To many, the COVID-19 pandemic was a traumatic life event. As such, it is possible that individuals may experience PTSD symptoms after experiencing the COVID-19 pandemic.

Effect of COVID-19 Pandemic on the Development of PTSD

Complex PTSD is a disorder resulting from prolonged trauma such as childhood abuse or neglect, abusive relationships, or political imprisonment or torture. C-PTSD includes some or all of the criteria of PTSD, as well as additional symptoms that negatively affect ones quality of life and is typically more severe and treatment resistant than classical PTSD.

Complex Post-traumatic Stress Disorder (c-PTSD)

Acceptance and Commitment Therapy (ACT) has been used amongst individuals with diagnosed PTSD after Traumatic Brain Injury (TBI) with the intent to improve mood processes, PTSD specific outcomes and related symptoms, ACT outcomes, and overall quality of life

Acceptance and Commitment Therapy Used with Individuals with PTSD after Traumatic Brain Injury

- acute stress disorder
- Adjustment disorder
- Disinhibited social engagement disorder
- Reactive attachment disorder

Related Conditions to PTSD

There are mixed findings for the role of oxytocin in psychological disorders such as autism spectrum disorder, PTSD, and social anxiety disorder. Hoge et al (2008) found a positive correlation between anxiety and plasma oxytocin levels, while Schneider et al (2021) found that high basal oxytocin predicted less anxiety. Hoge et al hypothesize that oxytocin in individuals with anxiety may increase to compensate for dysfunctional oxytocin receptors.

Oxytocin and psychopathology

In this study, researchers explored the implementation of the online platform VetChange as a way to decrease Iraq and Afghanistan veterans' alcohol use and PTSD symptoms . 

Impact of Web-Based Interventions on Veterans' Alcohol Use & PTSD Symptoms 

In 2021 the FDA approved the use of 3,4-methylenedioxymethamphetamine (MDMA) for the treatment of PTSD. The compound was studied as a treatment as studies suggest it acts by binding to the presynaptic serotonin transporters inducing a release of serotonin. The trials conducted administered three doses of MDMA paired with manualized therapy during an eighteen-week treatment plan. The results of the study showed significantly reduced symptoms of depression as well as regulated amygdalar serotonergic function in comparison to the control (placebo) group. Each study conducted showed similar results which led to the approval for the regulated use of MDMA to treat PTSD symptoms.

Treatment of PTSD using MDMA (Ecstasy)

Populations exposed to major natural disasters, a form of mass trauma, often show elevated rates of PTSD. For example, research conducted one year after Hurricane Katrina found that nearly 21% of residents in the affected areas suffered from the disorder.

PTSD Prevalence Following Natural Disasters

Throughout much of the 20th century, the condition now known as Post-traumatic Stress Disorder (PTSD) was referred to by other names, such as 'shell shock' and 'combat neurosis'. These terms originated from the belief that the symptoms were a direct result of the stress experienced during active combat.

Historical Terminology for PTSD

Experiencing a traumatic event does not automatically lead to the development of Post-traumatic Stress Disorder (PTSD). The likelihood of developing the disorder is influenced by a variety of identified risk factors, explaining why some individuals are more vulnerable than others after a similar experience.

Risk Factors for PTSD Development

The symptoms of PTSD form a constellation of responses to a traumatic event. Key symptoms include re-experiencing the trauma through intrusive and distressing memories or flashbacks. Individuals often engage in avoidance of stimuli or situations connected to the event. They may also experience persistently negative emotional states, feel detached from others, exhibit irritability and proneness to outbursts, and have a tendency to be easily startled.

Symptoms of Post-traumatic Stress Disorder (PTSD)

Several months after being involved in a serious car accident, an individual reports experiencing recurrent nightmares about the crash, actively avoids driving or even being a passenger in a car, and becomes intensely distressed and jumpy at the sound of screeching tires. Based on this pattern of symptoms, which of the following provides the most accurate psychological explanation for their condition?

Post-traumatic Stress Disorder (PTSD) is a condition where an individual experiences a collection of persistent symptoms following a traumatic or profoundly stressful event, such as combat, sexual assault, or a natural disaster. For a diagnosis, these symptoms must last for at least one month. The traumatic event can be witnessed firsthand or secondhand. Historically, PTSD was referred to by terms like 'shell shock' and 'combat neurosis' due to its frequent association with war, but it is now recognized as affecting a wider population.

