1. Abnormal Psychology & Therapy
By: Olivia, Carol, and Erin

2. Abnormal Behavior
Behavior that is deviant, maladaptive, or personally distressful over a relatively long period of time
Deviant: When behavior deviates from what is acceptable, it is often considered abnormal
Maladaptive: Interferes with a persons ability to function effectively in the world
Personal distress: The person engaging in behavior finds it troubling

3. The biological approach
Internal causes
Medical model: The view that psychological disorders are medical diseases with a biological origin.
Abnormalities=mental illness
Afflicted individual=patient
Treated by=doctors

4. The psychological approach
Contributions of experiences, thoughts, emotions, and personality characteristics in explaining psychological disorders

5. The sociocultural approach
Emphasizes the social contexts in which a person lives, including the individuals gender, ethnicity, socioeconomic status, family relationships, and culture.
Low income minority neighborhoods have the highest rate of psychological disorders
Living conditions can contribute to psychological disorders

6. The Biopsychosocial model
Can be influenced by genes, childhood experiences, and gender
Not everyone develops disorder
Not one factor more important than another

7. Classifying abnormal behavior
Classifying psychological disorders provides a common basis for communicating
Can help make predictions about how likely it is that a particular order will occur, which individuals are most susceptible to it, how the disorder progresses, and what the prognosis for treatment is

8. The DSM-IV classification system
Published in 1952, the first major classification of psychological disorders
The diagnostic and statistical manual of mental disorders
The number of diagnosable disorders has increased dramatically
Classifies individuals on the basis of 5 dimensions
Axis I: All diagnostic categories except personality disorders and mental retardation
Axis II: Personality disorders and mental retardation
Axis III: General medical conditions
Axis IV: Psychosocial and environmental problems
Axis V: Current level of functioning

9. Critiques of the DSM-IV
The manual classifies individuals based on their symptoms
It focuses strictly on pathology and problems
Emphasizing strengths as well as weaknesses might help to destigmatize labels
People-first language- professionals use this to avoid labels

10. Personality Disorders
Psychological disorders characterized by guiltlessness, law-breaking, exploitation of others, irresponsibility, and deceit
Recognized Personality Disorders Include:
Paranoid Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder
Antisocial Personality Disorder
Borderline Personality Disorder
Histrionic Personality Disorder
Narcissistic Personality Disorder
Avoidant Personality Disorder
Dependent Personality Disorder
Obsessive-Compulsive Personality Disorder

11. Antisocial Personality Disorder
A psychological disorder characterized by guiltlessness, law-breaking, exploitation of others, irresponsibility, and deceit

12. Antisocial Personality Disorder (ASPD)
Diagnosis:
typically not diagnosed unless a person has shown antisocial behavior before the age of 15
Biological Factors:
low levels of activation in the prefrontal cortex
Symptoms:
low levels of stress in aversive circumstances, including punishment
lack of empathy
constant rule-breaking
Psychopaths: a subgroup of people with ASPD who engage in violence to get what they want

13. Treatments
psychotherapy- helps the individual understand the causes and the consequences of their disorder, helps individuals to restrain their antisocial behavior
cognitive therapy- helps them to understand their skewed perception of the world and how it leads them to their choices; unwilling participants will not benefit
prison- sometimes the best way to treat and contain people with ASPD is to incarcerate them

14. Case Study: Theodore Bundy
Ted Bundy was born in 1946 and grew up in Washington.
Growing up, he had trouble socializing, but did not experience many behavioral problems.
He committed his first documented murder in 1974.
Bundy used his attractive looks and charming personality to gain the help of women.
When he was sentenced to death, he admitted to 23 murders
Bundy was later classified as a psychopath.

