Chapter 6 Flashcards
Acute Stress Disorder
A short-term anxiety disorder that occurs within a month of experiencing a traumatic event, characterized by dissociation, intrusive thoughts, nightmares, and hyperarousal.
Autonomic Nervous System (ANS)
An extensive network of nerve fibers that connect the central nervous system (the brain and spinal cord) to all other organs of the body. It controls involuntary activities such as breathing, heartbeat, blood pressure, sweating, and pupil dilation.
Corticosteroids
Hormones released by the adrenal cortex in response to stress, including cortisol, which helps regulate metabolism, immune response, and stress adaptation.
Depersonalization-Derealization Disorder
A dissociative disorder in which individuals feel detached from their own mental processes or body, experiencing a sense of unreality about themselves or their surroundings.
Dissociation
A mental process in which a person disconnects from their thoughts, memories, identity, or perception, often in response to trauma or extreme stress.
Dissociative Amnesia
A disorder characterized by an inability to recall important personal events or information, usually related to stress or trauma.
Dissociative Disorders
A group of disorders involving disruptions in consciousness, memory, identity, or perception, often occurring as a reaction of trauma
- Lacks the other problems that characterize other stress disorders
Dissociative Fugue
A severe form of dissociative amnesia where a person forgets their identity and past and may travel to a new location, sometimes assuming a new identity.
Dissociative Identity Disorder (DID)
A disorder in which an individual develops two or more distinct personalities, also known as sub-personalities or alternate personalities, which take control at different times
- Leads to memory gaps regarding daily events, key personal info, or trauma
Eye Movement Desensitization and Reprocessing (EMDR)
A therapy for PTSD and trauma that involves guided eye movements while recalling distressing memories, helping the brain process and integrate traumatic experiences.
Hypothalamic-Pituitary-Adrenal (HPA) Pathway
A major stress response system in which the hypothalamus signals the pituitary gland to release ACTH
- ACTH stimulates the adrenal cortex to produce corticosteroids (such as cortisol) that affect the body’s arousal and stress responses.
- Also known as HPA axis
Parasympathetic Nervous System (PNS)
The division of the autonomic nervous system responsible for calming the body after stress, lowering heart rate, promoting digestion, and restoring energy (rest-and-digest system).
Posttraumatic Stress Disorder (PTSD)
A mental health condition that develops after experiencing or witnessing a traumatic event, characterized by flashbacks, nightmares, hyperarousal, and emotional numbness
- Can develop shortly after event, or months/years (typically 6+ months after)
- Symptoms continue longer than a month
Self-Hypnosis
A trance-like state that a person enters voluntarily to enhance relaxation, focus, or control over certain bodily processes; sometimes used in therapy to manage pain or trauma.
State-Dependent Learning
A phenomenon in which information learned in a specific state (e.g., emotional, physiological, or environmental) is best recalled when the person is in the same state.
Sympathetic Nervous System
The part of the autonomic nervous system that prepares the body for fight-or-flight responses by increasing heart rate, blood pressure, and alertness in response to stress.
Fight-or-Flight Response
Hypothalamus excites sympathetic nervous system pathway
- Stimulates organs
- Stimulates adrenal medulla (epinephrine and norepinephrine released to bloodstream)
Typical Symptoms of Acute Stress Disorder and PTSD
- Exposure to traumatic event
- Experiences intrusive symptoms such as repeated memories, bad dreams, dissociative experiences, and physical/emotional distress in response to trauma cues
- Avoids trauma-linked stimuli
- Negative changes in trauma linked cognitions and mood
- Changes in arousal/reactivity (excessive alertness, sleep disturbance, etc.)
