Ch. 16: Stress Disorders Flashcards
What systems are involved in fight or flight?
Endocrine/Autonomic (Sympathetic/Parasympathetic)
What is the role of the sympathetic system?
Heart rate, breathing, BP increase
Adrenaline increases
Starts the fight or flight response
What is the role of the parasympathetic system?
Reduces HR, BP, respirations and slows to rest.
What are 2 types of stress disorders?
Acute stress disorder
PTSD
Describe acute stress disorder?
Exposure to actual or threatened death, serious injury, or sexual violation
What can cause acute stress disorder?
Directly experiencing traumatic event, learning event occurs to a close person, repeated exposure to violent or extreme event.
What are some intrusion symptoms of acute stress disorder?
Recurrent involuntary memories of trauma
Dreams related to trauma
Feel as if trauma is happening over again
Physiological reaction in response to external triggers
In acute stress disorder, a persistent inability to experience positive emotions is known as?
negative mood
What are Dissociative symptoms in acute stress disorder?
Altered sense of reality of one’s surroundings
Can’t remember an important aspect of trauma
What are some avoidance symptoms in acute stress disorder?
Efforts to avoid distressing memories
Avoid external reminders that cause memories to surface
What are some arousal symptoms of acute stress disorder?
insomnia Anger Hypervigilance Concentration issue Heightened startle
What is the general duration of acute stress disorder?
3 days to 1 month after trauma
Describe PTSD?
Exposure to actual or threatened death, serious injury, or sexual violation
What are some causes of PTSD?
Directly experiencing or witnessing trauma
Finding out that trauma happened to close family
Repeat exposure to trauma
What are some intrusion symptoms of PTSD?
Recurrent involuntary remembrance
Recurrent distressing dreams
Flashbacks
Prolonged distress in response to external trigger
What is arguably the most important symptoms when diagnosing PTSD (1 or more needed)?
Marked physiological reaction to internal or external cues that symbolize or resemble an aspect or traumatic event
What are some negative alterations in cognition in PTSD (2 or more needed)?
Can’t remember important aspect of trauma
Exaggerated negative belief about self
Persistent distorted thinking about cause/consequence
Negative emotional state
Diminished interest in activities
Detachment from others
What category was removed from PTSD?
Dissociative symptoms
What are some avoidance symptoms of PTSD (1 or both needed)
Efforts to avoid distressing memory about trauma
Efforts to avoid external reminders that arouse feelings
What are some arousal symptoms of PTSD (2 or more needed)
Sleep disturbance Anger Hypervigilance Concentration issues Exaggerrated startle Reckless behavior
What is the duration of PTSD in order to be diagnosed?
more than 1 month
What are some common triggers for stress disorders in soldiers?
WW1: shell shock
WW2: combat fatigue
Vietnam: First recognized soldiers experience serious psychological symptoms after combat
What percentage of our soldiers are diagnosed with a stress disorder?
29% have stress disorders
22% have symptoms
What percentage of traffic accident victims will develop PTSD?
40%
In rape cases, what percentage of victims under 11 will develop PTSD? 11-17? 18-29?
29& under 11
32% 11-17
29% 18-29
What percentage met criteria for acute stress disorder 12 days after sexual assault?
94%
What are some long term effects of victims of sexual assaults?
High anxiety, low self-esteem, sleep issues, sexual dysfunction
What percentage of torture victims develop PTSD?
30-50% depending on type of torture and length
What is the biological explanation as to why people develop stress disorders?
Trauma triggers change in brain/body
High cortisol found in combat soldiers, rape victims and Holocaust survivors
T/F: After 9/11, pregnant women in NY had higher than avg cortisol levels, therefore, babies were born with high cortisol.
True
What are some personality changes in stress disorders?
Higher risk for those with higher anxiety, perception of limited control of life, negative worldview
T/F: Soldiers with poor support have less risk of developing PTSD.
False, they have a higher risk
What are some multicultural aspects that may contribute to stress disorders?
Hispanic soldiers have the highest levels of PTSD , may be attributed to poor coping responses and lack of social support.
T/F: A soldier whose platoon was wiped out by an ambush wherein he was the only one who lived is more likely to develop PTSD than a soldier who has never seen combat.
True
What are some treatment options for those with stress disorders?
Drug therapy
Behavioral exposure techniques
What is eye movement desensitization reprocessing (EMDR)?
rhythmic eye movement with imagery exposure
What is insight therapy?
Need to come to grips with combat experiences and their impact, change dysfunctional attitudes and styles of interpretation
What is family therapy?
Families are impacted
Describe rap groups?
Group therapy with other veterans
Describe adjustment disorder?
Development of emotional or behavioral symptoms in response to an identifiable stressor occurring within 3 months of onset of stressor
What needs to be present to be diagnosed with an adjustment disorder?
Marked distress that is unproportional to intensity of stressor
Impairment in social.occupational areas of functioning
Doesn’t meet criteria for another disorder
In adjustment disorder, symptoms don’t represent __________.
bereavement
T/F: In adjustment disorders, after stressor and its consequences have terminates, symptoms don’t persist for more than addition 6 months.
True
What must you specify with an adjustment disorder?
If disorder is accompanied by depressed mood, anxiety or its mixed
What medical conditions can be affected by psychological factors like stress?
Ulcers Asthma Insomnia Headaches High BP CAD
What are some biological factors as to why some people develop a physical stress disorder?
Weakness in body systems
Individual difference
People who came into the ER w/ no MI had prior __________.
stressors
People who came into ER w/ or w/o MI all had what?
Abnormal hormonal functions
What are some psychological factors that cause people to develop a physical stress disorder?
Repressed coping style
Type A personality
What is the social adjustment rating scale?
measures link between stressors and likelihood of illness
Newer scales take into account different populations
Describe Psychoneuroimmunology?
study of connection between stress and immune system and illness
What does behavioral medicine do?
combines psychological and physical approaches to treat or prevent medical problems
What are some techniques used in behavioral medicine
Relaxation training, biofeedback and hypnosis
Describe mindful meditation
Mindful, not judgmental. Pays attention to every aspect of being, even pain.
