3^rd International Conference on Depression, Anxiety and Stress Management June 21-22, 2017 London, UK

David Muss has done his Medical Training in Italy in the year 1968 and obtained his Medical Degree in 1977. He is the Director of the BMI PTSD Unit since 1989. He has published a new technique for treating PTSD in 1991 i.e., Rewind Technique for PTSD and founded the International Association for Rewind Therapy. He has contributed to various books, published the fi rst PTSD self-help book in the UK and has many papers published in peer reviewed journal.

PTSD therapy: Currently in the UK NICE guidelines approve two CBT therapies, TFCBT and EMDR. Both are considered variations of cognitive therapy can involve up to twenty sessions and carry a success rate around 40%. Th e rewind technique, in clinical use since 1991, contrary to the above, provides rapid, eff ective (95% success rate), enduring closure rather than coping mechanisms or so called signifi cant improvement in just two to three sessions. Furthermore, it is the only treatment shown to be eff ective for group therapy of any size and greatly minimizes the risk of compassion fatigue. Th e workshop will identify those traumatized directly and those traumatized indirectly. Everyone willing to experience the treatment will be treated, prior to completing the IES. At the end of the workshop the rewind manual, IES, and role play reminder will be provided.

Arthur G O’Malley has worked as a Consultant Child and Adolescent Psychiatrist since 2004 and currently is an EMDR Consultant from 2008 to 2018. He is a member of the UK and Ireland EMDR Association since 2002 and was a member of the European Conference Organizing Committee for the London Conference and the Child and Adolescent Committee. He has given presentations at their AGMs in Glasgow, Manchester and Dublin. Currently, he is working in the fields of trauma, neglect and the developing brain, attachment disorders, personality disorders, emotional dysregulation in ADHD and ASD diagnosis and management. He has written articles on clinical effectiveness of BART psychotherapy, and is the author of a book “The art of BART”.

This is an integrated approach to psychotherapy, which incorporates elements of trauma focused cognitive behavior therapy (TF-CBT), eye movement desensitization and reprocessing (EMDR), mindfulness, somatic experiencing and sensorimotor psychotherapy (SP). Th is workshop gives participants an understanding of information processing in the body following signifi cant life events. Gut feelings are initially registered at the level of the gut brain. Research on the gut microbiome and its relation to mental health will be presented. Th e next level of reprocessing takes place at the level of the heart brain, which is often linked to feelings of loss, panic and anxiety. Activation of the body’s energy system continues with activation of the hypothalamic pituitary adrenal (HPA) axis. A key component of reprocessing is overcoming the symptoms of speechless terror, which are felt at the level of throat and pharynx. Th e goal of activating and reprocessing these sensations motor impulses feelings and thoughts is to bring unconscious triggers into conscious awareness. In trauma, the body keeps the score with 90% of information while we are consciously aware of only 10%. Th e reprocessing is continued with the patient being maintained in calm WATERS (window of aff ective tolerance emotional regulation and stability). Th e author will explain his two and three-dimensional models of high arousal RAPIDS (racing thoughts, aff ective instability, partitioned personality, impulsivity, dissociation and suicidality). Th is will also include a demonstration of low arousal states or FROZEN (freeze reaction, oblivious, zonked out and emotionally numb). I will illustrate the use of the BART psychotherapy with diff erent types of traumatic dissociation with reference to individual cases of both acute and complex PTSD.

Denny Meyer is a Professor in the School of Health Sciences at the Swinburne University of Technology. She is an Applied Statistician specialized in the area of Mental Health Research. Her areas of particular interest include suicide ideation, vision loss, stress and the analysis of data collected using online systems with high attrition rates. She has published more than 100 papers in reputed journals and has worked with research teams on numerous research grants and tenders.

Anxiety online was a very successful online platform, created with assistance from the Australian Department of Health and Ageing. Th is platform was designed to diagnose twenty-one mental health disorders and to provide online treatment for five anxiety disorders. In addition, this platform has provided a database consisting of very valuable mental health data. This database has been used to validate several mental health diagnoses provided by the platform, to investigate the factors associated with attrition and to study the comorbidity patterns found in this online sample. More recently this database has been used to build a model to predict the risk of suicide ideation and to produce a personalized study of the stress management strategies of people accessing this system. In particular, using a segmentation analysis and appropriate models, it has been shown that that there are strong links between certain combinations of coping strategies for stress and suicide ideation. The results confirm that more coping strategies are often used when distress or the number of mental health disorders is higher. In this address we describe some of the advantages of an online database of this nature, such as its ability to reach patients who do not seek other forms of mental health assistance and the relatively low cost of data collection. In addition we dwell on some of the disadvantages of such a database, such as the low rate of post-treatment assessment and biases in the sample in terms of age, gender and computer literacy.