15. Borderline Personality Disorder
A psychological disorder characterized by a pervasive pattern of instability in interpersonal relationships, self-image, and emotions, and of marked impulsivity beginning in early adulthood and present in a variety of contexts

16. Borderline Personality Disorder (BPD)
Biological Factors:
heritability is about 40%
Cognitive Factors:
tendency to hold a set of irrational beliefs
thinking that one is powerless and unacceptable
hypervigilance (constantly being alert and looking for threatening information)
Causes:
traumatic childhood experiences could be to blame
women are more likely to have BPD

17. BPD Treatments
psychotherapy- allows those with BPD to learn new coping skills, and emotion regulation
hospitalization- hospitalization is often an immediate answer to crisis management for people with BPD
antipsychotic or neuroleptic drugs- may be appropriate for treatment, but are not usually essential

18. Case Study: Jerry
Confessions of a man suffering from Borderline Personality Disorder - my story:
I am a 44 year-old, divorced white male, single full-time father of two, with a master's degree and a professional job, and I suffer from borderline personality disorder. Since I like to blog about what is going on with me, my therapist suggested that I try to share my experiences with others to try to help them understand what is going on inside a person with BPD, and this would help me understand my own disorder. So, I created a blog entitled Confession of a man suffering from BPD. Here is my story:
My father left when I was four years old, and married another woman while still married to my mother. Up until he left when I was four years old, my dad was my best friend. As my mother and I pulled out of the driveway to go visit my grandparents one day, my dad promised that he would pick me up. But, he never did.
My stepfather, who my mother married when I was nine, was an abusive, control freak... He emotionally abused me partly by controlling every little aspect of my life, and of course I never did anything good enough, and partly by always telling me that I would never amount to crap on an almost daily basis.
Since I left home at age 17, I have been through 5 marriages and numerous committed relationships. I ended each and every relationship, and no matter how good the relationship was. I loved them all deeply at first. I then came to despise them, but I wanted them to love me.
I am an exceptionally impulsive individual. I jump in and out of relationships. If I WANT to do or say something, I typically do or say it without any regard for the consequences. If I have something on my mind, it controls and engulfs me until I act upon it; I get no relief until I do.
It is like I push the limits of all relationships; lovers, friends, and co-workers/employers. I thrive on the drama of it all. After reeling people in, I want them to feel sorry for me and work to try to make me happy. I want them to stop worrying about their problems and/or responsibilities and concentrate on me. However, I am actually sabotaging these relationships because there is only so much people can take.
I go for the online dating thing when a relationship ends. I really don't have the desire for sex. For me, this is some kind of compulsive behavior were I try to seek the affection and, hence, validation from someone else.
Although my children live with me, I absolutely despise being alone and having no adult female around that loves me. However, I view everyone I know as either all good or all evil. When they do something good, I love them; when they do something I think is bad, I see them as evil, and I hold a grudge. At the same time, I trust no one. I feel like everyone has an ulterior motive. And, the thing I hate the most is being criticized because I try to do everything right.
When things don't go as planned or I am interrupted in my thought process, I have bouts of inappropriate anger....I have gone off on my kids to the point that I scared the crap out of them. To this day, even as teens, do pretty much everything I say without question. This attitude came about because they wanted peace and my love and this is the price they pay for it.
I also experience mood swings. One minute I am happy or content. The next minute I am depressed or mad. It is like I am bored with contentment and I seek excitement whether it is positive or negative. I also flee stressful situations.
Finally, I have no clue as to who or what I am and I experience intense feeling of emptiness. I feel like I am just faking it as I go through life. I have experimented with many lifestyles, and still don't know who or what I really am.
I hope my sharing can be of help to all of us. Please do not take anything that I may say personally.

19. Personality Disorder Sources

20. Schizophrenia
Schizophrenia is a severe psychological disorder characterized by highly disordered thought processes, referred to as psychotic because they are so far removed from reality.

21. Symptoms of schizophrenia
Positive symptoms:
They reflect something added above and beyond normal behavior
Hallucinations: sensory experiences in the absence of real stimuli.
Usually auditory or visual
Seeing things that aren't there
Delusions: false, unusual, and sometimes magical beliefs that are not part of an individual’s culture
Might think they are Jesus or Muhammad
Might seem completely illogical to outsider but are experienced as all too real
Thought disorders
Unusual thought process
Thoughts are disorganzied and confused
Dont make sense when they talk or write
Referential thinking: Ascribing personal thinking to completely random events
EX: Traffic light turned red because they were in a hurry
Disorders of movement
May show unusual mannerisms, body movements, and facial expressions.
Repeat certain motions over and over
Catatonia: State of immobility and unresponsiveness lasting for long periods of time

