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Stress Disorders

Chapter 6

Stress Disorders

Stressor

Stress Disorders

Stress Disorders

Stressor

Stress response

Stress Disorders

Stressor

Stress response

Physical, emotional, cognitive

Stress Disorders

Stressor

Stress response

Physical, emotional, cognitive

Stress disorders, physical stress disorders

Stress Disorders

Stressor

Stress response

Physical, emotional, cognitive

Stress disorders, physical stress disorders

Fight or flight reaction pathways

Stress Disorders

Stressor

Stress response

Physical, emotional, cognitive

Stress disorders, physical stress disorders

Fight or flight reaction pathways

Sympathetic nervous system: epinephrine, norepinephrine

Stress Disorders

Stressor

Stress response

Physical, emotional, cognitive

Stress disorders, physical stress disorders

Fight or flight reaction pathways

Sympathetic nervous system: epinephrine, norepinephrine

Hypothalamic-Pituitary-Adrenal: ACTH, cortisol

Stress Disorders

Stressor

Stress response

Physical, emotional, cognitive

Stress disorders, physical stress disorders

Fight or flight reaction pathways

Sympathetic nervous system: epinephrine, norepinephrine

Hypothalamic-Pituitary-Adrenal: ACTH, cortisol

Trait vs. state anxiety

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder

Triggers: combat, disasters, victimization, terrorism

Post-Traumatic Stress Disorder

Triggers: combat, disasters, victimization, terrorism

Etiology

Post-Traumatic Stress Disorder

Triggers: combat, disasters, victimization, terrorism

Etiology

Biological view: traumatic events trigger brain changes in hippocampus and amygdala; release of cortisol and norepinephrine; inherited strong reaction to stress

Post-Traumatic Stress Disorder

Triggers: combat, disasters, victimization, terrorism

Etiology

Biological view: traumatic events trigger brain changes in hippocampus and amygdala; release of cortisol and norepinephrine; inherited strong reaction to stress

Cognitive view: those with high trait anxiety, external locus of control are more at risk for PTSD

Post-Traumatic Stress Disorder

Triggers: combat, disasters, victimization, terrorism

Etiology

Biological view: traumatic events trigger brain changes in hippocampus and amygdala; release of cortisol and norepinephrine; inherited strong reaction to stress

Cognitive view: those with high trait anxiety, external locus of control are more at risk for PTSD

Sociocultural view: poverty, previous trauma, psychological disorders, early childhood divorce, poor social support are all risk factors for PTSD; Latino/a heritage show higher rates of PTSD

Post-Traumatic Stress Disorder

Treatment

Post-Traumatic Stress Disorder

Treatment

Biological: antianxiety or antidepressant medication

Post-Traumatic Stress Disorder

Treatment

Biological: antianxiety or antidepressant medication

Behavioral: exposure combined with relaxation

Post-Traumatic Stress Disorder

Treatment

Biological: antianxiety or antidepressant medication

Behavioral: exposure combined with relaxation

Virtual reality: http :// www.youtube.com/watch?v=4F4i6vEZ-H4

Post-Traumatic Stress Disorder

Treatment

Biological: antianxiety or antidepressant medication

Behavioral: exposure combined with relaxation

Virtual reality

Coping skills

Post-Traumatic Stress Disorder

Treatment

Biological: antianxiety or antidepressant medication

Behavioral: exposure combined with relaxation

Virtual reality

Coping skills

EMDR – eye movement desensitization and reprocessing

Post-Traumatic Stress Disorder

Treatment

Biological: antianxiety or antidepressant medication

Behavioral: exposure combined with relaxation

Virtual reality

Coping skills

EMDR – eye movement desensitization and reprocessing

Cognitive: insight therapy (reinterpret experience and view of self)

Post-Traumatic Stress Disorder

Treatment

Biological: antianxiety or antidepressant medication

Behavioral: exposure combined with relaxation

Virtual reality

Coping skills

EMDR – eye movement desensitization and reprocessing

Cognitive: insight therapy (reinterpret experience and view of self)

Critical incident stress debriefing

Post-Traumatic Stress Disorder

Treatment

Biological: antianxiety or antidepressant medication

Behavioral: exposure combined with relaxation

Virtual reality

Coping skills

EMDR – eye movement desensitization and reprocessing

Cognitive: insight therapy (reinterpret experience and view of self)

Critical incident stress debriefing

Sociocultural: family therapy, group therapy

Dissociative Disorders

Dissociative Disorders

Dissociative Amnesia – can’t remember identity or personal information

Dissociative Disorders

Dissociative Amnesia – can’t remember identity or personal information

Dissociative Fugue – amnesia but also leave for a new location, possibly new identity

Dissociative Disorders

Dissociative Amnesia – can’t remember identity or personal information

Dissociative Fugue – amnesia but also leave for a new location, possibly new identity

Dissociative Identity Disorder – two or more separate identities which may not be aware of the others

Dissociative Disorders

Dissociative Amnesia – can’t remember identity or personal information

Dissociative Fugue – amnesia but also leave for a new location, possibly new identity

Dissociative Identity Disorder – two or more separate identities which may not be aware of the others

Depersonalization-Derealization Disorder – feeling of unreality or being outside of body

Dissociative Disorders

Dissociative Amnesia – can’t remember identity or personal information

Dissociative Fugue – amnesia but also leave for a new location, possibly new identity

Dissociative Identity Disorder – two or more separate identities which may not be aware of the others

Depersonalization-Derealization Disorder – feeling of unreality or being outside of body

Etiology? Repression; reinforcement for escape; state-dependent learning; self-hypnosis

Dissociative Disorders

Dissociative Amnesia – can’t remember identity or personal information

Dissociative Fugue – amnesia but also leave for a new location, possibly new identity

Dissociative Identity Disorder – two or more separate identities which may not be aware of the others

Depersonalization-Derealization Disorder – feeling of unreality or being outside of body

Etiology? Repression; reinforcement for escape; state-dependent learning; self-hypnosis

Treatment? Integration of identities

Psychological Factors Affecting Other Medical Conditions

Psychological Factors Affecting Other Medical Conditions

Psychophysiological disorders, or physical stress disorders

Psychological Factors Affecting Other Medical Conditions

Psychological Factors Affecting Other Medical Conditions

Examples: ulcers, asthma, insomnia, tension headaches, migraine headaches, hypertension, heart disease

Psychological Factors Affecting Other Medical Conditions

Psychological Factors Affecting Other Medical Conditions

Psychological Factors Affecting Other Medical Conditions

Examples: ulcers, asthma, insomnia, tension headaches, migraine headaches, hypertension, heart disease

Etiology

Psychological Factors Affecting Other Medical Conditions

Examples: ulcers, asthma, insomnia, tension headaches, migraine headaches, hypertension, heart disease

Etiology: too many stressors; overreaction to stress; poor coping

Psychological Factors Affecting Other Medical Conditions

Examples: ulcers, asthma, insomnia, tension headaches, migraine headaches, hypertension, heart disease

Etiology: too many stressors; overreaction to stress; poor coping

Treatment: reduce stressors; build relaxation and other coping skills

Psychological Factors Affecting Other Medical Conditions

Conclusions

Conclusions

Stress, environment, and the brain are all interrelated

Conclusions

Stress, environment, and the brain are all interrelated

Combination of treatments often most effective

Conclusions

Stress, environment, and the brain are all interrelated

Combination of treatments often most effective

Need to focus on prevention – building resilience