Treatments for Acute Stress Disorder and PTSD
Antidepressants
- Helpful for negative emotions + arousal, less helpful for dissociations + negative memories
- Approx 1/2 experience some symptom reduction
Cognitive-Behavioral Therapy (CBT)
-Deal w/ difficult memories, effective but unpleasant
- Mindfulness based techniques: acceptance of feelings/emotions rather than judgement
- Exposure techniques: confront trauma
- EMDR
Family/Group Therapy
- Assist with/ lack of support
- Reduction of traumatizing others
Combination of all
Triggers for Stress Disorders
Combat
- “shell shock” , “combat fatigue”
- Approx 20% of vets from Afghanistan and Iraq
Disasters/Accidents
- Civilian traumas trigger stress disorder 10x more than combat triggers
Victimization
- Sexual assault & rape (1 in 6 women)
- 1/3 of all victims develop PTSD
Terrorism
Torture
Stress Disorder Statistics
- Any age
- 2:1, more common among women and low income individuals
- 2/3 of affected people seek treatment
- Approx 20% attempt suicide
- About 1/3 cases improve w/in 12 months, remainder may persist for years
- Treatment procedures depend on trauma
Factors that Increase Risk for Developing a Stress Disorder
- Biological factors
- Childhood experiences
- Personal styles
- Social support systems
- Severity and nature of the traumas
Factors that Increase Risk for Developing a Stress Disorder: Biological Factors
Brain-Body Stress Pathways
- Heightened arousal in the SNS and HPA pathways
- May be overly reactive prior or post trauma
- Abnormal norepinephrine and cortisol levels
Brain’s Stress Circuit
- Too little activity in prefrontal cortex, too much activity in amygdala
Inherited Predispostion
- If a twin develops PTSD post combat, identical twins are more likely to develop PTSD than fraternal twins
- Women with PTSD after 9/11: babies w/ higher cortisol
Factors that Increase Risk for Developing a Stress Disorder: Childhood Experiences
- Chronic neglect or abuse: leads to developing poor coping mechanisms
- Poverty
- Parental separation or divorce
- Catastrophe
Factors that Increase Risk for Developing a Stress Disorder: Personal Styles
Pre-existing high anxiety/negative world view means more likely to experience negative attitudes and feelings than those w/ positive attitudes and resiliency
Factors that Increase Risk for Developing a Stress Disorder: Social Support Systems
Weak family/social support systems
- Having support when processing trauma helps so lack of support increases risk
Factors that Increase Risk for Developing a Stress Disorder: Severity & Nature of the Traumas
- More severe/prolonged trauma
- More direct exposure to trauma
- Intentionally inflicted trauma
Goals of Stress Disorder Treatments
- End lingering stress reactions
- Gain perspective on painful experiences
- Return to constructive living
Psychodynamic Perspective on Dissociative Amnesia and DID
- Dissociative amnesia & fugue are single episodes of massive repression (blocks memory to avoid pain of facing it)
- DID results from lifetime of excessive repression, motivated by traumatic childhood
- Most support drawn from case histories
- Only small fraction of abused kids develop disorder, and some individuals don’t have bayside background
Cognitive-Behavioral Theory of Dissociative Amnesia and DID
State-dependent learning
- Learning becomes associated with conditions under which it occurred, best remembered under same conditions
- People prone to developing dissociative disorders have state-to-memory links that are unusually rigid/narrow
Parallel Between Hypnotic Amnesia and Dissociative Disorders
- Hypnosis: sleep like state when people become suggestible, can make people forget facts and info that is usually impossible
- Dissociative amnesia may develop in people who hypnotize self into forgetting horrifying experiences
Therapies for Dissociative Amnesia
- Psychodynamic: guide patients to search into unconscious and remember forgotten experiences
- Hypnosis: hypnotized + guided to recall forgotten events
- Drug: injections of barbiturates are used to help patients regain lost memories (calm people and free inhibitions, helps them to recall anxiety-producing event)
How Do Therapists Help With Dissociative Identity Disorder?
Recognize fully nature of disorder
- Try to bond w/ primary personality and each subpersonality
- Educate patients and help them understand disorder
- Introduce subpersonalities to each other, by hypnosis or through videos of other personalities
- Recover gaps in memory through therapies for dissociative amnesia
- Integrate subpersonalities into one personality