22. Symptoms of schizophrenia
Negative Symptoms:
They reflect social withdrawal, behavioral deficits, and the loss or decrease of normal functions.
Might lack in ability to read the emotions of others
Lack of positive emotional experience
Show deficient ability to plan, initiate, and engage in goal directed behavior
Flat Affect
The display of little or no emotion
Common
Cognitive Symptoms:
Difficulty sustaining attention
Problems holding info in memory
Inability to interpret info and make decisions
Often only detected through neuropsychological tests

23. Causes of schizophrenia
Biological factors:
Heredity
Research shows that disease is partially caused by genetic factors
Risk of developing it increases as genetic similarity to a person with it increases
Looking to pinpoint a chromosomal location of genes
Structural Brain Abnormalities
Studies show enlarged ventricles in their brain
They are fluid filled spaces
Enlargement indicates deterioration in other brain tissue
Small prefrontal cortex and lower activity in this area
Small differences in brain between normal and schizophrenic
Small changes in distribution of brain cells
Not accompanied by glial cells
Problems in prenatal development
Psychological Factors
Stress may contribute
Diathesis-stress model: View of schizophrenia emphasizing that a combination of biogenetic disposition and stress causes the disorder
Sociocultural Factors
Not a cause but affect the course of disorder; influence how schizophrenia progresses
Individuals in developing non industrialized nations have a better outcome than those in developed industrialized nations
Family and friends are more accepting
Marriage, supportive friends and employment are related to better outcomes

24. Causes of schizophrenia
The association of genes with Schizophrenia

25. Case Study
My son, was diagnosed as a paranoid/disorganized schizophrenic in Sept of The first signs we saw were:
1. He wouldn't eat, everything tasted "funny" or he thought I was putting something in the food to make it taste "funny". He wouldn't even eat McDonalds food, which he always loved. Below are the the first signs that we saw over a month period, before he received treatment.
2. He lost 50 lbs during this time (6 - 7 months). I took him to our family doctor who did a series of tests, including a drug test, all came back negative. (Started in Jan 95)
3. He then started to zone out for long periods of time (1 - 2 hours). He wouldn't blink very often or change his expression. I would ask him if anything was wrong and he'd just shake his head no. He then started to laugh during these times for no reason.(Started in May 95)
4. He would sit and stare at his hands for hours, when I would ask him what was wrong with his hands, he would say they are different then they use to be.
5. During this entire period, his grades in school went from C's - D's to all F's. The school
would call and say he would get up and walk out of class and just roam the halls.
6. Starting in June 95, he started getting very aggressive, talking to himself and laughing in his room. He would get very upset and run out of his room, down the stairs and outside. He started doing this everyday. It started really going down hill from there.
7. He would never say he was hearing voices, but it was very apparent he was. God told him what numbers to play for the lottery, if I bought a ticket I would win millions. He heard other voices, I would hear him talking to them.
8. He started talking in a language we did not understand, after research I found these to be called "word salads". He would call me by a name that no one understood, he said I was from a different planet sent here to kill him. He told his siblings they were from his planet and they were here to protect him from me. He would come out of his room, scream at all of us in the foreign language, and tell us we all were going to die. 6. Would no longer watch T.V., just listened to Pink Floyd "The Wall" over and over again.
In fact he broke his cd player by doing this.
9. Paced constantly or do just the opposite not get out of bed for hours during the day. (he would not sleep at night)
8. Started to hallucinate. The walls had bugs on them, we all looked different, my eye brows were pointed upward and my ears had grown. He said things were moving when they were not. During this time I was totally freaking out.

26. Treatments for schizophrenia
Medication- antipsychotics
electroconvulsive therapy
family psychoeducation
assertive community treatment
cognitive behavioral therapy

27. Reference page http://www.wimp.com/schizophrenicsymptoms/
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28. Anxiety Disorders
A psychological disorder involving fears that are uncontrollable, disproportionate to the actual danger the person might be in, and disruptive of ordinary life.

29. Are Psychological Disorders a Myth?
No. Psychological disorders are caused by genetic, biological, and environmental factors. Many people do recover from the disorders with the right kind of help.The vast majority of people with mental health problems are no more likely to be violent than anyone else. Most people with mental illness are not violent and only 3%-5% of violent acts can be attributed to individuals living with a serious mental illness.

