by Dr. Adina McGarr | Apr 4, 2010 | Abuse
Sexual abuse involves the occurrence of a child in any sexual situation with an adult. This can include actual contact (e.g. fondling, rape), having the child watch sexual acts or material, using the child in any aspect of pornography, and making the child look at an adult’s genitals.
California law further sub-divides sexual abuse into sexual assault and sexual exploitation. Sexual assault includes rape, statutory rape, incest, sodomy, lewd or lascivious acts, oral copulation, penetration by a foreign object, and child molestation. Sexual exploitation includes pornography and prostitution.
by Dr. Adina McGarr | Mar 30, 2010 | Anxiety Disorders
Posttraumatic Stress Disorder can occur after an individual experiences an extreme traumatic event or an event that involves actual or threatened death or serious injury to oneself or someone else. Fear, helplessness, and/or horror are experienced as a result. The individual continually re-lives the event via flashbacks, memories, nightmares, and/or intrusive thoughts, images, or perceptions. Avoidance of associated stimuli, physiological reactivity, psychological distress, and numbing are also present. Other symptoms include an inability to recall aspects of the trauma, avoidance of associated stimuli, feelings of detachment, hypervigilance, insomnia, difficulties concentrating, exaggerated startle response, and impaired social and occupational functioning.
The above symptoms must persist for more than one month. If the symptoms are of shorter duration, then a diagnosis of Acute Stress Disorder is made.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text Revision. Washington, DC American Psychiatric Association, 2000.
by Dr. Adina McGarr | Mar 30, 2010 | Anxiety Disorders
Excessive anxiety and worry, that occurs more days than not and persist for at least six months, constitute the core features of Generalized Anxiety Disorder. The worry and anxiety feels difficult to control and is about a number of different things. In addition, physical symptoms such as restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and disturbances in sleep plague the individual. Social and occupational functioning are significantly impaired.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text Revision. Washington, DC American Psychiatric Association, 2000.
by Dr. Adina McGarr | Mar 30, 2010 | Mood Disorders
Individuals suffering from Persistent Depressive Disorder evidence a chronically depressed mood that occurs for most of the day, more days than not, for at least a two year period. The impairment and depressed mood are usually not as severe as in Major Depression. Two of the following symptoms must also be present:
• Poor appetite or overeating
• Insomnia or hypersomnia
• Low energy or fatigue
• Low self-esteem
• Poor concentration
• Feelings of hopelessness
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text Revision. Washington, DC American Psychiatric Association, 2000.
by Dr. Adina McGarr | Mar 30, 2010 | Mood Disorders
Persons with Major Depressive Disorder experience, at least, a two week period of suffering either a depressed mood or the loss of interest or pleasure in nearly all activities. In addition, at least four of the following must be met:
• Change in appetite or weight
• Change in sleep
• Decreased energy
• Feelings of worthlessness or guilt
• Difficulties in concentrating
• Psychomotor changes (agitation, lethargy)
• Recurrent thoughts of death or suicidal ideation, plan, or intent
There is also impairment in social, occupational, and other important areas of functioning in one’s life. In general, individuals feel “down in the dumps”, “sad”, “hopeless”, etc. In children and adolescents, an irritable mood may be present as opposed to sadness. Studies indicate that depressive episodes occur twice as much in women than in men.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text Revision. Washington, DC American Psychiatric Association, 2000.
by Dr. Adina McGarr | Mar 30, 2010 | Mood Disorders
Individuals with Bipolar I Disorder have experienced one or more Manic or Mixed Episodes and often have had one or more Depressive Episodes, though a Depressive Episode is not necessary to meet diagnosis criteria. A Manic Episode is marked by a significant period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least one week. Additional characteristics include at least three of the following or four if the mood is irritable:
• Inflated self-esteem or grandiosity
• Decreased need for sleep
• More talkative and/or pressure to keep talking
• Flight of ideas or racing thoughts
• Distractibility
• Increase in goal directed activity
• Excessive involvement in pleasurable activities with a potential for negative consequences
There is also marked impairment in social and occupational functioning.
