Pre-class Mini Lecture
Mental Health Trauma/Stress(PTSD), Anxiety Disorders, Somatic Symptom
Disorders (BOYD)
We all know that stress is part of our daily lives, but our responses to stress vary from person to
person. For instance, a person may develop a severe emotional reaction (strong agitation of
feelings) and another person is hardly aware of a traumatic event. While most stressful events do
not lead to mental disorders, sometimes, emotional problems and mental disorders develop as the
response to trauma. One reason there is difference between the responses to stress from person to
person, is related to what is known as resilience.
In everyday terms this is described as the person’s ability to “bounce back” or ability to recover more
easily from adversities, illnesses, like depression. A goal for mental health treatment is to assist the
person to gain better coping strategies that will enhance future ability to be resilient, when faced with
adversity.
Traumatic events include those that are directly experienced, witnessed, learned about from others,
or repeated exposure to adverse events.
Post-Traumatic Stress Disorder (PTSD) is diagnosed following exposure to a traumatic event when
symptoms in four general areas appear:
1) intrusive symptoms, avoidance of person(s), places or objects that are a reminder of the traumatic
event. Intrusive symptoms also include dissociative reactions (i.e., feeling or acting as if the event is
re-occurring). Sleeping is difficult.
Terrifying FLASHBACKS and nightmares often include small pieces of traumatic events exactly as they
happened. Stimuli such as loud noises, and odors, associated with the trauma cause flashbacks and
dreams. Consequently, affected individuals avoid such stimuli. Many persons diagnosed with PTSD
escape situations by altering their state of consciousness or numbing, by dissociating. Dissociation is a
disruption in the normally occurring linkages among subjective awareness, feelings, thoughts, behavior,
and memories.
2) negative mood and cognitions or negative thoughts associated with the event. The person may
become irritable, with episodic explosive anger, guilt, fear and shame, and difficulty feeling love and
happiness. This results in becoming estranged from loved ones, as loved ones do not understand the
changes in person’s behavior.
3) hyperarousal characterized by aggressive, reckless or self-destructive behavior. The traumatized
person is hypervigilant for signs of danger, startles easily, reacts irritably to small annoyances, and sleeps
poorly. The state of hyperarousal causes other problems for family members.
4) sleep disturbances or hypervigilance
***Note: diagnostic criteria (DSM 5) requires that person has experienced these symptoms for at least
1 month
For many, symptoms often develop 3 to 6 months after the event. About a third diagnosed with PTSD
develop chronic symptoms. For these individuals, symptoms fluctuate in intensity with time and usually
are worse during periods of stress. Children with PTSD may react differently than adults.
Examples of Traumatic Events -Military combat violence can result in life-long effects for some
deployed service members, childhood physical abuse, torture, or kidnapping; sexual assault/ rape,
incest; Natural disasters; human disasters; Crime-related events: terror attacks, mugging, witnessing a
murder.
, For many, symptoms often develop 3 to 6 months after the event. About a third diagnosed with PTSD
develop chronic symptoms. For these individuals, symptoms fluctuate in intensity with time and usually
are worse during periods of stress. Children with PTSD may react differently than adults.
Examples of Traumatic Events -Military combat violence can result in life-long effects for some
deployed service members, childhood physical abuse, torture, or kidnapping; sexual assault/ rape,
incest; Natural disasters; human disasters; Crime-related events: terror attacks, mugging, witnessing a
murder.
***Note: for a diagnosis of ACUTE STRESS DISORDER- diagnostic criteria (DSM 5) requires that person
has experienced these symptoms for LESS THAN 1 month
Teamwork & Collaboration: Working toward Recovery
Major approaches to the treatment of PTSD include pharmacotherapy and psychotherapy.
Psychotherapeutic approaches to the treatment of patients with PTSD include cognitive behavioral
therapy (CBT); and eye movement, desensitization, and reprocessing (EMDR. Cognitive behavioral
therapies focus on the evaluation of situations, thoughts, feelings and the problematic ways these
evaluations cause a person to act. Group therapy and family therapy are also beneficial to person with
PTSD.
The selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, and β-blockers have been shown to
be effective in reducing the symptoms of PTSD. When prescribed in conjunction with psychotherapy,
pharmacotherapy can minimize the excessive fear and anxiety of PTSD.
Two SSRI antidepressants, sertraline (Zoloft) and paroxetine (Paxil), are approved by the
FDA for PTSD and are used to treat symptoms of sadness, worry, anger and numb feelings.
***Note: Safety Issues!!!: PTSD is associated with an increased risk of_SUICIDE , suicide attempts,
aggression, and substance abuse. What is the priority intervention?
Anxiety Disorders
The concept of anxiety: Anxiety is an uncomfortable feeling of apprehension which occurs as a result of
internal/external stimuli. Anxiety can result in feelings of dread, and can bring on physical, emotional,
cognitive and behavioral changes. See below breakdown of the levels of anxiety and the associated
symptoms.
