5. TSRDs & Somatic Disorders Flashcards
Where does trauma stem from? (3)
- poor upbringing
- early childhood trauma
- stress (can’t get PTSD from watching the news Noori)
Reactive Attachment Disorder (RAD)
Consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, where rarely or minimally:
- Seeking comfort when distressed
- Responding to comfort
What is the developmental age RAD presents?
> 9 months
At what age is RAD prevalent
prevalent BEFORE age 5
Disinhibited Social Engagement Disorder (DSED)
Behavior pattern where child actively approaches and interacts with unfamiliar adults and has at least 2 of:
- Reduced or absent reticence in approaching and interacting
- Overly familiar verbal or physical behavior (not age-appropriate or culturally consistent
- Diminished or absent checking back w/ adult
- Willingness to go off w/ unknown adult without hesitation
Adjustment disorders
Development of emotional or behavioral symptoms to an identifiable stressor(s) occurring within 3 months of onset
Symptoms of adjustment disorders are clinically significant when ____________ (5)
- Marked by disproportionate distress to severity of stressor (taking into account external and cultural factors)
- Significant impairment in social, occupational, or other important areas of functioning
- Disturbance doesn’t meet criteria for other mental disorder or re-occurrence of old
- Not normal bereavement
- Does not persist more than 6 months post-symptom resolution
Acute Stress Disorder (ASD)
Exposure to actual or threatened death, serious injury, or sexual violation in one or more of:
- Direct experience
- Direct witness
- Learning event happened to close family or friend (violent or accidental)
- Repeated or extreme exposure to aversive details (not via media, TV, pics, or movies unless work related)
Criteria for ASD
Presence of 9 or more of criteria from 5 major categories which begin or worsen after trauma exposure (14 total)
- Intrusion symptoms (4)
- Negative mood (1)
- Dissociative symptoms (2)
- Avoidance symptoms (2)
- Arousal symptoms (5)
What is the duration for ASD?
3 days to 1 month after exposure (after 1 month passes, it is PTSD critical)
T/F: PTSD is age dependent
True! Adults, adolescents, children over 6; children under 6 rare
PTSD
Exposure to actual or threatened death, serious injury, or sexual violence in 1 or more of:
- Direct exposure
- In-person witness
- Learning close family or friend affected
- Experiencing repeated or extreme exposure
What are some key differences between PTSD vs. ASD?
PTSD:
- Diagnosed after 1 month
- Does not include a dissociative symptom cluster
- Can develop from untreated ASD
- Has long-term effects and is more difficult to treat
ASD:
- Diagnosed within 3-30 days of a traumatic event
- Includes a dissociative symptom cluster
- Can lead to PTSD if left untreated
- Easier to treat
For PTSD, how long is the duration of disturbance from previous criteria?
More than 1 month
T/F: PTSD is not highly comorbid
FALSE! It is highly comorbid.
What are some dissociative symptoms associated with PTSD?
- Depersonalization (“out-of-body” recurring experiences
2. Derealization (“dreamlike”, “distant”, “distorted”)
What is delayed expression?
Add-on to PTSD
Full diagnostic criteria = 6 months after event
Onset and expression of some symptoms immediate
What is the evolution of PTSD?
WW1, Vietnam, Classrooms
PTSD prevalence in adolescents
- 2010 National Comorbidity Survey - Adolescent
- F > M (8%/2.3%)
- Total = 5%
- Severe impairment = 1.5%
PTSD in Africa
- S. Africa Study showed 3.2% prevalence
- Other regions vary (20-80%)
Other specified TSRDs
- Persistent complex bereavement disorder
- Adjustment-like disorders presenting 3 months after initial stressor
- Adjustment-like disorders 6 months+ without stressor duration
When is something characterized as unspecified?
In emergency settings where proper diagnosis cannot be given immediately
Somatic Symptom Disorder
- New classification
- Specifiers: severity, persistent, predominant pain
Illness Anxiety Disorder
- New hypochondriasis
- Care seeking vs. avoidant
- Worry having or acquiring serious illness
Conversion Disorder (Functional Neurological Symptom Disorder)
- originally “hysteria”
- Anna O. who was institutionalized for this disorder even though she didn’t have it
- Egyptian/Greek origins? (spontaneous uteral movement)
Conversion disorder prevalence
Varies widely:
- US (NY): 4.5%
- Turkey: 5%
- Italy: 0.3%
Primary symptoms varies:
- Japan: 40% visual
- Netherlands: motor
- Turkey: loss of consciousness
Malingering
Intentional falsification or production of signs and symptoms but to gain something of sort (like monetary)
Factitious
Deceptive behavior about illness or injury in themselves but they want care
Pseudocyesis
- False pregnancy belief
- High African prevalence (bc fertility valued)
- Rare in USA
