Understanding Panic, PTSD, SAD, Depression & Models

• Summarized notes from the provided text, about PANIC, PTSD, SAD, Depression and Models

PANIC

• DSM 5 criteria includes recurrent, unexpected panic attacks with at least four symptoms like palpitations, trembling, or dizziness
• At least one month of persistent worry about future attacks, concern about their implications, and significant behavioral changes signify panic disorder
• Cognitive Model of Panic involves catastrophic misinterpretation of bodily sensations
• This includes safety-seeking behaviors maintaining the cycle of panic
• Avoidance prevents disconfirmation of feared outcomes.
• The process starts emotional response from a trigger; external situation, memory
• Physical sensations> safety behaviors occur
• Thoughts with interpretation and beliefs cause emotional response
• CBT stages involve formulation, behavioral/cognitive techniques, preventing relapse, and monitoring

CBT for Panic

• Psychoeducation explains cognitive model of panic
• It provides alternative explanations for symptoms with a cognitive formulation diagram
• Cognitive Techniques challenge catastrophic thoughts
• Use Theory A vs. Theory B to contrast thought, to identify the problem, using evidence if theory A/B is true, and what to do if it is
• Behavioural techniques involve planned experiential activities based on experimentation or observation from a cognitive formulation of the problem
• Testing the validity of the person's existing beliefs about themselves, others, and the world
• Constructing and/or testing new, more adaptive beliefs
• Contribute to the development and verification of the cognitive formulation

PTSD

• DSM-5 criteria cover different experiences, including:
• Intrusion such as flashbacks and nightmares.
• Avoidance of trauma-related thoughts and places.
• Negative changes in cognitions and mood like emotional numbness.
• Alterations in arousal, hypervigilance, and sleep issues
• Symptoms must last more than 1 month, cause functional impairment, and not be due to other conditions
• C-PTSD (ICD-11) includes core PTSD symptoms plus emotional dysregulation, dissociation, and self-identity issues
• Clinical presentations involve intrusive thoughts and memories, sleep problems, body memories, dissociation, hypervigilance, and mood or behavior problems

Ehlers & Clark's Cognitive Model (2000)

• Current threat feeling arises from negative appraisals of trauma and sensory-processed consequences
• Making it a current threat Poortly processed trauma memories lead to re-experiences
• Strategies to control threat, like avoidance, worsen symptoms
• Maintained by negative appraisals lead to sense of current threat, strategies that attempt to control threat maintain these symptoms

CBT for PTSD

• The aim is to reclaim lives by aligning with personal rather than being controlled by fears from past trauma
• Focus on modifying negative appraisals, minimizing re-living events, and eliminating dysfunctional strategies, and update trauma memories with cognitive and imaginal exposure
• Re-live the event, describe it in present tense, eyes closed or in writing

Trauma hot spots

• Identify them with distressing moments and negative cognitive appraisals and ask:
• What were the worst things you ever thought about
• How can i remind myself of what i know not
• In vivo exposure involves behavioral experiments with safe stimuli or revisiting trauma-related situations

SAD

• Marked fear of social situations where the person may be scrutinized
• Out of Proportion: Anxiety disproportionate to actual threat
• Distress and Impairment: Significant distress or functional impairment in social or occupational domains.
• Duration: Symptoms lasting 6 months or more

Cognitive Model of Social Anxiety Disorder (Clark & Wells, 1995)

• Involves assumptions about self, specifically excessively high self standards
• Includes use of conditional beliefs as well as personal negative self-beliefs
• Self-Monitoring focuses excessively on how one appears to others during social interactions, by processing self as social object
• Social Threat leads to somatic and cognitive symptoms, using safety behaviors to inadvertently reinforce anxiety

Cognitive Behavioral Therapy (CBT) for SAD

• Includes Assessment with formulation and psychoeducation about SAD
• Behavioral Experiments test and challenge negative beliefs

Depression DSM5

• Symptoms includes depressed mood, the feeling of worthlessness and fatigue,
• Suffer loss of interest and pleasure for 2 weeks or more

Six Cycles of Depression

• Automatic Negative Thinking includes Self-critical, negative automatic thoughts
• Rumination & Self-Attacking are also elements, using dwelling on negative thoughts, replaying past mistakes, harsh self-criticism
• Persistent low mood and other negative emotions like guilt
• Withdrawal & Avoidance: Social isolation, reduced activity, reinforcing loneliness
• Unhelpful Behaviors: Coping mechanisms like substance misuse, comfort eating, and self-harm as well as motivational problems and physical symptoms

Maintenance

• Reinforced cycles feed into another, for example, loops leads to withdrawal, and withdrawal reinforces negative thoughts
• External Stressors like life events can sustain loops

Cognitive Techniques

• Includes assessment with formulation and thought records, thought should contain mood rates as well as all evidence
• Behavioural experiments are used to test beliefs and their values