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- Depression
- Obsessive-Compulsive Disorder
- Hoarding Disorder
- Post-traumatic Stress Disorder
- Anxiety/ Panic Disorders
- Social Anxiety Disorder
- Body dysmorphic disorder
- Schizophrenia 
- Borderline Personality Disorder

Mental Disorders Affected By The Covid-19 Pandemic

Interpersonal trauma is a type of trauma that occurs in one’s relationships with other individuals. Events that can cause interpersonal trauma include physical/sexual abuse, domestic violence, loss of a loved one, etc. 

Interpersonal Trauma

- Physiological or emotional numbing
- Sensory impairments feelings of disembodiment
- Distorted experience of time
- Feeling as if one is in a dream
- Visual perceptual distortions
- An unreal/absent sense of self
- May hear voices (dissociative episodes; distinct from the auditory hallucinations experienced in psychosis)
- DON’T have psychosis and HAVE intact reality testing
- Symptoms often overlap with both anxiety and other dissociative disorders (PTSD or panic disorder, OCD, depression, schizophrenia)

Depersonalization-Derealization Disorder Symptoms

List of Other Recognized Anxiety Disorders

Breedlove, S. & Watson, N. (2017). Behavioral neuroscience, eighth edition. Oxford University Press.

Behavioral Neuroscience 8th Edition

What Is Posttraumatic Stress Disorder? What Is PTSD? (2020, August). https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd. 

What is PTSD? 

Spielman, R. M., Jenkins, W. J., & Lovett, M. D. (2020, April 22). Psychology (2nd ed.). OpenStax. https://openstax.org/books/psychology-2e/pages/1-introduction

OpenStax Psychology (2nd ed.) Textbook

The COVID-19 pandemic and ensuing isolation measures has had negative psychological impact on the general population of China, measured by mean levels of stress, depression and anxiety. Authors conducted a cross-sectional study (Jan. 31 - Feb. 2) (n=1210, from 194 cities) using an online questionnaire disseminated to university students who were encouraged to pass it along. Overall, 75.5% of respondents reported psychological impacts resulting from the pandemic. Women, students, presentation of various symptoms (ex: dizziness, coryza), and low reported health-status are high risk-factors for worsened mental health. Identifying populations vulnerable to psychological distress, and factors favouring psychological health, provide insight for the formulation of psychological interventions.

Psychological response to the first wave of COVID-19 in China (stress, depression and anxiety)

Hoarding disorder is characterized by a persistent difficulty in discarding or parting with possessions, regardless of their actual value. This behavior frequently results in the accumulation of items that clutter and congest the individual's living area.

Hoarding Disorder

Schizophrenia is a severe psychological disorder that leads to a profound breakdown in an individual's ability to function, often necessitating hospitalization. It is characterized by significant disruptions in thought, perception, emotion, and behavior, including symptoms like hallucinations, delusions, incoherent thinking, bizarre actions, flat emotions, and a lack of motivation for basic activities. It is important to distinguish schizophrenia from dissociative identity disorder ('split personality'), as the term 'schizophrenia' refers to a 'splitting of psychic functions,' not a divided personality.

Schizophrenia

- Factors increasing anxiety
- Protective factors against anxiety

Areas impact between COVID and Anxiety/Panic Disorders

Post-traumatic Stress Disorder (PTSD)

Laura J. Dixon, Sara M. Witcraft & Mary J. Schadegg (2023) COVID-19 anxiety and mental health among university students during the early phases of the U.S. pandemic, Journal of American College Health, 71:4, 1152-1160, https://doi.org/10.1080/07448481.2021.1923504 

The Effects of COVID-19 on Anxiety-Related Mental Health Concerns

Obsessive-compulsive disorder (OCD) is characterized by the presence of obsessions and/or compulsions. Obsessions are defined as intrusive and unwanted thoughts, mental images, fears, sensations, or urges. Compulsions are repetitive behaviors or mental acts that an individual feels driven to perform, often in response to an obsession. These cycles of obsessions and compulsions are typically distressing, time-consuming, and can significantly disrupt a person's daily activities.

