Anxiety Disorders 329
Brain areas involved in PTSD include parts
of the frontal lobe, the hippocampus, the locus
coeruleus, and the amygdala—most of these
areas are involved in emotion and fear. Patients
with PTSD respond unusually to high levels
of norepinephrine, have disrupted serotonin
function, and produce less cortisol in response
to the traumatic event than do people who do
not go on to develop a stress disorder.
Psychological factors that exist before a
traumatic event contribute to PTSD; these fac-
tors include a history of depression or other
psychological disorders, a belief in being un-
able to control stressors, the conviction that
the world is a dangerous place, and lower IQ.
After a traumatic event, classical and oper-
ant conditioning contribute to the avoidance
symptoms. Social factors that contribute to
PTSD include the stress of low socioeconomic
status and a relative lack of social support for
the trauma victim.
Medication is the treatment that directly
targets neurological factors, specifically an
SSRI. Treatments that target psychological fac-
tors include CBT. Treatments that target social
factors are designed to ensure that the individ-
ual is as safe as possible from future trauma,
and to increase social support through group
therapy or family therapy.Thinking like a clinician
Two friends, Farah and Michelle, came back
from winter break. Each had been devas-
tated by personal experiences that occurred
during the break. Farah’s house burned
down after the boiler exploded; fortunately,
everyone was safe. Michelle’s house had
also been destroyed in a fi re, but the police
believed it was set by an “enemy” of her fa-
ther’s. Six months pass, and by the time they
go home for summer vacation, one of the
friends has developed PTSD. Which friend do
you think developed PTSD and why (based
on what you have read)? What symptoms
might she have and why? Based on what
you have read, what do you think would be
appropriate treatment for her?Key Terms
Anxiety (p. 248)
Anxious apprehension (p. 249)
Anxiety disorder (p. 249)
Fight-or-fl ight response (p. 249)
Panic (p. 249)
Phobia (p. 249)Generalized anxiety disorder (GAD) (p. 252)
Hypervigilance (p. 256)
Panic attack (p. 262)
Panic disorder (p. 263)
Agoraphobia (p. 266)
Concordance rate (p. 269)
In vivo exposure (p. 274)
Interoceptive exposure (p. 274)
Social phobia (p. 278)
Specifi c phobia (p. 289)
Obsessions (p. 299)
Compulsions (p. 299)
Obsessive-compulsive disorder
(OCD) (p. 299)
Posttraumatic stress disorder
(PTSD) (p. 314)
Acute stress disorder (p. 314)More Study Aids
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