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Like Macartney, Caledon obtained information about the distant parts of the colony by sending a Collins are reproduced in Moodie, The Record part 5, 1-
Table of contents
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- Clinical Definition of OCD
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Posttraumatic stress disorder is caused by life-threatening or comparable emotional experiences; flashbacks and recurrent re-living of a traumatic event are the most specific symptoms. Panic disorder is an anxiety disorder that is characterized by unexpected and recurrent panic attacks. The individual typically thinks they are having a heart attack or stroke and go to the emergency department thinking they are dying. Panic attacks often occur for no apparent reason, sometimes even during sleep.
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However, between attacks, the individual may experience considerable anxiety and fear in anticipation of having further attacks, particularly about where and when the next attack will take place. This anxiety is likely more disabling than the panic itself, and may be intense enough to trigger another attack. Occasional panic attacks are fairly common; many adults, however, do not develop the anxiety about having further attacks. Panic disorder is diagnosed if the individual has recurrent panic attacks minimum four in a four-week period , and at least one of the attacks is accompanied by one or more physical symptoms, including persistent concern about having another attack, worry about the implication or consequences of the attack i.
Panic disorder typically begins in late adolescence or young adulthood, but children and older adults can also be affected. Individuals who experience terror in anticipation of the next attack will likely avoid places where panic attacks have occurred, or where they cannot escape easily, where help is not readily available, or where they will face embarrassment if an attack strikes. The avoidance may grow over time and lead to agoraphobia see the next section , the inability to go anywhere beyond a surrounding that is known and safe due to intense fear. Agoraphobia can develop at any point in the course of panic disorder, but it usually develops within the first year of occurrence.
Separation anxiety and psychological traumas during childhood have also been associated with onset of the disorder. Early diagnosis and treatment are key components to improved prognosis. However, many people do not seek psychiatric treatment until they develop unbearable anticipatory anxiety or agoraphobia. The most effective treatment with lower relapse rates is a combination of medication and psychotherapy. Cognitive-behavioural therapy teaches the patient to examine and analyze their thoughts associated with the situations they fear, and to reassure themselves when they are frightened.
Panic disorder is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms.
While the panic attack is the hallmark of panic disorder, many people develop intense anxiety between episodes the chronic phase, which this health state describes , in anticipation of future attacks. Over time, the individual may avoid more and more places; their life may become so restricted that they cannot do everyday activities such as grocery shopping. They may become housebound, unless accompanied by someone they trust. Exacerbation might be accompanied with such somatic symptoms as chest pain and palpitations.
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Classification Panic disorder. The panic attack is the core feature of panic disorder and is described in this health state as acute. Panic attacks often occur suddenly and without warning, although they may be a result of classical conditioning. They are defined by a sudden surge of overwhelming fear and have a strong physical component to them, including lightheadedness, a rapid heartbeat, chills or hot flashes, flushing, trouble swallowing, terror, dizziness, and chest pains.
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Typically the individual experiencing a panic attack feels 'crazy' or 'out of control', and has a feeling of imminent danger. Symptoms of a panic attack peak within 10 minutes, but the frequency and severity of them varies from individual to individual. Classification Panic attack. Agoraphobia is a disorder characterized by an intense fear of public places, particularly places where help or immediate escape might be difficult e.
Clinical Definition of OCD
The most commonly feared places are elevators, bridges, public transportation, airplanes, and shopping malls; standing in a line or in a crowd of people may also be feared. Often the fear is so extreme that the individual avoids such places; in severe cases, the individual is housebound. Agoraphobia often accompanies another anxiety disorder, especially Panic Disorder there may be the presence of panic attacks. Alternatively, many individuals with agoraphobia have no history of panic attacks.
Agoraphobia can develop at anytime, but onset is typically in late adolescence or early adulthood. Agoraphobia is diagnosed by the DSM-IV if the individual has anxiety about being in places where it may be difficult or embarrassing to escape or places where they could not get help in the case of a panic attack. These situations are either avoided or endured with extreme anxiety and distress, or the individual insists that someone accompanies them.
Causes of agoraphobia are unknown but several risk factors have been identified, including having panic disorder or an alcohol or substance use disorder, experiencing a stressful life event, being female, or having a tendency to be nervous or anxious. Treatment for agoraphobia is important for better prognosis, 38 but often individuals are too fearful or embarrassed to seek treatment.
Treatment is often successful and begins with a combination of medication and psychotherapy. Antianxiety and antidepressant medications are commonly prescribed. Cognitive-behavioural therapy helps the individual learn about the disorder, how to cope with it and how to control it i. Desensitization therapy is a form of exposure therapy in which the individual imagines or confronts the situations that cause fear, in order from the least fearful to the most fearful, in order to change their unwanted behaviour.