Levels of Anxiety: Mild, Moderate, Severe and Panic
Mild t f d li i P ti i h d h d i f Y t thi
Mental Health Trauma/Stress(PTSD), Anxiety Disorders, Somatic Symptom
Disorders (BOYD)
We all know that stress is part of our daily lives, but our responses to stress vary from person to
person. For instance, a person may develop a severe emotional reaction (strong agitation of
feelings) and another person is hardly aware of a traumatic event. While most stressful events do
not lead to mental disorders, sometimes, emotional problems and mental disorders develop as the
response to trauma. One reason there is difference between the responses to stress from person to
person, is related to what is known as resilience.
In everyday terms this is described as the person’s ability to “bounce back” or ability to recover more
easily from adversities, illnesses, like depression. A goal for mental health treatment is to assist the
person to gain better coping strategies that will enhance future ability to be resilient, when faced with
adversity.
Traumatic events include those that are directly experienced, witnessed, learned about from others,
or repeated exposure to adverse events.
Post-Traumatic Stress Disorder (PTSD) is diagnosed following exposure to a traumatic event when
symptoms in four general areas appear:
1) intrusive symptoms, avoidance of person(s), places or objects that are a reminder of the traumatic
event. Intrusive symptoms also include dissociative reactions (i.e., feeling or acting as if the event is
re-occurring). Sleeping is difficult.
Terrifying FLASHBACKS and nightmares often include small pieces of traumatic events exactly as they
happened. Stimuli such as loud noises, and odors, associated with the trauma cause flashbacks and
dreams. Consequently, affected individuals avoid such stimuli. Many persons diagnosed with PTSD
escape situations by altering their state of consciousness or numbing, by dissociating. Dissociation is a
disruption in the normally occurring linkages among subjective awareness, feelings, thoughts, behavior,
and memories.
2) negative mood and cognitions or negative thoughts associated with the event. The person may
become irritable, with episodic explosive anger, guilt, fear and shame, and difficulty feeling love and
happiness. This results in becoming estranged from loved ones, as loved ones do not understand the
changes in person’s behavior.
3) hyperarousal characterized by aggressive, reckless or self-destructive behavior. The traumatized
person is hypervigilant for signs of danger, startles easily, reacts irritably to small annoyances, and sleeps
poorly. The state of hyperarousal causes other problems for family members.
4) sleep disturbances or hypervigilance
***Note: diagnostic criteria (DSM 5) requires that person has experienced these symptoms for at least
1 month
For many, symptoms often develop 3 to 6 months after the event. About a third diagnosed with PTSD
develop chronic symptoms. For these individuals, symptoms fluctuate in intensity with time and usually
are worse during periods of stress. Children with PTSD may react differently than adults.
Examples of Traumatic Events -Military combat violence can result in life-long effects for some
deployed service members, childhood physical abuse, torture, or kidnapping; sexual assault/ rape,
incest; Natural disasters; human disasters; Crime-related events: terror attacks, mugging, witnessing a
murder.
, For many, symptoms often develop 3 to 6 months after the event. About a third diagnosed with PTSD
develop chronic symptoms. For these individuals, symptoms fluctuate in intensity with time and usually
are worse during periods of stress. Children with PTSD may react differently than adults.
Examples of Traumatic Events -Military combat violence can result in life-long effects for some
deployed service members, childhood physical abuse, torture, or kidnapping; sexual assault/ rape,
incest; Natural disasters; human disasters; Crime-related events: terror attacks, mugging, witnessing a
murder.
***Note: for a diagnosis of ACUTE STRESS DISORDER- diagnostic criteria (DSM 5) requires that person
has experienced these symptoms for LESS THAN 1 month
Teamwork & Collaboration: Working toward Recovery
Major approaches to the treatment of PTSD include pharmacotherapy and psychotherapy.
Psychotherapeutic approaches to the treatment of patients with PTSD include cognitive behavioral
therapy (CBT); and eye movement, desensitization, and reprocessing (EMDR. Cognitive behavioral
therapies focus on the evaluation of situations, thoughts, feelings and the problematic ways these
evaluations cause a person to act. Group therapy and family therapy are also beneficial to person with
PTSD.
The selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, and β-blockers have been shown to
be effective in reducing the symptoms of PTSD. When prescribed in conjunction with psychotherapy,
pharmacotherapy can minimize the excessive fear and anxiety of PTSD.
Two SSRI antidepressants, sertraline (Zoloft) and paroxetine (Paxil), are approved by the
FDA for PTSD and are used to treat symptoms of sadness, worry, anger and numb feelings.
***Note: Safety Issues!!!: PTSD is associated with an increased risk of_SUICIDE , suicide attempts,
aggression, and substance abuse. What is the priority intervention?
Anxiety Disorders
The concept of anxiety: Anxiety is an uncomfortable feeling of apprehension which occurs as a result of
internal/external stimuli. Anxiety can result in feelings of dread, and can bring on physical, emotional,
cognitive and behavioral changes. See below breakdown of the levels of anxiety and the associated
symptoms.
Levels of Anxiety: Mild, Moderate, Severe and Panic
Mild t f d li i P ti i h d h d i f Y t thi
