Chapter 6-Disorders of Trauma/Stress Flashcards
Cannon’s Fight/Flight Response
stimulation of sympathetic nervous system
–>release Norepinephrine–>fight or flight
(Fast response)
Selve’s general adaptation syndrome
stress process of prolonged stressors
- Alarm phase: initial reaction to a stressor & initial mobilization of resources
- Resistance phase: resources are mobilized, levels of arousal/functioning are at highest level
- Exhaustion phase: Depletion of physiological resources & Decline in functioning
Transactional Model (Lazarus)
when demands from environment exceed social resources
Resources: social support, good active coping, finances, time, etc.
Greater the demands, more resources required
–>more resources one has the more demands they can handle
Acute Stress & illness
short term stressors-less of an effect on one’s health
Prolonged stress & illness
prolonged stressors-stronger effect on health & immune system
prolonged stress can be objective OR perceived
SAM system
Sympathetic AdrenoMedullary system
–>release of catecholamines (adrenaline)
Fast response
HPA system
Hypothalamic Pituitary Adrenocortical system
–>corticosteroids (cortisol)–>illness
Chronically elevated cortisol levels
- compromise immune system
- destruction of hippocampal neurons
- increase in centripetal fat
- ->”premature aging”
Acute PTSD
symptoms develop within 6 months of trauma
Prognosis: fairly good with treatment
Delayed PTSD
symptoms develop after 6 months from trauma
prognisis: poorer
Symptoms of PTSD
- hyperarousal & vigilance
- flashbacks of event
- difficulty concentrating
- sleep problems
- psychic numbing-dissociative states
- irritability
- intimacy problems
- substance abuse (dual diagnosis)
- avoidance of anything related to trauma
- increased arousal-exaggerated startal response
3 clustered symptoms of PTSD
- Re-experiencing: recurring thoughts, memories, dreams, nightmares connected to events, severe flashbacks
- Avoidance: avoid activities that remind them of traumatic event
- Arousal: increased negative emotions and guilt
Health effects of PTSD
- CHD
- Diabetes
- Hypertension
- Musculaskeletal disorders
- obesity
Combat PTSD
12-20% returning soldiers diagnosed
30% wounded diagnosed
many do not seek help, & delay leads to poorer outcomes
Variables to predict violence and PTSD (Hellmuth et al.)
numbing & hyperarousal–>TRAIT ANGER–>aggression
EMDR
eye movement desensitization rehabilitation
works via: exposure
*not proven to work
Virtual reality Therapy
virtual exposure
–>operates via classical conditioning
Treatment of PTSD
- EMDR
- CBT/Meds
- Virtual Reality Therapy
- Telehealth
Acute Stress disorder
“a normal reaction to abnormal circumstances”
symptoms: same as PTSD EXCEPTS symptoms must begin within the first 4 weeks
* symptoms must last at least 1 day, but no more than 30 days
Adjustment Disorder
most common stress related disorder amongst college students
Source: difficulty adjusting to one or more stressors–>reaction to stressor out of proportion to the actual stressor
prognosis: typically Good
symptoms of adjustment disorder
Depression OR Anxiety OR Both
- Adjustment disorder with _______
- anxiety
- depressed mood
- disturbance of conduct
- mixed anxiety & depressed mood
- mixed disturbance of emotions & conduct
Social withdrawal Decrease in performance conduct disturbances sleep problems physical complaints
Controversy of adjustment disorder
up to 30% receiving treatment receive this diagnosis
- overdiagnosed
- misdiagnosed
- extremes in difficulties with coping
Vulnerability to stress disorders
- Biological/genetic factors
- Personality
- childhood experience
- social support
- severity
biological/genetic factors for stress disorders
-cardiovascular reactivity: very strong cardiovascular response to stress & takes longer to return to baseline
Orr et al Police & Firefighters
Measured reactivity prior to trauma
-those showing reactivity more likely to develop PTSD symptoms after trauma
Personality predictors of stress disorders
- Neuroticism: chronically nervous, worry, unstable emotions
- Perceived lack of control over life (external LOC)
- Chronic negative affectivity: cynicism & hostility
Background factors of stress disorders
- history of poverty, early trauma, abuse
- family history of psychological disorders
- history of divorce of parents prior to age 10
- History of family upheaval
severity of trauma & stress disorders
very severe trauma can effect even those without vulnerability factors
Dissociative amnesia
memory loss without organic cause
localized dissociative amnesia
*most common
does not remember events from a specific time interval–loss of block of time
Generalized dissociative amnesia
*very rare
does not remember anything from past life after experiencing trauma
selective dissociative amnesia
*2nd most common
fails to remember some details, but remembers others
continuous dissociative amnesia
*also rare
cannot recall from a period of time, up to & including the present
*continue to not be able to make new memories
systematized dissociative amnesia
-only certain types of memories are lost (relating to theme)
events forgotten often relate to stressful theme
Dissociative fugue
in response to stress/trauma
*very rare
- some travel away, may establish new identity
- some do not remember who they are, where they are, etc.
most “wake up” and realized something happened, but remember nothing during fugue state
depersonalization/derealization
- most common dissociative disorder
- chronic change in self-perception: view of self from “outside (dream-like experience
Onset: adolescence/early adulthood
-linked to early abuse/trauma
Dissociative identity disorder
DSM:
- at least 2 separate personalities
- host & alters
- more common in females
- striking physiological changes noted among personalities
- personalities typically switch under stress
- history of trauma/abuse
- prevalence: highest in US & Canada
DID controversy
- are symptoms therapist-led
- are they related to cultural expectations
- over or mis diagnosed
*majority believe it exists but it is being over or mis diagnosed