30. Generalized Anxiety Disorder (GAD)
Definition: A psychological disorder marked by persistent anxiety for at least six months and in which the individual is unable to specify the reasons for anxiety.
Symptoms
Nervous almost all of the time
Worry about work, relationships, and health
This worry can cause fatigue, muscle tension, stomach problems, and difficulty sleeping
Causes
Genetic predisposition
Deficiency in the neurotransmitter GABA
Sympathetic nervous system activity
Respiratory system abnormalities

31. Generalized Anxiety Disorder (GAD)
Psychological and Sociocultural factors
Harsh or almost impossible self-standards
Overly strict and critical parents
Automatic negative thoughts when feeling stressed
History of uncontrollable traumas or stressors (such as an abusive parent)
Treatment:
Medication
Psychological counseling
Making lifestyle changes
Learning coping skills and relaxation techniques
Video:

32. GAD Case Study
Joe, 47 years old, 20 years in the ADF, deployments to Bougainville, the Solomons, and East Timor
The fact is, I’ve always been a worrier, ever since I was a kid. I’d worry about my family and my Mum and Dad (they used to fight a bit). I worried about whether there’d be enough money for me to finish school. I worried about my health – every time I had an ache or pain I was sure I was going to die. I worried about school work, parties, friends. Pretty much everything – you name it, I worried about it. And when I worried I’d get all tense, my stomach would churn, sometimes I’d even break out in a sweat.
Joining the army was good for me. I started to worry less – maybe because the army looked after most things in my life and made the decisions for me. I had some good mates and I was pretty good at my job, so my confidence lifted. I still got worried and anxious, of course, but nowhere near as bad. When I turned 45 I decided it was time to get out – quit while I still had a chance of a job on civvy street. And that’s when it all got worse again. As soon as I traded in my cams for a suit, the worries came back as bad as they ever were. What if I couldn’t find a job? And if I did, what if I was no good at it? What if I can’t support the wife and kids? What if I get sick? What if I run out of money? What if…..what if…..what if? It got to the point where I felt physically sick most of the time – tummy upsets, diarrhoea, pains in my neck and shoulders, headaches.
Taking action
It was really my wife who pushed me into getting some help. I found out that she’d been seeing a mental health social worker because she was worried about the kids. She told me I was making life miserable for her and the kids, that no-one was having fun with me around since I left the army. That was a real shock – I was so absorbed in my own little world of worry that I didn’t think about how it affected them. So I plucked up the courage to go and talk to our family doctor. God, that was hard. I felt like such an idiot, like I was weak and pathetic. I even cried a bit while I was telling him about it. But he was really understanding. He said he thought I had something called “generalised anxiety disorder” or GAD (an unnecessarily big name for worry, if you ask me). He gave me some tablets. I didn’t really want to take them – I thought they’d mess with my mind – but he said they were just for the short term, just for a few weeks to help me get back on my feet. He said if I wanted to beat this thing, I’d have to get some specialist help.
He sent me off to see a psychologist. Thank God my old army mates weren’t there to see me going into the shrink’s office! Still, the psychologist was really good, not at all what I’d expected. She listened carefully, asked me lots of questions, got me to fill in a few questionnaires. She thought the doctor was right, I did have GAD, and she explained how I could get on top of it.
That was three months ago. I’ve seen her about 10 times. First, she taught me how to control the physical side of my worry. We tried a few things, but I found the breathing exercises most helpful. Then she showed me how the way I think is the real cause of my worry – I’m always predicting the worst – and we’ve been working together on coming up with strategies to deal with it. And she made me get out and enjoy myself; now I’m exercising a couple of times a week, seeing old mates, and spending quality time with the family. I’ve still got a fair way to go, but I really feel I’m making progress. I’m definitely worrying much less and the family have noticed. They reckon I’m much better. My daughter gave me a big hug the other day and told me how good it was to have her old Dad back.

