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Abnormal Psychology

BY MADDIE PERRETT

Anxiety Disorders: PTSD

PTSD lasts for more than 30 days

Develops in response to a specific stressor

Characterised by intrusive memories of a traumatic event, emotional withdrawal, heightened autonomic arousal

Results in insomnia, hypervilgilance, or loss of control over anger and aggressive behavior

Decreased interest in others and a sense of estrangement.

Inability to feel positive emotions – called anhedonia.

Prevalence

US prevalence rate 1-3%

Lifetime prevalence of 5% in men and 10% in women (est.)

15-24% (est.) of individuals exposed to traumatic events develop PTSD symptoms

Communities exposed to traumatic events, average prevalence increases to 9%

Most frequent trauma that triggers PTSD is the loss of a loved one, one-third of all cases

Symptoms

AFFECTIVE: Anhedonia; emotional numbing

BEHAVIOURAL: hypervigilance; passivity; nightmares; flashbacks; exaggerated startle response

COGNITIVE: intrusive memories; inability to concentrate; hyperarousal

SOMATIC: lower back pain; headaches; stomach ache and digestion problems; insomnia; regression in some children, losing already acquired developmental skills, such as speed or toliet training.

STUDY: PTSD IN POST-GENOCIDAL SOCITIES: RWANDA

Conducted soon after the genocide

Continued to live in the communites where the atrocities had taken place

1995 UNICEF survey of 3000 Rwandan children (8-19 years old)

95% participants had witnessed violence, 80% suffered a death in immediate family, 62% had been threatened with death

1997 65,000 families headed by children aged 12 or younger

Over 300,000 children were growing up in households without adults

Those living in the community higher rates of intrusive memories

Exposed to stimuli that triggered memories

Etiology of PTSD

BLOA

Twin research has shown a possible genetic predisposition.Role of noradrenaline – neurotransmitter plays a role in emotional arousalHigh levels of noradrenaline cause people to express emotions more openlyPTSD patients have higher levels of noradrenalineStimulating the adrenal system in PTSD patients induced a panic attack in 70% of patients and flashbacks in 40%No control group members experience these symptomsEvidence of increased sensitivity of noradrealine receptors in patients

Etiology of PTSD

CLOA

How individual cognitions could make a difference to people who develop PTSDDifferences in the way individuals process experiences and attributional stylesLack of control over their lives, world is unpredictable (PTSD patients)Often experience guilt regarding the traumaInstrusive memories seem random: triggered by sounds, sights, smellsCue-dependent memory where stimuli trigger aspects of the memory, causing panicFlooding (over-exposure to stressful events) – eventually fade out due to habituation.Schema processing suggest in depressionHolocaust survivors have decreased trust levelsMore skeptical view of the world

Etiology

SCLOA

Racism and oppression are predisposing factors for PTSDMeta-analysis of Vietnam War Veterans – 20.6% Black, 27.6% Hispanic met criteria for PTSD compared to 13% WhiteThreat of death factor evidencing the strongest influence on intrusive thoughts and avoidance of behaviour1998 in Bosnia – 73% girls and 35% boys suffered symptoms of PTSDGirls is higher because of fear of rapeChildren may develop PTSD by observing domestic violence

CULTURAL CONSIDERATIONS

Common for survivors to initiate treatment with someone due to somatic complaintsDSM somatic symptoms of PTSD are atypicalIrrational and ethnocentric to assume non-western forms of this disorder are atypicalNon-western survivors exhibit what are called body memory symptomsE.g. dizziness experience by a woman which was found be a body memory of her repeated experience of being forced to drink large amounts of alcohol and then being raped.

GENDER CONSIDERATONS

Significant gender difference

Breslau et al. 1991 longitudinal study of 1007 young adults exposed to community of violence found a prevalence rate of 11.3% in women and 6% in men

Women have up to a 5 times greater chance than males to develop PTSD

Symptoms differ: Men irritability, impulsiveness and Women numbing, avoidance

Men Substance abuse disorders

Women Anxiety and affective disorders

Different traumas carry different risks

Rape is experienced more often by women and rape carries on of the highest risks of producing PTSD

Socialization differences – leads girls to internalize their problems and boys to externalize them.

Eating Disorders: Bulimia

2-3% of women and 0.02-0.03% of men in US (Diagnosed)

Female:male is approx 10:1

Binge eating is the most common eating disorder and it affects 2 % of adults

Similar rates found in Japan and some European countries

More than 5 million individuals are believed to experience an eating disorder in the USA alone.

Bulimia involves a preoccupation with eating, an idealisation of thinness and a fear of becoming fat.

Late teens or early twenties

Symptoms

AFFECTIVE: feelings of inadequacy, guilt or shameBEHAVIOURAL: recurrent epsiodes of binge eating;

use of vomiting, laxatives, exercise or dieting to control weight

COGNITIVE: negative self-image; poor body image, tendency to perceive events as more stressful than most people would, perfectionism

SOMATIC: swollen salivary glands, erosion of tooth enamel, stomach or intestinal problems and in extreme cases heart problems

Etiology

BLOA

Twin research shows some support for a genetic diathesis for eating disorders, still in early stages

Highly secretive nature of bulimia, self-reporting has not always led to reliable data.

First degree relatives of women with bulimia are 10 times more likely than average to develop the disorder.

Serotonin plays a role

Increased serotonin stimulate the medial hypothalamus and decrease food itake.

Carraso (2000) found lower levels of serotonin

Etiology

CLOA

Body-image distortion hypothesis – delusion that people think they’re fat

Overestimate body size

Some patients reflect their emotional appraisal rather than their perceptual experience

Uncertain about size and shape of their body, when compelled to make a judgment they err on the side of reporting an overestimation

Gender indifference in the perception

Cognitive disinhibition – dichotomous thinking – an all-or-nothing approach

Thoughts about eating (cognitions) act to release all dietary restrictions (disinhibition)

Etiology

SCLOA

Perfect body figure has changed over the years in the West

1950s female sex symbols had much larger bodies compared with those today

More rounded figure has been considered ideal suggests that the current position might be open to change.

People constantly compare themselves to other people and their self-esteem is affected by this

Media portrays the ‘ideal person’

Women are more likely than men or children to be the target for the media propaganda

Distorted ideas about what is normal and acceptable mean that many children become dissatisfied

Men too are now under pressure. Ideal ‘worked-out’ male figure appears in many commercials.

Produces strong demand to the mirror the idea.

GENDER

Men selected similar figures to themselves

Women chose ideal and attractive body shapes, much thinner

Women chose thinner in all choices