Agoraphobia in its moderate form is quite a disabling phobia that causes a high level of anxiety. Individuals are limited to the places and situations that they consider to be safe, or require the accompaniment of a trusted friend or family member.
Consequently, they feel helpless and dependent on others. In addition, their social and occupational opportunities are limited or avoided. Classification Agoraphobia - moderate. Individuals with severe agoraphobia suffer an extreme level of anxiety and avoid the places and situations in which they are most fearful. In fact, often the individual with severe agoraphobia is housebound. They are unable to leave trusted, safe places and people. As a result, they are unable to work or socialize outside the home, and feel detached and estranged from others.
If forced to undergo the feared situation, individuals experience intense anxiety and considerable dread, "break out in a" sweat, or have a rapid heart rate or high blood pressure. As well, nausea, abdominal pain, diarrhea, and headaches are common. Symptoms of a panic attack may also be experienced: lightheadedness, dizziness, flushing, chest pain, trouble swallowing, and a feeling of a loss of control. Classification Agoraphobia - severe.
Social phobia, also known as social anxiety disorder, is a disorder characterized by a fear of situations in which there is potential for embarrassment or humiliation in front of others. There are generally two subtypes of social phobia: one involves a fear of speaking in front of people, whether it be public speaking or simply talking with a person of authority; the other subtype involves more generalized anxiety and complex fears, such as eating in public or using public washrooms, and in these cases individuals may experience anxiety around anyone other than family.
Although the individual is aware that this anxiety is excessive and unreasonable, they cannot overcome it. Consequently, the individual desperately tries to avoid these situations, causing interference in work, school, or other daily activities. In extreme cases, the individual eventually avoids, or endures with intense distress, all social interaction, resulting in withdrawal even from friends and family.
Social phobia is one of the most common anxiety disorders, 40 and is among the most common psychiatric illnesses. The DSM-IV diagnoses social phobia if there is striking and persistent fear towards a situation in which the individual is exposed to potential scrutiny by others, and exposure to the situation provokes anxiety. The individual realizes that this fear is excessive and unreasonable but still either avoids the situation or undergoes it despite intense anxiety or distress.
For a diagnosis to be made, the avoidance or distress must cause significant impairments in the individual's daily routine, or in their occupational and social functioning.
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In addition, the fear is not due to the physiological effects of a substance or a medical condition. Although the exact cause of social phobia is unknown, it appears that individuals with relatives that have the disorder are at greater risk of developing it, suggesting a genetic predisposition.
Early diagnosis and treatment of social phobia are essential in improving prognosis of the disorder and preventing comorbidity with other disorders. However, many individuals with social phobia do not seek treatment for their disorder, 42 likely because they are either embarrassed to see a professional or because they feel their shyness is part of their personality or simply a social problem rather than a mental health problem.
Cognitive-behavioural therapy, specifically exposure therapy, gradually teaches the individual to become more comfortable in the situations that create fear. Group and family support therapy are effective in educating others about the disorder. Individuals with social phobia experience intense anxiety and worry about any situation in which others could judge them.
Physical symptoms, including a rapid heart rate, blushing, or trembling, often accompany the anxiety, which may be a source of further humiliation. Individuals with social phobia are constantly worried about looking foolish in front of others; for example, during public speaking, the individual has a fear of being embarrassed that others see their hands or voice tremble. Some side effects associated with the use of SSRIs include insomnia, anxiety, gastrointestinal upset, and sleepiness. One review of the research has suggested that approximately 40 to 60 percent of patients respond to treatment with SRIs with a 20 to 40 percent reduction in OCD symptoms.
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The specific treatment used, whether medication alone, psychotherapy alone, or some combination of the two, depends upon the individual needs of each patient. For example, CBT may be used alone in patients who are averse to taking medications or those who are pregnant or nursing. Medication might be prescribed alone for patients who have poor motivation for insight-based treatments or who lack access to a CBT-trained mental health practitioner.
In one review, researchers looked at earlier studies to see if certain symptoms subtypes of OCD responded better to certain treatment approaches. They found that in the majority of studies, OCD characterized by religious and sexual obsessions in the absence of compulsions i.
Exposure and response prevention, also known as ERP therapy, is a form of cognitive-behavioral and exposure therapy. It involves a trained therapist helping a client approach a fear object without engaging in any compulsive behaviors. Clients intentionally expose themselves to the objects, images, situations, or thoughts that make them anxious or that are the subject of their obsessions but are prevented from engaging in the compulsive behavior that typically follows these events. The goal of such therapy is to help patients learn how to effectively manage their symptoms without having to resort to acting upon compulsions in order to relieve mental distress.
So, is pure O really a distinct form of OCD?