Wayne Grant Carter completed a BSc (Hons) degree in Biochemistry with Nutrition and then a PhD in Biochemistry at the University of Southampton. He subsequently undertook post-doctoral research posts at The Babraham Institute, Cambridge; Imperial College, London; University of California at Irvine, USA, and the University of Oxford. Additionally, he has worked for a global reagent supplier, Sigma, a SME company, Mobious Genomics, and has been employed as a consultant for Syngenta. He is currently a Lecturer and research Group Leader within the School of Medicine, University of Nottingham. His research interests are varied and include detection and utilisation of novel biomarkers of toxicological exposure. He currently serves on the Editorial Board of over 40 different medicallyrelated journals and reviews for over 50 more.

The brain is a target of physiological stress, and is infl uenced and responds to stress-induced adaptation via synaptic plasticity. This brain structural remodelling can infl uence an individual’s behaviour and physiological responses. Dysregulation of stress may contribute to the development of a number of psychiatric disorders, including major depressive disorder (MDD). The management of stress typically involves pharmacological and non-pharmacological interventions. For the former, drug or herb therapy has been employed, but stressed individuals may also adopt acute (binge) and/or repetitive alcohol drinking behaviour. Excessive alcohol intake also drives neurobiological changes, some of which may contribute to the development of MDD. Alcohol dependency and MDD have alarmingly high rates of co-morbidity, indicative of a commonality of molecular mechanisms. In this talk I will highlight some of the neurobiological changes associated with stress, alcoholism and consider alcoholism and depression co-morbidity.

Deen Mirza is a General Practitioner in South London. He qualifi ed from Imperial College School of Medicine in the year 2000 and was trained to become a GP in the Croydon VTS. He has done DGM, the DCH, the DTMH and a Post-graduate certifi cate in Healthcare Education. He has held academic GP posts at several universities. He currently works as a Clinician and Educator at AT Medics, London, UK.

General practitioners are a high achieving section of the population with perfectionist tendencies. Under the strain of increased work pressure, some experience professional burnout. Identifying contributory factors common to GPs who have suffered burnout may help to predict and intervene with those at risk of burnout. Five UK family doctors who have suffered burnout personally were interviewed to explore the context of their burnout experience. The interviews were analyzed qualitatively to identify common themes. Personality traits, risk tolerance threshold and situational pressure appear as prominent commonalities for these GPs as potential causes for burnout. Awareness of these characteristics may help to identify those GPs prone to burnout. Further research is required to clarify what interventions are of proven benefit t in such cases.

Marina Ziff holds a degree in International Relations and a MA in Health and Social Marketing. She has previously worked at MIND (Mental Health Charity) and the NHS. Currently, she is completing her fi nal year of Gestalt Counseling Diploma at the Albany Centre in Hertfordshire and is a student of Shamanism at the Mystery School of Amaru. She has a special interest in helping individuals fi nd a deeper meaning in their life through igniting their soul’s spiritual purpose.

Research suggests that people in emerging nations are more stressed than those in the developed world, yet there is a signifi cant rise of stress related mental health issues in developed countries like the UK. Some of the most stressed people in our society are those who are prohibited from being in such a state. They are the type of people that as a society we struggle to have compassion for and who are likely to have had a privileged upbringing that most people can only dream of, yet they too experience stress and related emotional health issues. Why is their stress ‘forbidden’? It is because sections of our society are not allowed to admit that they are unhappy because they have money and money is supposed to be the answer to everything. Our society is built on this concept and it’s called, capitalism and consumerism. Why is their stress hidden? It’s hidden because as a society we are not interested, we may struggle to feel sympathy and compassion for those people who on paper seem to have it all but these people are not allowed to admit the truth, even to themselves, that there is something more beyond the material world. Th ey represent the pinnacle of ultimate happiness and the solution to our entire mortal woos so what on earth have they got to be stressed and unhappy about? You may ask why it calls for a spiritual solution, it calls for a spiritual solution because until you have meaning and purpose in your life, you’ll never truly feel alive or happy and money cannot acquire it.

