2. PTSDPTSD Abnormal Psychology Chapter 5.2 Anxiety Disorder

3. What is PTSD PTSD is an anxiety disorder that develops in response to a stressful event or situation of exceptionally threatening or catastrophic nature

4. What are the core features?

5. Reexperiencing of the Traumatic event Avoidance of associated stimuli and numbing of general responsiveness (last more than 1 month) Symptoms of extreme arousal

6. The Symptoms The symptoms of PTSD can start after a delay of weeks, or even months. They usually appear within 3 months after the traumatic event. Some people get better within 6 months. Others may have the illness for much longer. For ABCS see p. 158

7. WHAT CAUSES P T S D ?

8. Natural disasters  PTSD can occur at any ages  exhibit the symptoms varies: acute: less than 3 months chronic: 3 months or longer delayed onset: more than 6 months (DSM-IV)

9. Terrorism War The facts of child with PTSD experienced……… traumatic events by age of 6: 68% physical problems and emotional difficulties: 20% more than one traumas: 50% (NCTSN http://www.nctsn.org/ )http://www.nctsn.org/

10. Physical abuse A recent review of research on children exposed to specific traumas found wide ranges in rates of PTSD 20 percent to 63 percent in survivors of child maltreatment 12 percent to 53 percent in the medically ill 5 percent to 95 percent in disaster survivors (NCTSN)

11. Post Traumatic Stress Disorder (PTSD) – is considered a normal reaction to a potentially traumatic event such as war, torture, rape, natural disasters, etc. However, it is still classified as a “mental disorder” within the DSM system.

12. Please Read: Research in psychology on p. 158 about the case of Rwanda and answer the three questions afterwards

13. PTSD Symptom Prevalence: Several studies, including those in post-conflict settings, indicate that approximately 25-33% of persons exposed to an extreme stressor/ violence experience will go on to develop PTSD symptoms (Breslau et al 1991, Kilpatrick et al 1992). Aprox 70% of persons exposed to a traumatic stressor will NOT develop PTSD symptoms. This may point to a certain level of inherent resilience/ coping skills among the majority.

14. The two most frequently comorbid (occurring at the same time) disorders with PTSD are substance abuse and major depression, both of which may be accompanied by a high risk of suicide. 80% of persons with long-term PTSD suffer from depression, another anxiety disorder, or substance abuse (International Society for Traumatic Stress Studies, 2000).

15. Etiology (why do some develop PTSD more than some…) Biological Twin research has shown a possible genetic predisposition for PTSD (Hauff and Vaglum 1994) Higher levels of noradrenaline (Geracioti 2001)

16. Etiology Cognitive If individual cognitions could make a difference to people who develop PTSD Intrusive memories – flasbacks – cue- dependent memories (Brewin et al 1996) Virtual reality as a therapy: flooding which will lead to habituation (Albert Rizzo) Attributional style (Beck): Focusing on Personal responsibility or not/ emotion or problem makes a difference (Sutker et el. 1995)

17. Etiology Sociocultural Majority of research Experiences of racism and oppression are predisposing factors for PTSD (Vietnam war, Roysircar 2000) Threat of death, Bosnia (Dyregrov 1998) Social learning – domestic violence (Silva 2000)

18. Cultural Considerations in PTSD Several studies and existing biological research suggest there is a universal biological response to traumatic events (A. Marsella et al 1993). For example, intrusive thoughts/memories or “flashbacks” may transcend culture.

19. Cultural… However, Avoidance/ numbing and arousal symptoms may be more specific to various cultural groups; Some cultural groups may be more likely to describe physical symptoms (somatic complaints);

20. Gender Considerations There is significant gender difference Breslau et al (1991) longitudinal study of 1007 young adults exposed to community violence Found prevalence rate of 11,3 % in women compared to 6% in men According to Horowitz et al 1995, women have a 5 times greater risk of developing PTSD after a traumatic/violent event Why do you think?

21. Gender Considerations Women are raped more than men and rape carries the highest risk of producing PTSD 50%! Sexual abuse as well Socialization could be a factor – lead to how the girls and women deal with their traumas to internalize them compared to men who externalize them (Nolen-Hoeksema 1994 and Achenbach 1991)

22. War Veterans Suffer from PTSD http://www.youtube.com/watch?v=z0DMNpYa3dg PTSD: What is it? http://www.youtube.com/watch?v=H_H_mAm4a4s The Virtual PTSD Treatment http://www.youtube.com/watch?v=eHmXYhS4HQI&feature=related

23. Etiology of PTSD Cause Natural disasters Terrorism/Warfare Abuses Accidents ….. Core features Reexperiencing of the traumatic event Symptoms of extreme arousal Avoidance of associated stimuli and numbing of general responsiveness Assessment DSM-IV Acute: > 3 months Chronic: 3~6 months Delayed onset: > 6 months PTSD Relapse (risk factors)

24. Treatments EMDR http://www.youtube.com/watch?v=gZ5MLn1Cc9 4&feature=relatedhttp://www.youtube.com/watch?v=gZ5MLn1Cc9 4&feature=related (2:57) Video Game Tetris Used to Treat PTSD http://www.redorbit.com/news/video/technology/ 7/video_game_tetris_used_to_treat_ptsd/26700/i ndex.htmlhttp://www.redorbit.com/news/video/technology/ 7/video_game_tetris_used_to_treat_ptsd/26700/i ndex.html (0:50)

25. April, 2 2009 The Department of Veterans Affairs (VA) will spend more than $1.4 billion as part of President Obama’s economic recovery plan of PTSD to improve services to America’s Veterans. NO MORE FEAR!!