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Mental disorders
Sub-Topics
Depression and Manic Depression
Alzheimer’s-type Dementia

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Help Les phobies Phobies La phobie démystifiée
The fear of being closed in
Original modules
Experiment : Identifying the Brain Structures Involved in Conditioned Fear Identifying the Brain Structures Involved in Conditioned Fear
Tool Module : Treating Anxiety Disorders   Treating Anxiety Disorders

A baby monkey that is raised in captivity has no fear of snakes. But if he is shown a film in which another monkey appears frightened of a snake, then snakes will immediately become terrifying for him as well. It would thus seem that this fear is not innate, in the strict sense, but rather is learned, albeit very rapidly. Interestingly, this rapid learning of fear does not occur with other objects, such as flowers, which shows that there is still something innate about this process.

Some of the things that humans are predisposed to be afraid of (and that often become the target of phobias) include snakes, spiders, birds of prey, dogs, reptiles, and heights. But our evolutionary predispositions are of little help to us in dealing with some very real modern-day dangers, such as firearms and automobiles.

The studies showing that monkeys are predisposed to be afraid of snakes point in the same direction: they confirm that the mechanism by which phobias originate is very old and was established even before hominization.

History : Hominization, or The History of the Human Lineage

 

PHOBIAS
PANIC DISORDERS POST-TRAUMATIC STRESS DISORDER (PSTD) OBSESSIVE-COMPULSIVE DISORDER (OCD) GENERALIZED ANXIETY DISORDER (GAD)

Phobias may be associated with a specific object or situation, but in either case, they seem to originate from a combination of biological factors and certain events that have marked the life of the individual concerned.

Some Freudian psychologists believe that phobias may sometimes be caused by unconscious psychological conflicts. In contrast, proponents of learning theory believe that the extreme fears associated with phobias are simply learned, either directly (for example, when someone is bitten by a snake) or indirectly (when someone observes someone elses's reactions of fear or pain; see sidebar).

Often a phobia may also arise from a conditioned fear, in which a neutral object that is present at the same time as a threatening stimulus becomes associated with that stimulus and thus itself gradually acquires connotations of danger. For example, in the 1920s, researchers demonstrated that they could condition a child to be afraid of a harmless laboratory rat if they simply made the child hear an unpleasant noise whenever the rat was nearby. This phenomenon may also explain the irrational nature of some phobias—the fear-conditioning process often occurs without the individual's being aware of it, so that he or she would later have trouble in remembering the event that first gave rise to this fear.

In other people, however, a phobia may develop as the result of an identifiable traumatic event. For example, if someone experiences a panic attack in a broken elevator, it might result in a fear of any enclosed space (claustrophobia).  

Other kinds of phobias are more common within particular families, which suggests that some genetic factors may be at work. But the question is still open as to whether this higher frequency is due to heredity or simply to having grown up around other anxious people. For example, studies have shown that in general, people who have social phobia or agoraphobia have experienced a family breakdown, felt shy, had few romantic relationships, and not been encouraged by their parents to develop social ties.

Many of the explanations offered for the origins of phobias also revolve around the idea that people have a biological predisposition to be more sensitive to certain specific stimuli such as snakes, spiders, and the dark, which is why these stimuli are the subject of phobias throughout all cultures in the world.

  Indeed, phobias very commonly involve categories of objects or situations that seem to have been especially significant in the course of human evolution. In a stable environment like the one that our ancestors lived in, the dangers that threatened a species changed very slowly. Hence a mechanism that let people quickly learn to recognize such dangers could be very advantageous.

This evolutionary mechanism would explain why phobias about electrical power lines are very rare, even though these lines are very common and dangerous in modern society, while phobias about many harmless insects are very common, simply because they remind us of other insects that are potentially very dangerous.







       

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Le trouble panique Troubles paniques avec agoraphobie (TPA) (1ère partie) Le trouble panique Panic Attack
La psychologie peut vous aider dans le traitement du trouble panique What is Panic Disorder? Answers to Your Questions About Panic Disorder Panic Disorder: A Highly Treatable Disorder
PANIC DISORDERS
PHOBIAS POST-TRAUMATIC STRESS DISORDER (PSTD) OBSESSIVE-COMPULSIVE DISORDER (OCD) GENERALIZED ANXIETY DISORDER (GAD)

At least once in our lives, most of us have suffered a panic attack brought on by some specific event. But people who have panic disorders experience panic attacks suddenly and with no apparent external threat that precipitates them. These attacks peak rapidly, usually in less than 10 minutes, and then subside. But despite their brevity, these attacks are typically described by their victims as terrifying experiences that leave them drained of emotion and anxious about their health.