Saddiga Al-Ghalib is an Assistant Professor, Psychology Department, Effat University, Jeddah, Saudi Arabia. She is the Chair of the Psychology Department, Effat University, Jeddah, Saudi Arabia. She has done her PhD (Educational Psychology) from Southern Illinois University Carbondale in 2004. She has done her MS (Educational Psychology) from Southern Illinois University Carbondale. She has done her BS (Curriculum and Instruction) also from Southern Illinois University Carbondale, in 1991. She was the First Director to the Center of Excellence in Teaching and Learning, Effat University, Jeddah, Saudi Arabia, in 2007 and also the First Director to the Research and Consultancy Institute, Effat University, Jeddah, Saudi Arabia. She was the Dean of Graduate Studies and Scientifi c Research, Effat University, Jeddah, Saudi Arabia from 2009-2013.

The aim of this research is to look into the prevalence rates and determine which gender has higher depression, anxiety and stress among university students of both genders in Jeddah, and to determine the relationship among depression, anxiety and stress. Random stratifi ed sampling was used and a sample from all private and public universities in Jeddah was selected. Th e Arabic and English version of depression, anxiety and stress scale (DASS21) was used. According to the Anxiety and Depression Association of America (2016), people always face life stressors and go through hard situations that make them feel anxious, stressed or even depressed, but it is normal to express the right emotions at the right time. But some people have anxiety or/and depression which makes them experience those emotions continuously at all times, and make it a very difficult for them to function normally and make them struggle in practising their daily activities. Mental illness, in general, is becoming a global problem, and the numbers reaching crisis level, that is why this problem requires proper intervention and management (Almutairi, 2015), so shedding light to the prevalence rates of depression, anxiety and stress among university students is very important because when people have a prove of their problem then they will seek help. Therefore, this current research will benefit  the society because by understanding the phenomena it would help the individuals in controlling it before it gets out of control and learn how to cope with it positively and hopefully reduce the prevalence of those conditions.

Jacqueline A Hinds is a certifi ed Emotional Intelligence Coach (CEIC) and Leadership Consultant and, has worked in the healthcare sector for over 30 years. From 2006-2010, she has worked as a Leadership Development Consultant at the Imperial College Healthcare NHS Trust (10,000 staff) and, from 2010-2015 as Education Academy Training Manager of Barts Health NHS Trust (15,000 staff). Currently, she is the Chair of SoEI, UK.

Leading transformation in health care has a tremendous advantage in improving the services, patient experience and care within the National Health Service (NHS). It also bears the scars and, has had a significant impact on staff undergoing the transformation and, in a large majority of cases, impairing their duty of care to the patients and services under their care. The concept of emotional intelligence (EI) in healthcare, although not referred to or identified as an integral part of the healthcare infrastructure, is in reality interwoven into everything that is delivered as part of a service provider. In fact, EI is crucial throughout all levels of employees within healthcare and not just senior managers or leaders; the knowledge of EI enables individuals to understand their emotions, emotional meanings and to, reflectively regulate these emotions whilst transitioning through change initiatives and periods of significant and, sometimes, rapid transformation. Not all healthcare transformational projects have been successful in the past, some have been more transactional and result driven, which has led to employees feeling pressured and disturbed about the changes that were taking place and, more often than not, being emotionally unstable or stressed as a result of the changes at that juncture. Experiences ineffective transformational change and, the fallout of transactional change initiatives, has resulted over the years in a significant rise in organisations requesting external consultants to deliver stress management, conflict resolution and more recently, anger management training within their establishments. The presentation will highlight some examples of where Emotional Intelligence has made a significant contribution to leading smoother transformation initiatives within the healthcare.

 

In this presentation, two Psychiatrists with extensive experience in psychiatric workplace casualties offer an examination of stress symptoms in the context of asymmetrical work relationship stress. Helpful psychodynamic principles are discussed, and the clinical equation of panic attack=suppressed forbidden rage is suggested as a valuable pointer in clinical cases of work stress. Anxiety is only one of several responses to trauma. A case series of panic attacks in 33 patients is presented to confirm the high incidence of comorbidity of panic disorder with the depressive spectrum. It is suggested that chronic disability may be prevented by open acknowledgement of irreconcilable asymmetrical relationships, as occurs in marital therapy and in the DSM system a new V-Code “irreconcilable work diffi culties with a superior” should be added.

Lucy Lila Nelson is a Wellness Specialist and Workshop Facilitator with a wide variety of background and schooling. She is trained in various mind-body modalities such as a Yoga Teacher (Level I and II, Stress Management), Positive Psychology Practitioner and Life Coaching Skills, Interfaith Minister, certified in whole-food plant-based (WFPB) nutrition, Wellness Coach, Mindfulness-based Eating Awareness Educator (MB-EAT), Emotional Freedom Technique Practitioner (EFT), and Yoga Dancer.

