Criteria for PTSD..

"The relevancy of an individual's subjective experience in determining what constitutes a traumatic event has been a source of debate among PTSD specialists for years. The study concludes that both objective and subjective factors are relevant and that current PTSD criteria are missing several reactions that many trauma survivors experience."

"A person's response is multifaceted and may include appraisals and other thoughts, a variety of felt emotions and behaviors. It's not enough to rely on the objective qualities of an experience to determine whether it should be considered traumatic or not," said co-author Brian P. Marx, PhD, an associate professor of psychiatry at Boston University School of Medicine and psychologist at the VA National Center for PTSD.

"Trauma should be defined as the interaction between the individual and his or her environment and all parts of an individual's response should be considered."

PTSD is believed to be the result of exposure to trauma, so understanding what defines a traumatic experience is critical. The authors suggest that researchers investigate and add more appropriate examples to these criteria in order to more accurately categorize traumatic events.

"Knowing exactly what trauma is can help us to better know who is a trauma survivor and who is not," said Marx. "It is critical that we know this for the purposes of understanding the disorder as well as being better able to help those who are survivors of trauma."

It seems to me that the main problem with PTSD, as stated above, is that there is no concrete way of defining an event or experience as 'traumatic.' Indeed, although there may be events that we generally consider 'traumatic,' for example a bad car accident, it doesn't mean that any one individual suffering an event will become traumatised, or indeed, suffer from PTSD.

So if it's not an objective event that generates the trauma, then it is the perception or the thought process within a person that makes the event traumatic. So, logically, if this though process is generated through any event, even one that isn't considered traumatic - for example, realising you hadn't turned the plug on, symptoms and problems assocaited with PTSD could still manifest, and would it really be fair to claim that this individual wasn't suffering with PTSD just because we don't consider the event 'traumatic?'

Okay, maybe that example was a little far-fetched, but it makes you think, who am I to judge whether an event should or should not make you feel traumatised?

Original Article

New Breathing Treatment Program Effective Against Hyperventilation

"A new treatment program teaches people who suffer from panic disorder how to reduce the terrorizing symptoms by normalizing their breathing."

According to a recent study by panic disorder expert Alicia E. Meuret, this method - called Capnometry-Assisted Respiratory Training, or CART - has proved better than traditional cognitive therapy at reducing both symptoms of panic and hyperventilation.

"CART helps patients learn to breathe in such a way as to reverse hyperventilation, a highly uncomfortable state where the blood stream operates with abnormally low levels of carbon dioxide.

CART: Breathing exercises twice a day:

The goal of these exercises is to reduce chronic and acute hyperventilation and associated physical symptoms. This is achieved by breathing slower but most importantly more shallowly. Contrary to popular belief, taking deep breaths actually worsens hyperventilation and symptoms.

"Most panic-disorder patients report they are terrified of physical symptoms such as shortness of breath or dizziness," Meuret said. "In our study, cognitive therapy didn't change respiratory physiology, but CART did effectively reduce hyperventilation. CART was proved an effective and powerful treatment that reduces the panic by means of normalizing respiratory physiology."

CART breathing a proven biological therapy:

The study pitted CART against a conventional cognitive therapy treatment, or CT.

Both treatment programs were equally effective in reducing symptoms. But CART was the only treatment to physiologically alter panic symptoms by actively reversing hyperventilation in the patients."

Link to Full Article

The Pain of Discrimination

"In a new study, researchers found that adolescents from Latin American and Asian backgrounds experienced more discrimination than their peers from European backgrounds and that the discrimination came not only from other adolescents but from adults as well. The level of discrimination also impacted these teens' grade-point averages and their health and was associated with depression, distress and lower levels of self-esteem.

601 Teens (equal males and females) kept a daily diary for 2 weeks to record any discriminatory events or comments they experienced. They were also asked to separately record on a four-point scale any physical symptoms, such as headaches, stomach-aches or general pain.

Among the teens in the study, nearly 60% reported experiencing discrimination from other teens, and 63% reported discrimination from adults; 12% reported experiencing discrimination on a daily basis.

The researchers found that teens who reported higher levels of peer or adult discrimination also reported more aches, pains and other symptoms, as well as a lower overall grade-point average. Thus, discrimination may not only tax adolescents' physical and psychological resources but may also affect their ability to achieve in school, the researchers said.

"Discrimination significantly predicted lower GPAs, higher levels of depression, higher levels of distress, lower self-esteem and more physical complaints," Fuligni said. "So the bottom line? Discrimination is harmful."

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This interesting study highlights the link between the personal world, i.e. one's own wellbeing and health, and the social world. This link can be good, in terms of positive interactions and suppport, but, as this study shows, negativity in the social world can create bad results in the personal world.

Although people may think the discrimination is only small, it can mount up on a single individual, much like in the story 'An Inspector Calls' by J.B Preistley, and can manifest itself in a number of physical and psychological problems.

The modern world already seems to be accelerating the number of people that are being diagnosed with depression and ADHD and personality disorders etc, and people are quick to blame the fast paced life and music and videogames. This study is an interesting wake-up call that shows how our interactions with each other, although seemingly harmless, may be commiting more pain than we realise.