The fear of having another attack becomes so worrisome that these people quickly learn to avoid the situations that seem to have triggered these episodes. Some people alter their behaviour considerably, thus somewhat relieving their anxiety about having more attacks. But some of the changes they make are so radical that they can cause even more serious problems.

  One such problem is panic disorder with agoraphobia. Contrary to what the Greek and Latin roots of this word suggest, agoraphobia is the fear not only of open spaces but also of any situation that can cause anxiety. This anxiety is quite often associated with the fear of losing control in places where it could become embarrassing to do so. These places may include not only open spaces such as public squares or crowds, but also closed spaces such as supermarkets, buses, and airplanes.

In fact, often these will be places where the person has previously experienced a panic attack. The circumstances that precipitated the original attack seem to give way to a lasting association with any environment resembling the one where the attack took place. Thenceforth, such an environment will generate anxiety and possibly further panic attacks, thus potentially creating a positive feedback loop that increases the number of anxiety-producing situations and panic attacks even more.

Tool Module : Cybernetics

Panic disorders occur in about twice as many women as men and in all countries, ethnic groups, and social classes. An estimated 33% of the general population will suffer a panic attack each year, but panic disorders are far rarer, affecting less than 1% of the population.

Most panic attacks last only a very few minutes; some last up to 10. They can occur for the first time at any age, but most often do so in early adulthood. Studies have also shown that they might be more common in certain families, which suggests the possibility of a genetic component.

Other studies have shown that in people with panic disorders, common antecedents include stressful events or the anticipation of such events, anxiety in childhood, overprotective parents, and substance abuse.


       

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About Medications For Combat PTSD Posttraumatic Stress Disorder
Researcher
Alain Brunet, Ph.D.
Experiment
Neural systems for executive and emotional processing are modulated by symptoms of posttraumatic stressdisorder in Iraq War veterans

In predicting the seriousness of cases of PTSD, the seriousness of the originating trauma (such as the injuries suffered in a physical attack) may be less important than the survivor's initial emotional reaction.

Certain people appear to be be more vulnerable to PTSD, in particular people who have experienced depression, anxiety, or other traumas in the past, or who are predisposed to anger, or whose style of adapting to stress involves not talking and not thinking about the traumatic event.

POST-TRAUMATIC STRESS DISORDER (PSTD)
PHOBIAS PANIC DISORDERS OBSESSIVE-COMPULSIVE DISORDER (OCD) GENERALIZED ANXIETY DISORDER (GAD)

Post-traumatic stress disorder (PTSD) involves severe anxiety resulting from stimuli to which someone was exposed during a traumatic event. PTSD is common in combat veterans, but the same symptoms have been found in victims of sexual abuse, physical trauma, highway and workplace accidents, and life-threatening illnesses such as cancer, as well as in people who are repeatedly exposed to other people's traumas, such as emergency-room nurses and ambulance attendants. Some psychiatrists also speak of PTSD in people who are especially troubled by the death of a close friend or relative.

Like phobias, PTSD is regarded by many authors as a particular form of conditioned fear. The difference is that in PTSD, it is the unconditioned stimulus that plays the decisive role, assuming the status of a genuinely traumatic experience—one that differs significantly from the kinds of events experienced in everyday life.

Experiment : Identifying the Brain Structures Involved in Conditioned Fear

Many researchers believe that PTSD results from adaptive mechanisms. For example, symptoms of hypervigilance may represent the body's attempts to stay alert enough to do whatever is necessary to stay out of danger. The deadening of emotions might represent a mechanism that protects the individual when the stress level is too high to handle. The problem with PTSD is that these mechanisms remain active even when they are no longer necessary, thus disturbing the individual's behaviour.

This condition of acute stress develops rapidly after a traumatic event and lasts less than a month. PTSD will not be diagnosed unless these disturbances persist for more than a month and cause the individual profound distress.

 

Many other psychological disorders can coexist with PTSD. For example, because people who have PTSD are constantly reliving the traumatic event, they often suffer from depression as well. They may also be subject to panic attacks triggered by persons, places, or conversations that remind them of the traumatic event.

Lastly, many people who have PTSD turn to drugs as a way of coping with the painful memories associated with their trauma. But in the long term, drugs will only accentuate the symptoms of anxiety and depression.


       

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Gene for obsessive behaviour Le trouble obsessionnel-compulsif (TOC) Quand l'inquiétude tourne à l'obsession Obsessive-Compulsive Disorder(OCD)

The connection between stress and OCD is not well understood, but researchers have observed that 50 to 70% of people with OCD develop their symptoms after some stressful event in their lives, such as job loss or the death of a relative.

