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Genetic
Anxious
unknown,
internal, impending Alerting Deal with Anxiety
vague, or danger signal
conflictual.
Known,
external,
definite,
nonconflic impending Alerting
Deal with Fear
tual danger signal
Pusing / limbung
Pikiran
cepat
Pandangan kabur
Gangguan tidur
Sulit menelan
Rasa sesak/ sulit
bernafas/ nafas Jantung berdebar
pendek
tremor
mual
Berkeringat/
bergetar
Ingin berlari
Panic Disorder & Agoraphobia
Panic Disorder
• An acute intense attack of anxiety accompanied by feelings of impending doom
• Patients with panic disorder present with a number of comorbid conditions, most
commonly agoraphobia
• Women are two to three times more likely to be affected than men
• recent history of divorce or separation.
• most commonly develops in young adulthoodâ the mean age of presentation is about
25 years but both panic disorder and agoraphobia can develop at any age
• abnormal regulation of brain noradrenergic systems is also involved in the
pathophysiology
Agoraphobia
• refers to a fear of or anxiety regarding places from which escape might be difficult
• most disabling of the phobias, because it can significantly interfere with a person's
ability to function in work and social situations outside the home.
etiology
Biology
• Abn NA system (NE;SE;)GABA
• Autonomic NS
• Sympatethic NS slow addpat to
repeated stimuli
• respond excessively to moderate
stimuli
Biology
• Abn NA system (NE;SE;)GABA
• Autonomic NS Psychodynamic
• Sympatethic NS slow addpat to repeated • Freud dorongan Id
stimuli (unconsious & agresiveness)
• respond excessively to moderate stimuli thd Ego- Represi
Social
• conditioned response to a specific
environmental stimulus
Agoraphobia Social Phobia
Crowds Public speaking
Stores Writing, eating, or drinking in public
Bridges Initiating or maintaining conversations
Tunnels
Traveling on a bus, train, or airplane
Theaters
Standing in a line
Small enclosed rooms
escape might be difficult, embarrassing, Marked and persistent fear of one or
or in which help may be unavailable in the more social or performance situations in
event of having a panic attack which the person is concerned about
negative evaluation or scrutiny by others,
Spesific Phobia Obsessive Compulsive Disorder
Cued by spesific object / situations Obsession : recurrent & persistent
thouhts/impulse/image that inapropriate
such :
flying Contatmination
Hights Repeated doubts
Animal (snakes/spider/chicken) Order
Injection Impulses
Blood Sexual images
Psychosocial
• Perfectionism; concern detail; etc
• Freud ; regresi fase oedipal ke fase anal
• Ambivalence : consciously experience both love & Hate to Love Object
General Anxiety
Disorder/Overanxious disorder
• Anxiety is an; it warns of and enables a person
to take measures to deal with a threat. Fear is
a similar alerting signal, but should be
differentiated from anxiety. Fear is a response
to a known, external, definite, or
nonconflictual threat; anxiety is a response to
a threat that is unknown, internal, vague, or
conflictual.
Normal vs Pathological
Anxiety
Normal Pathologic
Prognosis
• ~ comorbiditas dg sakit lainnya
• Stres Life event
• Dr shoping sejak usia 20 an
Treatment
• Psychotherapy : CBT(memperbaiki distorsi cognitive);
BT (Relaksasibreathing)
• psychopharmacath/: Benzo; Buspirone; SSRI
Reaksi thd Stress & ggn Penyesuaian
Gangguan yang berhubungan
dengan TRAUMA
REAKSI STRESS AKUT GANGGUAN STRESS GANGGUAN
PASCA TRAUMA PENYESUAIAN
Terjadi segera setelah Terjadi > 1 bulan – 6 Perubahan hidup yg
trauma (stressor luar bulan delayed onset bermakna
biasa) - <1 bln
Gangguan tidur Gangguan tidur Gangguan Tidur
Depresi Depresi Depresi
Cemas Cemas Cemas
Daze (terpaku) Flash back Disabilitas dl ADL
bencana alam, kecelakaan,
perang, serangan tindakan
kriminal, perubahan luar
biasa yg mendadak
Gangguan Disosiatif
Kehilangan sebagian / keseluruhan dari integrasi Normal (kendali kesadaran)
Amnesia Disosiatif
Trans (kesurupan)
Convulsi
Disosiatif penginderaan
Gangguan somatoform
Hypochondriasis
• Keluhan fisik tidak dapat di jelaskan (hasil
pemeriksaan dbn)
Somatisasi
• >keluhan fisik, mengakibatkan distress
Hypochondriasis
• Keluhan fisik tidak dapat di jelaskan (hasil
pemeriksaan dbn)
Somatisasi
• >keluhan fisik, mengakibatkan distress