Obsessive-Compulsive Disorder (OCD)

Body Dysmorphic Disorder (BDD) is a condition where an individual is intensely preoccupied with a perceived flaw in their physical appearance, which is often nonexistent or barely perceptible to others. This preoccupation can cause the person to believe they are unattractive, ugly, or deformed. The intense focus on these imagined defects leads to repetitive, ritualistic behaviors and mental acts. These compulsions can include constantly checking one's appearance in the mirror, attempting to conceal the perceived flaw, making comparisons to others, and in some cases, seeking cosmetic surgery.

Body Dysmorphic Disorder (BDD)

Instances of interpersonal trauma are prevalent in the lives of low-income women. It has been suggested that low-income women who have been exposed to interpersonal trauma experience various significant mental and physical health issues.

The Impact of Interpersonal Trauma on Low-Income Women

Military sexual trauma (MST) is defined as sexual harassment and/or assault occurring during active duty or other military training.

Military Sexual Trauma

Childhood trauma occurs between ages 0-18, and can be any life-threatening, scary, or violent event that occurs in their life. 

Childhood Trauma

DDD manifests as a pervasive disruption of self-awareness at its most basic level (what it feels like to be an entity; to exist). Other dissociative disorders/conditions usually impair identity at levels involving autobiographical memory, self-narratives, and personality.

Depersonalization-Derealization Disorder (DDD) vs. Other Dissociative Disorders

Generally speaking, depression is an overall feeling of sadness. More specifically, those with depression tend to experience several things such as: an increase or decrease in weight, troubles with concentration, feelings of meaninglessness or worthlessness, thoughts of death or suicide, and so on. 

Depression

- Derealization
- Anomalous subjective recall
- Emotional numbing
- Feelings of disembodiment

Experiential Components of DDD

Generalized Anxiety Disorder (GAD) is characterized by a persistent and relatively continuous state of excessive, uncontrollable, and often pointless worry and apprehension. Individuals with this disorder typically worry about routine, everyday matters, such as health, finances, or the safety of family members, without any justified reason. For a diagnosis, this diffuse worrying must occur more days than not for a period of at least six months, not be attributable to another disorder, and be accompanied by at least three of the following symptoms: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep difficulties.

Generalized Anxiety Disorder

This disorder is hallmarked by the experience of multiple, unexpected panic attacks. These attacks are often associated with intense fear that occurs quickly. Generally, this diagnosis is applied if you have had four or more panic attacks, and fear their reocurrence. Having one panic attack, is not a panic disorder. Worry over panic attacks and avoidance of situations, places, etc. that are associated with panic attacks can lead to further problems. 

Recurrent panic attacks may show temporal lobe abnormalities. Those who suffer from panic disorder typically have lower temporal lobe volumes. These attacks can occur unexpectedly or by a trigger. 



Panic Disorder

The term 'phobia' originates from the Greek word for fear. A phobic disorder is defined by an intense, persistent, and irrational fear of a particular object, activity, or situation. This overwhelming fear compels the individual to actively avoid the source of their phobia. Exposure to the phobic stimulus results in significant distress and dysfunction, even when the person intellectually understands that their fear is excessive. Phobic disorders are generally categorized into three types: specific phobias, agoraphobia, and social phobia.

Phobic Disorder

https://books.google.co.in/books?hl=en&lr=&id=AbYwDwAAQBAJ&oi=fnd&pg=PA2&dq=hypochondria&ots=wBYJuZQSsU&sig=teQPxyaj2KUQ0DsgOF1f8rEyrlQ&redir_esc=y#v=onepage&q=hypochondria&f=false

Hypochondriasis: Illness Anxiety Disorder and Somatic Symptom Disorder

Hypochondriasis, commonly known as hypochondria was considered a disorder where an individual believes that they have illnesses or symptoms of diseases, even when they did not. It caused anxiety and distress for patients, and potentially impeded their day-to-day functioning. However, in the DSM-V (Diagnostic and Statistical Manual of Mental Disorders), hypochondria itself was declassified as a separate disorder and instead was considered a symptom or manifestation that occurred in two different disorders. Certain characteristic features of hypochondriasis were classified under Illness Anxiety Disorder and more severe manifestations under Somatic Symptom Disorder. These disorders are both largely characterized by the preoccupation over certain undiagnosed or unexplained symptoms that persist in the individual. 

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