Chapter 7: Anxiety

Disorders
Posttraumatic Stress Disorder and
Obsessive-Compulsive Disorder

Posttraumatic Stress
Disorder (PTSD)
is a set of symptoms including
hypervigilance, reexperiencing of the
trauma, and emotional numbing
experienced by trauma survivors.

3 Categories of Symptoms Characterized by PTSD

1. REEXPERIENCING OF THE TRAUMATIC EVENT
-

Distressing memories of the event

Distress dreams about the event
Reliving of the event by acting/feeling as if the event were recurring
Intense psychological and physiological distress when exposed to
situations reminiscent of the event

2. EMOTIONAL NUMBING AND DETACHMENT

Avoidance of thoughts, feelings or conversations about the event
Avoidance of activities, places or people associated with the event
Trouble recalling important aspects of the event
Loss of interest in activities
Feelings of detachment from others
Inability to have loving feelings toward others and a general
restriction of feelings
- Sense that the future is bleak
-

3. HYPERVIGILANCE AND CHRONIC AROUSAL

-

Difficulty falling or staying asleep

Irritability or outbursts of anger
Difficulty concentrating
Hypervigilance
Exaggerated startle response

Role of Trauma in PTSD

1.

Natural Disasters- such as floods, earthquakes, fires,

hurricanes and tornadoes.

2.

Abuse- physical abuse (battering relationships), sexual abuse

(rape and incest) and emotional abuse (parents who ridicule
their children).

3.

Combat and War-Related Traumas- combat fatigue

syndrome, war zone stress and shell shock

4.

Common Traumatic Events- sudden death of a loved one,

knowing that ones child has a life threatening disease or
observing someone being killed.

Contributors to PTSD

Treatments for PTSD

1. Cognitive-behavioral Therapy- systematic
desensitization is used to extinguish fear
reactions to memories; cognitive techniques are
used to challenge irrational thoughts. (ex. Rape
survivor works through hierarchy of feared
memories of rape using relaxation techniques;
therapist helps her confront self-blaming
thoughts.)
2. Stress management- Therapist helps the client
solve concrete problems to reduce stress; may
use thought-stopping strategies to quell
intrusive thoughts (ex. Disaster survivor is
helped to find a new home and job.)

Treatments for PTSD

3. Biological therapies- Anti anxiety and
antidepressant drugs are used to quell
symptoms. (ex. Person uses valium
(benzodiazepine) to help induce sleep at
night.)
4. Sociocultural approaches- PTSD symptoms are
understood and treated within the norms of
peoples culture. (ex. Culture-specific rituals
might be used to help a PTSD sufferer make
peace with the trauma and reintegrate into the
community.)

Obsessive-Compulsive
Disorder
is classified as an anxiety diorder
because people with OCD experience
anxiety as a result of their
obsessional thoughts and when they
cannot carry out their compulsive
behaviors

Symptoms of OCD
The person must show either
obsessions or compulsions which he
or she recognizes are excessive or
reasonable.

Obsessions are defined as:

1. recurrent and persistent thoughts, impulses, or
images that are experienced as intrusive and
inappropriate and that can cause anxiety or
distress.
2. thoughts, impulses, or images that are not simply
excessive worries about real-life problems
3. thoughts, impulses, or images that the person
attempts to ignore or suppress or to neutralize
with some other thought or action.
4. obsessional thoughts, impulses, or images that
the person recognizes are a product of his or her
own mind.

Compulsions are defined as:

1. repetitive behaviors (such as hand-washing,
ordering, checking) or mental acts (such as
praying, counting, repeating words silently) that
the person feels driven to perform in response to
an obsession or according to rules that must be
applied rigidly.
2. behaviors or mental acts that are aimed at
preventing or reducing distress or preventing
some dreaded event or situation; however, these
behaviors or mental acts either are not connected
in a realistic way with what they are designed to
neutralize or prevent or are clearly excessive.

Theories of OCD
1.

Biological theories- People with OCD suffer from

dysfunction in the circuits in the brain regulationg
primitive impulses, possibly due to deficiencies in
serotonin, which cause OCD.

2.

Psychodynamic theories- The obsessions and

compulsions of people with OCD represent unconscious
wishes or conflicts

3.

Cognitive-Behavioral theories- People with OCD have

difficulty turning off intrusive thoughts because of
chronic distress, a tendency toward rigid thinking,
and the belief they should be able to contol their
thoughts.

Treatments of OCD
A. Biological Treatments- use serotoninenhancing drugs (Paxil, Prozac)
B. Cognitive-Behavioral Treatments- Expose the
client to obsessions until anxiety about
obsessions decreases; prevent compulsive
behaviors and hel the client manage anxiety
that is aroused. (Systematic
desensitization to help a person with a
germ obsession gradually tolerate exposure
to dirty materials)