ABNORMAL PSYCHOLOGY: PSYCHOLOGICAL DISORDERS 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 hats.  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 escape.

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 longer- term 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 friends. These kinds of events can produce stress in anyone, but not everyone develops PTSD.

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 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 genocide.

Etiology of PTSD: Biological level of analysis  Hauff and Vaglum (1994) Twin research has shown a possible genetic predisposition for PTSD.  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 event. Brewin et al. (1996) argue that the flashbacks occurs as a result of cue- dependent 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 diminishes.

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 problem. 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 veterans. 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 raped.

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 event.

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).