33. Panic Disorder
Definition: An anxiety disorder in which the individual experiences recurrent, or sudden onsets of intense apprehension or terror, often without warning and no specific cause.
Symptoms
Can produce severe palpitations, extreme shortness of breath, chest pains, trembling, sweating, dizziness, feelings of helplessness
Fear that they will
Die
Go crazy
Do something they cannot control
Some may feel like they are having a heart attack
Causes
Genetic predisposition
Autonomic nervous system that is overly active
Problems with either or both neurotransmitters
Norepinephrine
GABA

34. Panic Disorder
American women are twice as likely as American men to have panic attacks
May be due to biological differences in hormones and neurotransmitters
Treatment:
Cognitive Behavioral Therapy
Medication
Video:

35. Panic Disorder Case Study
Sue, 30 years old, recently left the RAN after ten years of active service
I remember my first panic attack like it was yesterday. I guess I’d always been an anxious type, but this was like nothing I’d ever experienced. I was at a football game about six years ago, big crowd, St Kilda getting hammered by the Pies. I think I was a bit edgy – I’ve never liked being hemmed in, stuck somewhere I couldn’t get out of easily. Then suddenly this thing just took me over. I got these pains in my chest and I couldn’t breathe. I was sure I was having a heart attack and was going to die. I was thinking about my daughter – she was two at the time – and thinking it can’t end like this, I’ve got to see her again. I was sweating, heart racing, trembling….I had to get out of there. I managed to push my way through the crowd and I saw a St John’s ambo. What a relief. He helped me to the ambulance and they took me straight to hospital, wired me up to all sorts of machines and then…..they told me there was nothing wrong, that it was all in my head. All in my head? Those pains were real, I can tell you. All they said was that I’d had a panic attack, and I was so happy to be alive, I didn’t ask them more about it. I just wanted to get home. But since then, my life has changed. I only went back to sea once (my skills are needed more on shore than at sea, thank God) but that was terrifying. I spent the whole time worrying about whether I’d have an attack while we were far from land and I avoided being below decks whenever I could. Since the first time, I’ve had about a dozen attacks and each one was terrifying. I’ve stopped going anywhere that I can’t get out of easily in case I have another one. No shopping centres. No cinemas. No football games. No public transport. No crowded places. I left the navy because I couldn’t face going to sea again.
Taking action
A month ago it came to a head, my daughter’s 8th birthday. She wanted me to take her and a couple of friends into the city on the train to see a movie. I told her I couldn’t and got angry with her – poor kid. Then I had a big fight with my husband. After we’d all had a bit of a cry I decided I had to do something about it. I went along to see our GP – he told me I had panic disorder (which I guess I already knew) and something called agoraphobia. That’s the part where I won’t go anywhere in case I have an attack. He gave me a script for some tablets and a referral to see a psychologist. I managed to get in to see her and the first thing she told me was to only take the tablets when I absolutely had to. That annoyed me – one doctor tells you one thing, another tells you something else. But the more she explained what was happening, the more it made sense. The tablets help to stop the attacks when they’re happening, but they don’t do anything to prevent another one. She says I can only learn how to control them if I let myself risk having one.
I think we’re on the right track. We’ve spent a lot of time talking about my breathing. She says I’m “hyperventilating”, that my body is getting ready for fight or flight when there’s no danger there. I’ve been practicing the exercises she gave me and I really do feel more in control. The next step is to start getting back to do the things I’ve been avoiding. That’s very scary, but she says I can do it in small steps. And she’s started to talk about how my thoughts play a part.
I’m a long way from being cured, but I feel much more confident now. My husband says I’m much better. And I’m going to take my daughter to the city on her 9th birthday for sure.

36. Phobic Disorder or Phobia
Definition: Anxiety disorder characterized by an irrational, overwhelming, persistent fear of a particular object or situation.
A fear becomes a phobia when a situation is so dreaded that an individual goes to almost any length to avoid it
With anxiety disorders, phobias are fears that are uncontrollable, disproportionate, and disruptive
Phobias usually begin in childhood
There is a neural circuit for social phobias that include the thalamus, amygdala, and the cerebral cortex
A number of neurotransmitters may be involved in social phobias
Serotonin is the main one
Many theorists consider phobias to be learned fears

37. Phobic Disorder or Phobia
Treatment:
Face your fears one step at a time
Relaxation techniques
Challenge negative thoughts
Video:

38. Phobic Disorder or Phobia Case Study
“Looking back on it, it seems as if I always had a sense of anxiety whenever I was in a crowd,” says the 32 year old airline attendant. “But it wasn’t until I had my first panic attack and sought the advice of a counselor that I was able to say what it was.”
Anne had a panic attack one day after a flight. She started the attack when the plane was airborne and went to a doctor as soon as it touched down. She thought she was having heart attack symptoms, but also felt she was a bit too young for such a thing to happen. She was diagnosed as having an anxiety attack and given anti-depressants along with Xanax. The Xanax made her groggy and she did not feel that she needed to follow up with this. Until the attack recurred. It was then that she sought treatment and was diagnosed with Social Anxiety.
Anne is typical of many people who are diagnosed with social anxiety in that she chose a profession where she would interact with people. Most people who suffer from this condition also work in professions where they frequently interact with the public. Anne began the medication and sought therapy with the counselor that enabled her to cope with her condition. She thinks that it resulted from her being picked on in school when she was very young.
“I was smaller than the other kids and they used to tease me about it,” she said. “Looking back on that, I often strove to over please people so that they would not ridicule me.”

39. Obsessive Compulsive Disorder (OCD)
Definition: An anxiety disorder in which the individual has anxiety provoking thoughts that will not go away and and/or urges to perform repetitive, ritualistic behaviors to prevent or produce some future situation.
Obsessions are recurrent thoughts and compulsions are recurrent behaviors
Individuals with OCD dwell on normal doubts and repeat their routines sometimes hundreds of times a day
The most common compulsions are excessive cleaning, checking, and counting
There may be a possible genetic component with OCD
Brain-imaging studies have suggested that the frontal cortex or basal ganglia are so active in OCD that numerous impulses reach the thalamus which create obsessive thoughts or compulsive actions
Individuals with OCD have the inability to turn off negative, intrusive thoughts by ignoring or effectively dismissing them

40. Obsessive Compulsive Disorder (OCD)
Treatment:
Obtain a trained therapist
Cognitive Behavior Therapy
Medicine
Video:

41. OCD Case Study
Diana Wilson suffered with obsessive compulsive disorder (OCD) for 26 years. She now works for OCD UK and shares her story of how she finally overcame the disorder.
“My earliest memory of the illness was probably when I was about eight years old. The symptoms then were a fear of stepping on the pavement cracks. I don’t know why this was, but it made me feel physically uncomfortable if I did it.
That was one ritual; another ritual, which was a compulsion, was the fear that if I didn’t say my prayers so respectfully and sincerely my mother might be killed in a car accident. I took on this huge responsibility as a child for another person’s life.
A lot of people know about the hand washing and the checking of things, but many people are unaware that OCD can also take a rather sinister angle, where you can have a fear that you may harm, very violently, your own children.
When I had my fourth child I used to have intrusive thoughts when I went to bed that I would go to the children’s bedrooms and in my sleep, take out their dressing gown cords and strangle each one. This was horrendous to go through, because I didn’t know whether I was going to do it or not.
People with OCD are not dangerous and they do not harm, but I was permanently exhausted.
That was the obsession: the compulsion was to try to relieve some of the pain and terror that I was going through because of the thoughts. I would get out of bed, find their dressing gowns, take the cords out of the dressing gowns and tie them into as many knots as possible, thinking I won’t actually be able to put the cords around their necks.
Then I’d go back to bed, but I still couldn’t sleep. So I would get out of bed again, get the cords, put them in a bag, seal the bag, and put the bag in a high cupboard. This would give a little bit of relief, but it was still terrifying.
After I saw my doctor I saw a consultant psychiatrist. I was put on antidepressants, which helped me enormously. Medication gave me the strength to sleep and eat well so that I could then have cognitive behavioral therapy (CBT), which is a psychological treatment that deals with the here and now. I was able to put my heart and soul into my own recovery.
I often used to ask myself what was wrong with my memory and why I couldn't remember whether the gas has been turned off, because I would have checked 13 times and I only checked 10 seconds ago. In fact, people with OCD have a perfectly accurate memory, but what we don’t have is a confident memory. This is where CBT can come in and help restore that."

