Psyc 213 - Chapter Six Stress Disorders

Stress Disorders and Their Understanding

Key Concepts and Definitions

• Stressor: An external event or situation that places physical or psychological demand on a person.

• Stress: An internal response to a stressor.

Models for Understanding Stress

Autonomic Nervous System (ANS)

1. Components:

   • Hypothalamus: Regulates the ANS.

   • Sympathetic Nervous System (SNS): Activates fight-or-flight responses.

   • Parasympathetic Nervous System (PNS): Calms the body down after stress.

   • Adrenal Medulla: Releases epinephrine (adrenaline) and norepinephrine.

2. HPA Axis:

   • Hypothalamus → Pituitary Gland → Adrenal Cortex

   • Releases Adrenocorticotropic Hormone (ACTH) → Stimulates adrenal glands → Secretion of corticosteroids (cortisol).

3. Endocrine System: Plays a role in stress responses.

Stress Disorders

Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD)

• Acute Stress Disorder:

  • Occurs within 3 days to 1 month following a traumatic event.

• PTSD:

  • Can develop after exposure to a traumatic event, lasting more than 1 month.

Prevalence and Risk Factors

• Prevalence:

  • ASD: Approx. 3.5% of the population.

  • PTSD: Lifetime prevalence: 7-9%.

  • Higher incidence in women (20%) than men (8%).

• Risk Factors:

  • Severity of trauma.

  • Family history of mental illness.

  • Socioeconomic status (e.g., lower SES increases risk).

  • Childhood experiences of trauma or abuse.

  • Social support; lack of support increases susceptibility.

Types of Trauma Leading to PTSD

• Natural disasters (earthquake, floods, etc.): ~30% develop PTSD.

• Physical assaults and domestic violence: High prevalence rates (50% exposed to terrorism/torture).

• Sexual assault: Approximately 300,000 rapes per year in the U.S.

Biological Etiology of PTSD

• Autonomic Nervous System Abnormalities:

  • Persistent startle response even after the stressor is removed.

• Hormonal Dysregulation:

  • Abnormal cortisol and norepinephrine levels can damage brain areas like the Hippocampus (memory) and Amygdala (emotion).

Psychological and Environmental Factors

• Personality Types:

  • Higher anxiety and coping issues linked to susceptibility.

• Childhood Trauma:

  • Early trauma increases risk.

• Social Support:

  • Strong support systems may protect against PTSD; weak ones may lead to higher risk.

• Cultural Differences:

  • Variability in risk among different ethnic groups.

Treatments for PTSD

1. Medications:

   • Antidepressants are commonly used.

2. Psychotherapies:

   • Cognitive Behavioral Therapy (CBT): Restructures negative thought patterns.

   • Exposure Therapy: Gradual exposure to trauma-related stimuli.

   • Eye Movement Desensitization and Reprocessing (EMDR): Involves lateral eye movements while recalling trauma.

   • Peer Support Groups: Helps shared experiences.

3. Crisis Intervention:

   • Immediate counselling after trauma, benefits are debated.

Dissociative Disorders

Types

• Dissociative Amnesia:

  • Partial or total memory loss following trauma.

  • Types:

  1. Localized Amnesia: Recall loss surrounding a specific event.

  2. Selective Amnesia: Able to remember some details but not others.

  3. Generalized Amnesia: Complete loss of memory about life.

  4. Systematic Amnesia: Forgetting specific information.

  5. Continuous Amnesia: Forgetting events between a specific time.

  6. Posthypnotic Amnesia: Cannot recall events experienced while hypnotized.

Dissociative Fugue

• Sudden travel away from home and inability to recall identity.

• Prevalence: 0.2% of the population, often following traumatic events.

Depersonalization/Derealization Disorder

• Experiences of unreality regarding self or environment.

• Prevalence: ~2% of the population.

Dissociative Identity Disorder (DID)

• Presence of two or more distinct identities in one individual.

• Key Characteristics:

  • Recurrent control of behavior by different identities.

  • Extensive memory loss that cannot be explained by normal forgetfulness.

• Prevalence: Estimated 1% of the population, more common in females.

Diagnosis and Controversy

• Historical context and the role of therapy in increasing false diagnoses.

• DSM-5 Criteria for PTSD:

  • A range of symptoms across intrusion, avoidance, negative changes in mood and cognition, and alterations in arousal.

PTSD Symptoms Breakdown

1. Intrusion Symptoms: Distressing memories, dreams, flashbacks.

2. Avoidance Symptoms: Efforts to avoid reminders of trauma.

3. Negative Alterations in Cognition/Mood: Negative beliefs about oneself and persistent estrangement.

4. Arousal Symptoms: Sleep disturbances, irritability, hypervigilance.

5. Duration: Symptoms must persist for more than 1 month for PTSD.

6. Distress: Symptoms must cause significant functional impairment

Acute Stress Disorder vs PTSD Criteria

• Similarities with symptomatic expressions; key distinction lies in duration of severity post-trauma.

Conclusion

Understanding the multifaceted nature of stress disorders like PTSD is crucial for effective intervention and treatment. The interplay between biological, psychological, and social factors must be considered in both diagnosis and management.

Biological Etiology of PTSD

• Autonomic Nervous System Abnormalities:- Persistent startle response even after the stressor is removed.

• Hormonal Dysregulation:- Abnormal cortisol and norepinephrine levels can damage brain areas like the Hippocampus (memory) and Amygdala (emotion).