Link to article

Mindfulness Meditation Increases Well-Being in Adolescent Boys

'Mindfulness', the process of learning to become more aware of our ongoing experiences, increases well-being in adolescent boys, a new study reports.

Researchers from the University of Cambridge analyzed 155 boys from two independent UK schools, Tonbridge and Hampton, before and after a four-week crash course in mindfulness. After the trial period, the 14 and 15 year-old boys were found to have increased well-being, defined as the combination of feeling good (including positive emotions such as happiness, contentment, interest and affection) and functioning well.

Professor Felicia Huppert of the Well-being Institute at the University of Cambridge said: "More and more we are realising the importance of supporting the overall mental health of children. Our study demonstrates that this type of training improves well-being in adolescents and that the more they practice, the greater the benefits. Importantly, many of the students genuinely enjoyed the exercises and said they intended to continue them -- a good sign that many children would be receptive to this type of intervention.

"Another significant aspect of this study is that adolescents who suffered from higher levels of anxiety were the ones who benefitted most from the training."

The success of this initial study has recently led to the creation of an exciting 8 week mindfulness curriculum for schools in both the state and private sectors. This new curriculum, which includes games and video clips, should have even greater benefits.

(More information by clicking HERE)

Another link: mindfulnessinschool

Managing Anxiety-Based Problems in Older People - Feedback

Paul Grantham has just finished the first block of trainings on Managing Anxiety-Based Problems in Older People.
The feedback has been very good - with the vast majority of delegates rating the course as "Very Good" or "Good".
Below are some examples of feedback given by delegates after the course:

"Excellent day + very relevant + helpful to my job role." (A.A., Social Worker)
"Very good hands-on information, good video clips, excellent background information." (I.K., OT)
"Lots of useful ideas to work with." (B.B., CPN)
"Interesting stuff! Will test some of those approaches when the opportunity arises." (T.W. RMN/AMHP)
"Very relaxed style. Have learnt a lot of ideas to try. Thank you." (H.P., OT)
"Very interesting concepts that will aid my support work & counselling." (G.L., CMSW)
"Useful - practical techniques, and interventions." (S.B., Nurse)
"I have learnt a great deal. It was very informative. I will use this when working with anxiety and with illness in my workplace." (G.O., OT/Physiotherapist)

This topic is currently only available for in-house training. If you are interested please contact us via info@skillsdevelopment.co.uk

Anxiety Seminar 2009 - Feedback

Our first Anxiety seminar took place in London yesterday. It was fully booked and attained very positive feed back from delegates.

Some examples of feedback:

"I very much enjoyed the training with its various techniques and the focus on different psychological diagnoses." DF, Psychologist

"Fantastic day. Very engaging course; with materials that I would like to build upon further. Particularly liked Mr Grantham’s style of delivery." ML, Counsellor

"Course content & process very appropriate to my work as a counsellor. Challenging to reconsider how I work." MC, Counsellor

Although this event was fully booked there are still some places available at other venues. Please visit our website for further information:
http://www.skillsdevelopment.co.uk/seminars.php?courseid=68

When booking this course you still can take advantage of our promotion by saving £10 on every single place booked online or by phone. (Note that all usual terms and conditions apply to bookings made through this promotion.)

Looking forward to seeing you on one of our courses.

SDS Delegate Debate: A single session cure for panic attacks?

Dear All

Recently I came across an interesting piece of research, whilst preparing reading materials for our forthcoming seminar on Anxiety. (http://www.skillsdevelopment.co.uk/seminars.php?courseid=68)
As it was a very simple and useful way of helping clients I thought I would share it with you.

We all know that excessive caffeine consumption is probably not the most sensible thing for anxious clients to be doing. However, the question is - what is “excessive” and how un-sensible is it? On one hand, the British Coffee Association states that “scientific evidence consistently shows that drinking up to … four to five cups of coffee a day is perfectly safe … and may confer health benefits.” On the other hand, a paper published last month in Psychiatry Research suggests otherwise and indicates that caffeine consumption alone may be more than sufficient to promote and maintain panic attacks.

In a double blind experiment in Brazil (appropriately enough), of those experiencing panic attacks, nearly two thirds had such an attack after drinking the equivalent of 5 cups of coffee. However in a control group of those who had previously experienced such attacks, not a single panic attack was reported after consuming non-caffeinated drinks. *

As is so often in our field, substance consumption plays an important role. Not just in making problems more complex but also in providing potentially simple solutions.
Next time you work with an anxious client, remember to encourage caffeine elimination before engaging in more complex interventions. It may be sufficient to cure the problem.

We are looking forward to working with you in our future seminars. Remember that our seminar on Anxiety is fully booked on the first day in London, but there are still places left on the second London date and at other venues around the country.

Book online (http://www.skillsdevelopment.co.uk/seminars.php?courseid=68) and receive automatic £10 discount.

Kind regards
Paul Grantham
Consultant Clinical Psychologist

* References: Panic disorder and social anxiety disorder subtypes in a caffeine challenge test Nardi AE, Lopes FL, Freire RC, Veras AB, Nascimento I, Valença AM, de-Melo-Neto VL, Soares-Filho GL, King AL, Araújo DM, Mezzasalma MA, Rassi A, Zin WA. Psychiatry Res. 2009 Sep 30;169(2):149-53.