Psyc+anxiety+disorders

LEEREENHEID / LEARNING UNIT 4

Angs, Obsessief-kompulsiewe en trauma verwante versteurings

Anxiety, Obsessive-compulsive and trauma related disorders

Youtube video

https://www.youtube.com/watch?v=dw3GXuYaXQ0•Kyk die volgende video en let op na:/ Watch the following video and be aware of:1.Jou asemhaling/ your breathing2.Jou hartklop/ your heart rate3.Jou handpalms/ your palms4.Jou gevoel van veiligheid/ your sense of safety

Inleiding / IntroductionMees algemene versteuring / Most common disorder

74% het komorbiede versteuring / 74% have co-morbid mental disorder

Vroue groter risiko / Women at greater risk

Normale vrees en angs = funksioneel / Normal fear & anxiety is functional

e.gsomatoformmoodanother anxietysubstance-related

Paniek / Panic

• Wat is paniek, en hoe is dit anders as vrees?

• What is panic, and how is it different to fear?

Paniek = disfunksionele vrees!Panic = dysfunctional fear!

Angs / Anxiety

• Toekoms / Future

• Negatiewe affek / Negative affect

• Hiperwaaksaamheid / Hypervigilance

• Somatiese simptome / Somatic symptoms

• Disfunksionele angs / Dysfunctional anxiety • vals alarm / false alarm• preokkupasie / preoccupation• wanaanpassend / maladaptive• chronies / chronic• nie beheer / no control• verswak algemene funksionering / impairs general

functioning

Funksie / Function:

Beskerm / ProtectBeplan / PlanAanpas / Adjust

Stres / Stress• Stres is persepsie dat eise beskikbare bronne oorskry / Stress =

perception that demands are more than available resources• Eustres / eustress Funksionele angs • Distres / distress Disfunksionele angs

• Algemene Aanpassingsindroom (AAS) / General Adaptation Syndrome (GAS):• Phase 1: Alarm / Alarm• Phase 2: Weerstand / Resistance• Phase 3: Uitputting / Exhaustion

• Chroniese of onbeheerbare stres neg effek op immuunsisteem + vatbaarheid vir fisiese & psigologiese siektes / Chronic or unmanageable stress: negative effect on immune system & risk of developing physical & psychological disorders

Angs, obsessief-kompulsiewe en trauma verwante versteurings/ Anxiety, obsessive-compulsive and trauma related disorders

Veralgemeende angsversteuring (VAV)Generalised Anxiety Disorder (GAD)

Chronies, oormatige, onbeheerbare, disfunksionele kommer Chronic excessive, uncontrollable, dysfunctional worry

Rusteloosheid, irriteerbaarheid, spierspanning, konsentrasieprobleme, versteurde slaap / Restlessness, irritability, muscle tension, difficulty concentrating, disturbed sleep

Algemeen, affekteer meer vroue / Common; affects more women

Vroeë aanvang / Early onset (childhood/adolescence)

Paniekversteuring / Panic disorders

• NB: Paniekaanval vs paniekversteuring / NB: Panic attack vs panic disorder

• Veg /vlug + ontoepaslike en disfunksionele leer / Fight/flight accompanied by inappropriate and dysfunctional learning

• Vrees nalv vals alarm / fear based on false alarm

• Fisiese simptome / Physical symptoms

Situasioneel-gebondeSituationally bound (Cued)

Onverwagte Unexpected (uncued)

Situasioneel-gepredisponeerdSituationally predisposed

Spesifieke Fobies / Specific PhobiasIrrasionele, oormatige en disfunksionele vrees vir objekte & situasies /

Irrational, excessive & dysfunctional fear of objects & situations

DefinisieIrrasionele, disfunksionele vrees vir spesifieke situasies of objekte

DefinitionIrrational, dysfunctional fear of specific situations or objects

OormatigVeroorsaak hoë

angsBeïnvloed

funksionering

ExcessiveCauses high

anxietyInfluences

fundctioning

Tipes:1. Diere 2. Situasionele3. Natuurlike

omgewing4. Bloed-inspuiting-

besering Types:1. Animals2. Situational3. Natural

environment4. Blood-injection-

injury

Sosiale angsversteuring/ Social anxiety disorder

• Vrees om veroordeel/ geëvalueer/ verneder te word.

• Oormatige vrees om voor ander op te tree.

• Fear of being scrutiny and evaluation by others and being embarrassed.

• Excessive fear of performing in front of others

Obsessief-kompulsiewe versteuring (OKV)Obsessive-Compulsive Disorder (OCD)

Obsessies / Obsessions

Kompulsies / Compulsions

Obsessies/Obsessions

• Voortdurende, indringende, angswekkende gedagtes, beelde of impulse buite persoon se beheer/ Persistent, intrusive, anxiety provoking thoughts, images or impulses that a person cannot control.

