Ch. 5: (pt2) Trauma, Stress, OCD Disorders Flashcards
What is PTSD?
Posttraumatic Stress Disorder, or PTSD, is an enduring, distressing emotional disorder that follows exposure to severe helplessness or a fear- inducing threat. The victim reexperiences the trauma, avoids stimuli associated with it, and develops a numbing of responsiveness and an increased vigilance and arousal
What is the clinical description of PTSD?
DSM-5 added reckless or self-destructive behavior under the criteria as a sign of increased arousal and reactivity
• DSM-5 also added a dissociative subtype to describe victims who do not necessarily react with the reexperiencing or hyperarousal characteristics of PTSD
– Respond differently to treatment when meet this subtype criteria
• Diagnosis of PTSD cannot be made until at least one month after the incident due to the natural experience of symptoms for about a month after an incident that may disappear
– Delayed onset PTSD
– Acute stress disorder
What are the causes for PTSD?
PTSD is the one disorder where we know the cause in terms of the precipitating event
• As with the other disorders, there are individual generalized biological and psychological vulnerabilities
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– Family history of anxiety suggests a biological vulnerability for PTSD
– Stress-diathesis model and reciprocal gene-environmental interactions from chapter 2
• Family instability and home environment
• Social support post-trauma
• Neurobiological factors
– Threatening cues active the CRF system, which actives fear and anxiety areas of the brain, and leads to increased HPA axis activation
What is the treatment for PTSD?
Pharmacological Interventions
– SSRI’s help relieve the anxiety and panic attacks
– Use of DCS to augment CBT therapy as discussed with social anxiety disorder
• Psychological Interventions
– Face original trauma, process the intense emotions, and develop effective coping procedures in order to overcome the debilitating effects
– Prolonged exposure therapy
– Cognitive Processing Therapy
– Narrative Therapy
What are the 5 stressor related disorders to PTSD?
Prolonged Grief Disorder
• Adjustment Disorders
• Attachment Disorders
• Reactive Attachment Disorder
• Disinhibited Social Engagement Disorder
What is obsessive compulsive disorder?
Obsessive-Compulsive Disorder, or OCD, involves unwanted, persistent, intrusive thoughts and impulses, as well as repetitive actions intended to suppress them
What is the clinical description for OCD?
Four major types of obsessions and compulsions
– Symmetry, forbidden thoughts or actions, cleaning and contamination, and hoarding
• Tic disorder and OCD
– Characterized by involuntary movement of limbs
– May be compulsive behavior rather than tics seen in individuals with Tourette’s syndrome and are often related to symmetry
– PANDAS
What is the onset range for OCD?
Age of onset ranges from childhood through 30’s
– Median age of onset is 19 years old
– Peaks earlier in males (13-15 years old) than females (20-24 years old)
What are the causes of OCD?
Generalized biological vulnerability – Possible genetic basis
• Generalized psychological vulnerability
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– Early life experiences
– Thoughts are dangerous/unacceptable
– Thought-action fusion
What is the treatment for OCD?
Pharmacological/Medical Interventions
– SSRI’s
– Clomipramine is most widely used for OCD
– Benefits 60% of patients with OCD
– Relapse often occurs when medication is discontinued
– Psychosurgery
– Radical treatment when resistant to other forms of treatment
– Cingulotomy showed benefit for 30% of patients
OCD Treatment
• Psychological Interventions
– Exposure and ritual prevention (ERP)
– Process in which rituals are actively prevented and the patient is systematically and gradually exposed to the feared thought or situations
– CBT
– 86% benefit in patients
What is body dysmorphic disorder?
Body dysmorphic disorder, or BDD, is a disorder featuring a disruptive preoccupation with some imagined defect in appearance
What is the clinical description of BDD?
Not typically seen in mental health clinics as most individuals with BDD often first seek as other health professionals to address their concerns
• Men tend to focus on body build, genitals, and thinning hair with more severe BDD; women focus on more varied body areas and are more likely to have a comorbid disordered eating pattern
• Age of onset varies from early adolescence through 20’s and peaks around 16-17 years old
Often react to what is perceived as a “grotesque” or horrible feature
• Due to wide acceptance of plastic surgery, this disorder may be a an exaggeration of normal culturally sanctioned behavior
• Very little information on causes of BDD other than speculations
– Psychoanalytic defense mechanism
What is the treatment for BDD?
Only two current treatments with any evidence of effectiveness
– Medications that block the reuptake of serotonin (Clomipramine and Fluvoxamine)
– Exposure and response prevention
• Individuals who seek out plastic surgery and other medical treatments to address their perceived flaw are often dissatisfied with the result
– 88% of individuals in a large group of people with BDD seeking medical rather than psychological treatment did not have any change or increase in mental health after their surgery
What are other disorders related OCD?
Hoarding Disorder
– Compulsive hoarding due to fear of urgent need of discarded items
– 2-5% of the population
– Excessive acquisition of things, difficulty discarding anything, and living with excessive clutter under conditions best characterized as gross disorganization
• Trichotillomania
– Urge to pull out their own hair from anywhere on the body, including the scalp, eyebrows, and arm
• Excoriation
– Recurrent, difficult-to-control picking of one’s skin leading to significant impairment or distress
