Appraisals of Social Trauma and Their Role in the Development of Post-Traumatic Stress Disorder and Social Anxiety Disorder.

Cognitive theories of post-traumatic stress disorder (PTSD) feature appraisal of trauma as a critical factor in the development and maintenance of the disorder. Here we explored appraisals of social trauma (severe rejection or humiliation). Participants were outpatients with social anxiety disorder (SAD) and clinically significant PTSD symptoms (PTSS) after social trauma (n = 15); two clinical control groups of either SAD (n = 32) or obsessive-compulsive disorder (OCD; n = 13); and a control group with no diagnoses (n = 38). Measures included a clinical interview to assess social trauma and related open-ended appraisals and the Posttraumatic Cognitions Inventory (PTCI). Raters blind to group assignment performed content analyses of appraisals. Results showed that the PTSS group scored significantly higher than either clinical group on the PTCI SELF subscale. Only the SELF subscale predicted a diagnosis of both PTSS and SAD. All but one PTSS participant reported primarily negative beliefs about their social trauma, and the most common categories were flawed self and others are critical or cruel. Post-traumatic appraisals implicated in the course of PTSD are significant in how individuals respond to social trauma, with negative self-cognitions linked to both PTSS and SAD.

Social trauma and its association with posttraumatic stress disorder and social anxiety disorder.

The key characteristic of a traumatic event as defined by the Diagnostic and Mental Manual of Mental Disorders (DSM) seems to be a threat to life. However, evidence suggests that other types of threats may play a role in the development of PTSD and other disorders such as social anxiety disorder (SAD). One such threat is social trauma, which involves humiliation and rejection in social situations. In this study, we explored whether there were differences in the frequency, type and severity of social trauma endured by individuals with a primary diagnosis of SAD (n = 60) compared to a clinical control group of individuals with a primary diagnosis of obsessive compulsive disorder (OCD, n = 19) and a control group of individuals with no psychiatric disorders (n = 60). The results showed that most participants in this study had experienced social trauma. There were no clear differences in the types of experiences between the groups. However, one third of participants in the SAD group (but none in the other groups) met criteria for PTSD or suffered from clinically significant PTSD symptoms in response to their most significant social trauma. This group of SAD patients described more severe social trauma than other participants. This line of research could have implications for theoretical models of both PTSD and SAD, and for the treatment of individuals with SAD suffering from PTSD after social trauma.

Implementation of the Bergen 4-Day Treatment for Obsessive Compulsive Disorder in Iceland.

OBJECTIVE: The purpose of this study was to evaluate the first implementation outside of Norway of the Bergen 4-day treatment for Obsessive Compulsive Disorder (OCD), an innovative and effective treatment format with high acceptance and basically no drop-out. METHOD: Nineteen patients with OCD underwent the treatment at the Icelandic Anxiety Clinic (Kvíðameðferðarstöðin). Of these, 17 of the patients were classified pretreatment with severe to extreme symptoms and 2 were classified with moderate symptoms. 63% of the patients had previously received treatment for OCD (ERP or CBT). RESULTS: Mean pretreatment score on Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was 28.79 (SD = 4.42). One week post-treatment mean Y-BOCS score was 9.95 (SD = 3.67). 94.7% of the patients had responded to treatment and 73.7 were in remission according to the international consensus criteria. At 3-month follow-up, the Y-BOCS score was 11.09 (SD = 5.89) where 78.9% of the patients had responded to treatment and 63.2% were in remission. CONCLUSIONS: All patients expressed high satisfaction with the treatment format, and none of the patients would have preferred longer term treatment. The therapists also expressed satisfaction with the treatment format. The Bergen 4-day treatment for OCD is a very promising treatment for OCD, and can be successfully implemented outside Norway.

[Health anxiety - increased knowledge and treatment options]. / Heilsukvidi - aukin pekking og medferdarmoguleikar.

Patients with hypochondriasis are preoccupied with the fear or belief that they have a serious, undiagnosed disease. This concern derives from misinterpretations of benign physical sensations, and persists despite appropriate reassurance to the contrary. They have, on average, disproportionately high rates of visits to physicians, specialty consultations, laboratory tests, and surgical procedures, as well as high health care costs. Despite this extensive medical attention, they find their care unsatisfactory, which is understandable, as convincing alternative explanations to their ailments are repeatedly delayed. Physicians, in turn, may feel discouraged and frustrated in relation to these individuals where their best efforts to help often prove ineffective or are even rejected. Recent scientific studies have shown that cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitors (SSRI) are effective treatment options for health anxiety as demonstrated in clinical trials.