42. Post- Traumatic Stress Disorder (PTSD)
Definition: Anxiety disorder that develops through exposure to a traumatic event that has overwhelmed the person’s ability to cope.
Symptoms
Flashbacks in which the individual relives the event
Avoidance of emotional experiences and of talking about emotions with others
Reduced ability to feel emotions
Inability to experience
Happinesss
Sexual desire
Enjoyable personal relationships
Excessive arousal
Difficulties with memory and concentration
Feelings of apprehension, including nervous tremors
Impulsive outbursts of behavior

43. Post- Traumatic Stress Disorder (PTSD)
Causes
Combat and war-related traumas
Sexual abuse or assault
Natural Disaster (hurricanes or earthquakes)
Unnatural disasters (plane crashes or terrorist attacks)
Treatment:
Trauma-Focused cognitive-behavioral therapy
Family therapy
Medication
EMDR (Eye movement desensitization and reprocessing)
Video:

44. PTSD Case Study
Mick, 41 years old, currently MEC3 on sick leave from ADF, 20 years in the infantry
Most of my life I thought people with mental problems were wimps or fakers who needed a good kick up the arse. I’m a soldier, that’s what I’m good at. Over the years I got promoted to warrant officer, had a lot of younger blokes looking up to me, expecting me to be a strong leader. And I was. I was bloody good. Until about a year ago.
I’d seen some pretty horrible things in my time. All part of the job. I coped by blocking it all out. Job done, put it behind you, have a few beers. And that worked well for me. Until we went into this little village, a few hours after the militia had left. They thought the villagers were collaborators and wanted to set an example. I won’t go into details because it was bloody horrible, but I’ve never seen so much destruction. Homes burnt down, people screaming, many of them with terrible injuries or crying over the body of a dead loved one. We did our job and we did it well. We called in the medics, did all the right things, and managed to track down some of the militia. Enough said.
But when I got home a few weeks later, I couldn’t get those images out of my mind. There were lots of them, but one in particular – a young child who’d been mutilated but left alive – came back to me over and over again. Pictures jumping into my mind during the day, nightmares at night. I was short-tempered and on edge, shouting at my wife, losing my cool with the kids. Couldn’t think straight. Just wanted to lock myself away and draw the curtains. I was losing my mind. I was one of those wimps.
Taking action
I’d heard vaguely of PTSD but even when I had all those problems it never entered my head that I might have it. I figured I was going round the bend and I was the only one who’d ever felt like this. Yes, I know that sounds stupid, but that’s what it felt like. It was my wife who got me to ask for help. She saved my life by doing that. Someone she knew at work had a husband who was a cop with the Feds, one of the first into the Solomons after the trouble. Seems like he’d developed PTSD and, like me, refused to admit it. He got sicker and sicker until eventually he had to see a shrink. Apparently he’d gone on some brain pills and got some therapy and was doing OK now. So my wife made an appointment and dragged me along to see the psychiatrist. I tried to tell him what I was going through, but I kept crying. Felt like a complete idiot. But I managed to tell him enough.
He put me on some tablets. I don’t like taking them – they stuffed up my sex life something terrible (although to be honest I wasn’t feeling much like sex anyway since this whole thing started). But I’ve been on them for four months now and I think they’re helping. I’ve read a lot about PTSD, and spoken to a few people who’ve had it but recovered, so I’m feeling optimistic. I’m also seeing a psychologist every week. He’s given me a whole lot of tips about how I can control the anxiety. We’ve just started the really hard part – talking in detail about that day in the village. It is hard, but I also feel a great sense of achievement. I’m not blocking it out, I’m facing up to it (maybe that makes me a real man after all!). And we’ve been through it a few times now and it’s getting easier.
I’ve got a long way to go, but I hope to go up before the medical review people in about three months. I reckon I’ll be back with the boys by next year. It will have been a long break, but we had a bloke who injured his back and he was off for a year – came back good as new. Mine’s not that different really. Just happens to be my head instead of my back.