OBSESSIVE-COMPULSIVE DISORDER (OCD)
PHOBIAS PANIC DISORDERS POST-TRAUMATIC STRESS DISORDER (PSTD) GENERALIZED ANXIETY DISORDER (GAD)

Obsessive-compulsive disorder involves thoughts and/or behaviours that are invasive, persistent, and repetitive. These behaviours are carried out in a very precise way that is meant to neutralize anxiety, but they constitute such excessive responses to the situations that they are meant to neutralize that they can actually become quite a handicap.

  The exact causes of obsessive-compulsive disorder (OCD) are not yet well understood. It was once thought that a very strict upbringing, emotional deprivation, or an excessive emphasis on cleanliness in childhood might contribute to the development of OCD later in life. But these explanations were soon found inadequate. In other words, you do not have to have monsters for parents in order to develop OCD.

As with many other anxiety disorders, certain genes may be involved in OCD. Cases of OCD that develop in childhood tend to be hereditary. When a parent has OCD, there is a slightly higher probability that his or her child will do so as well. When OCD is inherited, it is the general nature of the disorder that seems to be transmitted, and not the specific symptoms (for example, a mother may have a handwashing compulsion, while her child engages in compulsive checking rituals).

More recent studies also seem to indicate that streptococcal infections in young children may damage the part of the brain responsible for repetitive behaviour and thus predispose these children to develop OCD. Other preliminary studies have found that the brains of people who had OCD contained less white matter than those of people who did not.

Brain-imaging studies have also revealed differences between the brain-activity patterns of OCD sufferers and those of normal subjects. For example, people with OCD seem to show a problem in communication between the frontal cortex and the deeper structures of the central grey nuclei. Positron-emission tomography (PET) scans have also shown that after treatments that produced notable improvements in the condition of OCD patients, the activity patterns in these parts of the brain became more normal.

Researchers have also found lower levels of serotonin in these parts of the brain in OCD patients, which helps to explain why treatment with selective serotonin reuptake inhibitors (SSRIs) produces positive effects.

The compulsive, repetitive behaviours of OCD develop slowly and insidiously and become harder and harder to control. It is not unusual for some OCD sufferers to take two or three showers or wash their hands 100 times every day. Others may spend tremendous amounts of time tidying their home according to very special criteria, such as lining up all their canned foods in alphabetical order and folding their clothes in a very precise way. Still others may need to follow exactly the same path and cross the streeet at exactly the same spot on their way to work every day.

Some OCD patients are obsessed with numbers: they must brush their hair exactly the same number of strokes every morning, or wait the same number of rings every time before they answer the telephone, or tap a table a certain number of times whenever they pass by it.

OCD is diagnosed when such ritualized behaviours are causing the person significant distress and taking up so much time (in general, more than one hour per day) that they are interfering with his or her normal daily activities.

 

       

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Link : Generalized Anxiety Disorder (GAD)

Anxiety is a psychological mechanism that can very likely serve useful purposes for human beings. It is closely related to our ability to anticipate and to project into the future. This ability to construct mental scenarios is far more advanced in humans than in other species whose prefrontal cortex is less developed. Hence this faculty is involved in many behaviours that make us uniquely human. But when it gets out of control, it can also be responsible for anxiety that paralyzes us and prevents us from functioning.

GENERALIZED ANXIETY DISORDER (GAD)
PHOBIAS PANIC DISORDERS POST-TRAUMATIC STRESS DISORDER (PSTD) OBSESSIVE-COMPULSIVE DISORDER (OCD)

What generally distinguishes anxiety from fear is the absence of any external stimulus that triggers the anxiety reaction. Actually seeing a snake may trigger fear, while remembering a snake when you pass by a place where you once saw one may trigger anxiety. By keeping us away from potential dangers, both fear and anxiety have significant adaptive value, which is why we have inherited them from our ancestors. But when anxiety becomes so recurrent and persistent that it interferes with someone's normal activities, they may be diagnosed as having generalized anxiety disorder (GAD).

There are probably a number of factors that contribute to this disorder. Since it is more common in certain families, some genetic factors seem to be involved. These factors might make certain individuals biologically predisposed to GAD, which they would then develop if certain kinds of triggering external events occurred in their lives.

In other cases, GAD might be caused by traumatic memories or unresolved internal conflicts. In many cases, these precipitating factors and the disorder itself date back to very early childhood.

Most people who have GAD also experience depression and/or panic attacks. All of these disorders seem to be influenced by certain neurotransmitters, such as serotonin. GABA and norepinephrine may also be involved in anxiety disorders.

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