin > 6 Months after event What qualifies as a traumatic experience? A. Person variables -predisposing factors (ex. prior trauma) -specific experience during events -person’s evaluation during & after event B. Stimulus properties of event: ex. manmade or natural; type of exposure C. Characteristics of post trauma environment (e.g., supportive or not) Facts and Statistics Occurs in ____% of Population; ____% lifetime Most Common Traumas? Trauma Event is Necessary, not Sufficient Severity of Event & Response Seems Important Runs a Chronic Course Causes Only Disorder With ________________ Biological Vulnerability Prior Experience With Events That are... Uncontrollable and Unpredictable Severity of Trauma and One’s Reaction _________________________ Social Support / Acceptance Helps Psychological Interventions - Ensure Safety and Teach Coping Skills - Face the Original Trauma - Is it Necessary? Imaginal Reexposure - Telling the story – remembrance & mourning - Arrange for Corrective Emotional Learning - Problem of Secondary Gain Disability and Compensation Pharmacological Interventions ________________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________