45. Anxiety Disorder Reference Page
Symptoms
agoraphobia/

46. Therapy
Biological therapies: Also called biomedical therapies, treatments that reduce or eliminate the symptoms of psychological disorders by altering aspects of body functioning

47. Antianxiety Drugs
Definition: Commonly known as tranquilizers, drugs that reduce anxiety by making the individual calmer and less excitable.
Benzodiazepines are the antianxiety drugs that generally offer the greatest relief for anxiety symptoms, though these drugs are potentially addictive, they work by binding to the receptor sites of neurotransmitters that become overactive during anxiety.
Side effects:
Drowsiness
Loss of coordination
Fatigue
Mental slowing
Benzodiazepines are also linked to abnormalities in babies born to mothers who took them during pregnancy

48. Antianxiety Drugs
Many physicians and psychiatrists prescribe these kinds of drugs to improve people’s ability to cope with their problems effectively but too often they are overused and become addictive.

49. Antidepressant Drugs Definition: Drugs that regulate mood
Four main classes:
Tricyclics
Reduce the symptoms of depression in 70% of cases
Take 2-4 weeks to improve mood
Side effects are
Restlessness
Faintness
Trembling
Sleepiness
Memory difficulties
Tetracyclics
In recent studies was proven to be more effective in reducing depression than any other antidepressant

50. Antidepressant Drugs Monoamine oxidase inhibitors (MAO)
May be especially risky because of their potential interactions with certain fermented foods and drugs, which leads to high blood pressure and risk of stroke
Selective serotonin reuptake inhibitors
Reduces the symptoms of depression with fewer side effects than any other antidepressant
Negative effects including insomnia, anxiety, headaches, and diarrhea
Lithium: The lightest of the solid elements in the periodic table of elements, widely used to treat bipolar disorder

51. Antipsychotic Drugs
Definition: Powerful drugs that diminish agitates behavior, reduce tension, decrease hallucinations, improve social behavior, and produce better sleep patterns in individuals with severe psychological disorder, especially schizophrenia.
Neuroleptics are the most extensively used class of antipsychotic drugs
They do not cure schizophrenia only treat the symptoms
Possible side effect is Tardive Dyskinesia
Involuntary movements of the facial muscles, tongue, and mouth
Twitching of the arms, legs, and neck
Atypical antipsychotic medications carry a much lower risk
Two most common drugs used
Clozaril (clozapine)
Risperdal (risperidone)

53. Electroconvulsive Therapy
Commonly called shock therapy
Goal is to set off a seizure in the brain
100,000 people a year undergo ECT
PTSD and depressive disorder
Passing a small electrical current through 2 electrodes placed on the individuals head
Given to individuals who have not responded to drug therapy or psychotherapy
Only applied to the right side of brain
Just as effective as cognitive therapy or drug therapy
Relapse rate is moderate to high
Possible side effects include memory loss and other cognitive impairments
They have began to apply electrical stimulations in very specific parts of the brain
Deep brain stimulation

54. Increase suicide risk in children
There have been many cases of children committing suicide after being prescribed antidepressants
Many stories do not indicate suicidal tendencies in the children before being prescribed the antidepressants
The FDA did a study of children taking antidepressants and there was a higher occurrence of adverse events in children taking the antidepressants
Antidepressants were then given a “black box” warning and the rate at which doctors prescribed children antidepressants dropped
The “black box” warning led to other studies that did not show a correlation between children and adolescents taking antidepressants and committing suicide
Most children and adolescents respond better to psychotherapy than drug therapy

55. Psychosurgery
Definition: A biological therapy, with irreversible effects, that involves removal or destruction of brain tissue to improve the individual’s adjustment.
Many physicians felt in treating patients with severe psychological disorders with lobotomies
A lobotomy is a surgical operation involving incision into the prefrontal lobe of the brain, used to treat mental illness.
Many individuals who received lobotomies suffered permanent and profound brain damage
Lobotomies are no longer performed unless in a last resort
Psychosurgery now involves only a small lesion in the amygdala or another part of the limbic system
Psychosurgery may be performed for OCD, major depression, bipolar disorder, and schizophrenia

56. Duties and Content Olivia: Topic 2 (Anxiety Disorders)
Topic 8 (Therapy)
Carol:
Topic 6 (Personality Disorders)
Handout
Erin:
Topic 5 (Schizophrenia)
Topic 1 (Abnormal Behavior)