A Mixed Episode is defined by a period of time (at least 1 week) in which, the criteria for a Major Depressive Episode and a Manic Episode are both met. This period is marked by a rapidly changing mood.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text Revision. Washington, DC American Psychiatric Association, 2000.
by Dr. Adina McGarr | Mar 30, 2010 | Mood Disorders
Bipolar II Disorder is defined by the presence of a Major Depressive Episode and at least one Hypomanic Episode (a distinct period of elevated., expansive, or irritable mood lasting, at least, 4 days) The criteria for a Hypomanic Episode are as follows and include at least three of the following:
• Inflated self-esteem or grandiosity
• Decreased need for sleep
• More talkative and/or pressure to keep talking
• Flight of ideas or racing thoughts
• Distractibility
• Increase in goal directed activity
• Excessive involvement in pleasurable activities with a significant potential for negative consequences
A Hypomanic Episode is not severe enough to cause major impairment in social or occupational functioning.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text Revision. Washington, DC American Psychiatric Association, 2000.
by Dr. Adina McGarr | Mar 30, 2010 | Anxiety Disorders
Panic Disorder can be defined as the presence of recurrent, unexpected Panic Attacks (at least 2), followed by significant concern over having another attack. A Panic Attack is marked by a discrete period of intense fear or distress in the absence of any real threat. The attack is sudden in onset and typically peaks in ten minutes or less. This attack is accompanied by at least four of the following somatic and cognitive symptoms:
• Heart palpitations
• Sweating
• Trembling
• Shortness of breath or a sense of smothering
• Feelings of choking
• Chest pain
• Nausea
• Dizziness
• Fear of losing control or “going crazy”
• Fear of dying
• Paresthesias
• Chills or hot flashes
• Derealization or Depersonalization
Criteria for Agoraphobia:
• Anxiety about being in places or situations where escape may be difficult or embarrassing
• Fear that help will not be available if a panic attack occurs
• Situations are avoided or, if encountered, are endured under considerable distress
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text Revision. Washington, DC American Psychiatric Association, 2000.
by Dr. Adina McGarr | Mar 30, 2010 | Anxiety Disorders
Social Phobia, aka Social Anxiety Disorder, is defined by a marked and persistent fear of social or performance situations in which embarrassment or humiliation may occur. The individual feels acutely aware of the perceived scrutiny of others. When exposed to a feared social situation, he/she feels anxiety, which may precede a Panic Attack, despite awareness that the excessive fear is unreasonable. This anxiety causes individuals to avoid most social situations or to be incredibly uncomfortable if they must be endured. Due to the level of distress, individuals with Social Phobia suffer impairment in social, occupational, and/or academic functioning.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text Revision. Washington, DC American Psychiatric Association, 2000.
by Dr. Adina McGarr | Mar 28, 2010 | Self-Harm
Self-injury (self-inflicted violence, self-injurious behavior or self-mutilation) can be defined as deliberate, intentional injury to one’s own body that causes damage to the skin and/or underlying tissue. This behavior is usually engaged in to cope with overwhelming and distressing feelings and situations, where the physical pain acts to release the emotional pain. However, the relief one feels is temporary, thereby causing the individual seek out the behavior again and again.
Self harming behaviors serve as a way to regulate strong emotions, distract from emotions, express things that the individual cannot put into words, and to soothe the individual who does not have the ability to regulate themselves via internal mechanisms. Those who engage in self-harm often suffer from a poor sense of self-worth.
The behavior, over time, becomes compulsive and addictive. Like any other addiction, it becomes overwhelmingly difficult to stop, despite the negative consequences of their actions. With self-harm, in particular, endorphins (body’s natural pain killers) are released in the body following injury, which results in positive feelings, even euphoria. These feelings are reinforcing, which is part of why the addiction cycle is difficult to break.
Although self-injury does not usually imply suicidal intent, it must be taken seriously because accidental deaths do occur.