Yoga, as we now know, has proven to demonstrate enormous benefits in many different spectrum and aspects of life. In the past 30 years, research in mind-body medicine has placed yoga as a leading approach to promoting greater balance and relieving stress. Many contributors to this work involves several researchers and physicians including but not limited to Dr. Dean Ornish, who adapted an Integral Yoga Hatha class (calling it stress management) as part of a lifestyle change program to reverse heart disease; Jon Kabat-Zin used hatha yoga as a mindfulness of movement practice at the Stress Reduction Clinic

of the University of Massachusetts Medical Centre; and Herbert Benson described “relaxation response” based on his study of transcendental meditation and other yoga techniques, eventually founding the Mind and Body Institute at Harvard Medical School. Th ere is a growing research that recognizes stress as an important health concern. Th ey continuously support the efforts to bringing awareness of the benefits of yoga in the medical community. Yoga fosters a renewed sense of the body and mind, developing the skills to transform our physical, mental and emotional responses. Th e yogic approach to stress management is an adaptation of the yoga practices and philosophy (such as Hatha and Raja yoga); making these tools accessible and relevant to people from different backgrounds in a variety of settings. Hatha yoga includes centering, stretching, breathing, and meditation, and Raja yoga includes developing self-awareness and using the power of the mind to manage change. It was concluded that a combined methodology is the most effective.

Aboelezz Mahmoud Kalboush is a Consultant Psychiatrist; he received his Master’s degree in Psychiatry and Neurology from Ain-Shams University, Egypt in 2007. He is the Head of Psychiatry department in Alnoor Specialist Hospital, Saudi Arabia. He is responsible for training of medical students (both undergraduates and post-graduates) in Psychiatry.

Introduction: In 1950’s the clinical introduction of the fi rst two specifi cally anti-depressant drugs: iproniazid, a monoamineoxidase inhibitor and imipramine, the first tricyclic antidepressant started. Since that time up till now, many antidepressants working on different neurotransmitters and receptors linked to depression were discovered and introduced in clinical practice but the main advantage of them over the old ones is their higher tolerability by patients. Combining psychotherapy with pharmacological treatment can improve the success rate of treatment but a considerable portion of patients stay resistant to this combined treatment. Even with using electro-convulsive therapy (ECT) in treating resistant depression, up to 20% of patients don't respond to it. Th is means that there is still something missed in treating patients with resistant depression and something more is needed to treat resistant depression more effectively.

Belinda Neil is a Director at PTSD Australia New Zealand, former Police Inspector, an 18 year veteran of the New South Wales (Australia) Police Force (medically retiring with PTSD in 2005), Hostage Negotiator, and Keynote Speaker in both the corporate arena and in her role as a Mental Health Advocate. She is the author of the book “Under Siege”. Currently, she is working on various management tools to assist in early intervention and minimising the symptoms of post-traumatic stress disorder.

One of the goals of therapy is to reduce symptoms and provide a better quality of life for the patient suffering post-traumatic stress disorder, anxiety, or depression. Post-traumatic stress disorder occurs after traumatic events exposure. PTSD is characterized by symptoms of re-experiencing such as intrusive memories and dreams: avoidance including avoiding thoughts, feelings and places associated with the traumatic event: numbing or feeling detached from others; and hyperarousal including poor sleep, irritability and hypervigilance. Th ere are now many studies that show a growing awareness that the cerebellum plays a higher role in cognitive functions such as sensory processing, attention, verbal working memory, and emotion. Recent studies have shown that the cerebellar fluid reduction is associated with mood, anxiety and PTSD symptoms and that there is a possible role of the cerebellum in the vulnerability to experience negative eff ect. Th is is the second study involving participants diagnosed with PTSD undertaking a novel physical exercise designed to stimulate cerebellar function. Those participants who regularly performed the exercise advised of a significant reduction in their PTSD symptoms. Th e participants advised of improved sleep, a positive change in themselves, a reduction in negative emotions, improvement in memory and a reduction in intrusive memories. Both studies clearly showed an overall improvement in participants. Besides providing the patient with improved quality of life, it is stated that the use of putative cerebellum exercises may assist the patient in early stages of treatment, not only with their concentration but more importantly allowing them to participate in CBT or exposure therapy

rather than dissociating.

Andrew John Ashworth has graduated from Leeds University Medical School in 1980. He became a member of the Royal College of General Practitioners in 1985. He was a Royal Navy Medical Officer between 1980 and 19994 with experience including combat in the Falklands Conflict and in submarines at sea. He is dual qualified in Occupational Medicine. His special interest is in the treatment of Psychological Trauma and is qualified in Brainspotting as well as CBT. He works as an NHS General Practitioner in Scotland as well as providing occupational medical services and carrying out research on trauma and anxiety.