Kompulsies/ Compulsions

• Herhaalde gedrag of mentale pogings in respons tot obsessie met die doel om angs te verlig/ Repetitive behaviour or mental acts in response to obsessions with the aim of reducing anxiety.

Obsessief-kompulsiewe versteuring (OKV)Obsessive-Compulsive Disorder (OCD)

• DSM-5 kriteria/ Criteria (Table 4.7 p. 125).• A: Presence of obsessions, compulsions or both…

– Obessions defined by…– Compulsions defined by…

• B: O&C time consuming & cause clinically significant distress or impairment in… functioning.

• C: Not attributed to physiological effects of substance or medical condition.

• D: Not better explained by another mental disorder

Trauma en stresverwante versteurings /Trauma and Stress related disorders

PTSV / PTSD Tydens trauma: Intense vrees, hulpeloosheid, afskuAanvang 1- 6 mnde3 Simptoomgroepe:

herbelewenisvermydinghiperwaaksaamheid

During trauma: intense fear, helplessness, horrorOnset 1- 6 months3 symptom groups:

re-experience avoidance hypervigilance

Akute stres / Acute stress

Aanvang 1 dag-1 mnd Onset 1 day - 1month

Minder ernstigLess severe

Meer dissosiatief More dissociative

traumatic event

• Mnr B was in erge motorongeluk, 1 jaar gelede. Het 40 dae na die ongeluk begin nagmerries kry, misbruik alkohol, skrik maklik wanneer hy ‘n motor hoor rem, is bang om motor te bestuur, is baie angstig, voel emosioneel afgestomp. Hou nou al 4 maande aan.

• Mr B was in a severe car accident, 1 year ago. He started to get nightmares 40 days after the accident, abuses alcohol, is frightened easily when he hears a car braking, is afraid to drive, is extremely anxious, and feels emotionally detached. Ongoing for 4 months now.

PTSV / PTSD

Mev H is bekommerd dat haar dogter se kamer so vuil en onnetjies is. Sy is ook bekommerd omdat haar man nooit sy klere self in die wasmasjien gooi nie, maar is bang om dit vir hom te sê, want ‘dalk los hy haar’. Sy voel onseker of haar vriendinne regtig van haar hou, en is baie angstig oor die moontlikheid dat daar by hulle huis ingebreek sal word. Sy vroetel gedurig, voel moeg en rusteloos. Die onsekerheid veroorsaak dat sy glad nie meer effektief kan funksioneer nie.

Mrs H is worried about the dirty, untidy room of her daughter. She is also worried because her husband never puts his clothing in the washing machine, but is afraid to tell him, as he will then ‘probably divorce her.’ She feels uncertain if her friends really like her and is extremely anxious about the possibility that someone will break into their home. She constantly fidgets, feels tired and restless. The result is that she is not able to function effectively any more.

Veralgemeende angsversteuringGeneralised anxiety disorder

Mev Z raak elke dag baie angstig by die werk – sy voel benoud, voel sy verloor beheer, begin hiperventileer, ervaar spierspanning, kry nie haar werk gedoen nie. Hoewel sy bang is daarvoor om dit weer te ervaar, keer dit haar nie om wel elke dag werk toe te gaan nie.

Mrs Z gets very anxious every day at work – she finds it difficult to breathe, feels that she is going to lose control, starts to hyperventilate, experience muscle spasms, and does not get her work done. Even though she is afraid to experience it again, it does not prevent her from going to work. Paniekversteuring / Panic disorder

• Mnr L was in ‘n motorongeluk, 1 maand gelede. Hy het nog pyn, en voel baie hartseer oor sy vriend wat daarin oorlede is. Hy ry deesdae versigtiger en volg al die padreëls na. Hy is darem al terug by die werk waar dit baie goed met hom gaan.

• Mr L was involved in a car accident, 1 month ago. He still has physical pain, and feels very sad about his friend who died in the accident. Since the accident, he drives more carefully and complies to all road rules. He is back at work, where he is coping well.

Geen diagnose / No diagnosisWHY??

Risikofaktore in Suid-AfrikaRisk factors in South Africa

• Misdaad, geweld & ongelukke / Crime, Violence & accidents– Geweldstrauma & gesinsgeweld / Violent trauma & domestic

abuse– MIV/VIGS / HIV & AIDS– Seksuele geweld: verkragting / Sexual violence: rape

• Verkragtingtrauma-sindroom / Rape Trauma Syndrome

– Motorongelukke / Motor vehicle accidents

• Beskermende faktore/ protective factors