 Abnormal Psychology BY MADDIE PERRETT

Anxiety Disorders: PTSD  PTSD lasts for more than 30 days  Develops in response to a specific stressor  Characterised by intrusive memories of a traumatic event, emotional withdrawal, heightened autonomic arousal  Results in insomnia, hypervilgilance, or loss of control over anger and aggressive behavior  Decreased interest in others and a sense of estrangement.  Inability to feel positive emotions – called anhedonia.

Prevalence  US prevalence rate  1-3%  Lifetime prevalence of 5% in men and 10% in women (est.)  15-24% (est.) of individuals exposed to traumatic events develop PTSD symptoms  Communities exposed to traumatic events, average prevalence increases to 9%  Most frequent trauma that triggers PTSD is the loss of a loved one, one-third of all cases

Symptoms  AFFECTIVE : Anhedonia; emotional numbing  BEHAVIOURAL : hypervigilance; passivity; nightmares; flashbacks; exaggerated startle 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 speed or toliet training.

STUDY: PTSD IN POST-GENOCIDAL SOCITIES: RWANDA  Conducted soon after the genocide  Continued to live in the communites where the atrocities had taken place  1995  UNICEF survey of 3000 Rwandan children (8-19 years old)  95% participants had witnessed violence, 80% suffered a death in immediate family, 62% had been threatened with death  1997  65,000 families headed by children aged 12 or younger  Over 300,000 children were growing up in households without adults  Those living in the community higher rates of intrusive memories  Exposed to stimuli that triggered memories

Etiology of PTSD BLOA  Twin research has shown a possible genetic predisposition. Role of noradrenaline – neurotransmitter plays a role in emotional arousal High levels of noradrenaline cause people to express emotions more openly PTSD patients have higher levels of noradrenaline Stimulating the adrenal system in PTSD patients induced a panic attack in 70% of patients and flashbacks in 40% No control group members experience these symptoms Evidence of increased sensitivity of noradrealine receptors in patients

Etiology of PTSD CLOA  How individual cognitions could make a difference to people who develop PTSD Differences in the way individuals process experiences and attributional styles Lack of control over their lives, world is unpredictable (PTSD patients) Often experience guilt regarding the trauma Instrusive memories seem random : triggered by sounds, sights, smells Cue-dependent memory where stimuli trigger aspects of the memory, causing panic Flooding (over-exposure to stressful events) – eventually fade out due to habituation. Schema processing suggest in depression Holocaust survivors have decreased trust levels More skeptical view of the world

Etiology SCLOA  Racism and oppression are predisposing factors for PTSD Meta-analysis of Vietnam War Veterans – 20.6% Black, 27.6% Hispanic met criteria for PTSD compared to 13% White Threat of death factor evidencing the strongest influence on intrusive thoughts and avoidance of behaviour 1998 in Bosnia – 73% girls and 35% boys suffered symptoms of PTSD Girls is higher because of fear of rape Children may develop PTSD by observing domestic violence

CULTURAL CONSIDERATIONS Common for survivors to initiate treatment with someone due to somatic complaints DSM somatic symptoms of PTSD are atypical Irrational and ethnocentric to assume non-western forms of this disorder are atypical Non-western survivors exhibit what are called body memory symptoms E.g. dizziness experience by a woman which was found be a body memory of her repeated experience of being forced to drink large amounts of alcohol and then being raped.

GENDER CONSIDERATONS  Significant gender difference  Breslau et al longitudinal study of 1007 young adults exposed to community of violence found a prevalence rate of 11.3% in women and 6% in men  Women have up to a 5 times greater chance than males to develop PTSD  Symptoms differ: Men irritability, impulsiveness and Women  numbing, avoidance  Men  Substance abuse disorders  Women  Anxiety and affective disorders  Different traumas carry different risks  Rape is experienced more often by women and rape carries on of the highest risks of producing PTSD  Socialization differences – leads girls to internalize their problems and boys to externalize them.

Eating Disorders: Bulimia  2-3% of women and % of men in US (Diagnosed)  Female:male is approx 10:1  Binge eating is the most common eating disorder and it affects 2 % of adults  Similar rates found in Japan and some European countries  More than 5 million individuals are believed to experience an eating disorder in the USA alone.  Bulimia involves a preoccupation with eating, an idealisation of thinness and a fear of becoming fat.  Late teens or early twenties

Symptoms AFFECTIVE: feelings of inadequacy, guilt or shame BEHAVIOURAL: recurrent epsiodes of binge eating; use of vomiting, laxatives, exercise or dieting to control weight COGNITIVE: negative self-image; poor body image, tendency to perceive events as more stressful than most people would, perfectionism SOMATIC: swollen salivary glands, erosion of tooth enamel, stomach or intestinal problems and in extreme cases heart problems

Etiology  BLOA   Twin research shows some support for a genetic diathesis for eating disorders, still in early stages  Highly secretive nature of bulimia, self-reporting has not always led to reliable data.  First degree relatives of women with bulimia are 10 times more likely than average to develop the disorder.  Serotonin plays a role  Increased serotonin stimulate the medial hypothalamus and decrease food itake.  Carraso (2000) found lower levels of serotonin

Etiology  CLOA   Body-image distortion hypothesis – delusion that people think they’re fat  Overestimate body size  Some patients reflect their emotional appraisal rather than their perceptual experience  Uncertain about size and shape of their body, when compelled to make a judgment they err on the side of reporting an overestimation  Gender indifference in the perception  Cognitive disinhibition – dichotomous thinking – an all-or-nothing approach  Thoughts about eating (cognitions) act to release all dietary restrictions (disinhibition)

Etiology  SCLOA   Perfect body figure has changed over the years in the West  1950s female sex symbols had much larger bodies compared with those today  More rounded figure has been considered ideal suggests that the current position might be open to change.  People constantly compare themselves to other people and their self-esteem is affected by this  Media portrays the ‘ideal person’  Women are more likely than men or children to be the target for the media propaganda  Distorted ideas about what is normal and acceptable mean that many children become dissatisfied  Men too are now under pressure. Ideal ‘worked-out’ male figure appears in many commercials.  Produces strong demand to the mirror the idea.

GENDER  Men selected similar figures to themselves  Women chose ideal and attractive body shapes, much thinner  Women chose thinner in all choices