A method of rapid attenuation of symptoms of anxiety (including panic) is described using interoception combined with simultaneous stimulation of the third and fourth cranial nerves by the subject. Th e method is thought to interrupt a neurological feedback loop which will be described by direct stimulation of the Edinger-Westphal nucleus which is the rostralmost parasympathetic nucleus in the brainstem. Attenuation of interoceptive (physical) symptoms usually occurs in less than 5 minutes with associated elimination of psychological symptoms. Having learnt the method it can be carried out by the patient without further therapeutic intervention. Th e method has been used in a Scottish General Practice now for over 12 months with associated reduction in prescribing and referral numbers to mental health services. In an oral presentation, a demonstration with a volunteer can be carried out to demonstrate both the delivery of the method and to have feedback from the volunteer subject.

Asa Westrin is a Senior Consultant in Psychiatry in Southern Sweden. She is a University Lecturer and is an Associate Professor at Lund University. She is the Head of Clinical Psychiatric Research Center (VKP), Region Skåne. She is the Head of the Unit for Clinical Suicide Research, Lund University. She has published more than 35 papers in reputed journals and has been serving as an Editorial Board Member of repute.

There are reasons to believe that maladaptive coping strategies are related to brain areas fundamental to learning, memory, and thinking. Brain-derived neurotrophic factor is located in these brain areas and has an important role in the regulation of neuroplasticity. We have observed an association between BDNF Val66Met gene polymorphism and avoidant coping strategies,

suggesting a genetic predisposition for vulnerability to stress in a subgroup of suicide attempters. Interestingly, we have also observed an association between low BDNF levels and high impulsiveness, a trait related to increased suicide risk. Furthermore, we have observed associations between low BDNF levels and hypothalamic pituitary adrenal (HPA) axis hyperactivity in female suicide attempters. As the HPA-axis regulates different reactions to stress, for example mood and emotions, our results suggest that increased stress is associated with low BDNF levels in female suicide attempters. Another biomarker of interest

when studying stress and cellular damage is mitochondrial DNA (mtDNA). Animal studies have suggested that chronic stress causes cellular damage, mitochondrial dysfunction and possibly a release of mtDNA into the peripheral circulation. We have reported significantly increased levels of free-circulating mtDNA in suicide attempters compared to healthy controls and a significant correlation between mtDNA and cortisol after a dexamethasone challenge. Th is suggests an association between mitochondrial dysfunction and HPA-axis hyperactivity in suicide attempters. We conclude that further studies should explore subgroups of suicide attempters with maladaptive coping strategies and biomarkers of cellular damage, in order to find new strategies to recognise and treat suicidal patients.

Pam Ramsden has completed her PhD in Counseling Psychology from an American Psychological Association approved program at the University of Kansas. She then completed an internship with the Veterans Administration in Tucson Arizona specialising in PTSD. She has worked in the area of trauma and PTSD as a Clinician and Educator for over 25 years. She is a Specialist in PTSD, trauma therapy, stress therapies and victimology.

Social media allows the general population to view videos and pictures with never before seen levels of devastation and destruction. Th e world has been bombarded with pictures of the aft ermath. Stretchers of wounded and possibly dying victims were on display as well as grief stricken relatives searching through the deceased for their loved ones. As a result of watching these events and feeling the anguish of those who are directly experiencing them does have an impact on our daily activities whilst they are being broadcast, it is believed that a proportion of the population may suffer longer lasting eff ects such as negative stress reactions, anxiety and in some cases post-traumatic stress disorders-PTSD. Studies have shown that vicarious trauma does happen to health professionals and is defined as the transfer of violent, traumatic experiences from client/patients to a person of a helping profession. Th e trauma does not occur directly but indirectly. Th e results of my research indicates that approximately 20% of the research participants across four clinical studies were signifi cantly aff ected by media events and these individuals scored high on clinical measures of PTSD even though none of the individuals had previous trauma and were not present at the traumatic events and had only watched them on social media. My research indicates that the general populations are being aff ected by the viewing of violent images on social media and are being aff ected by vicarious trauma. Acts of violence erode our sense of security and safety, random acts of violence can create intense feelings of anger, frustration, fear and helplessness. As a result of watching these events, a certain percentage of individuals are experiencing lasting effects such as negative stress reactions, anxiety and in some cases post-traumatic stress disorders or vicarious PTSD. It is important that clinicians are aware and provide additional support and guidance in the community in times of extreme violence and terroristic acts.