Chapter 7 Flashcards
CPTSD
complex post traumatic stress disorder not in dsm but is in icd
this has a much more in depth treatment plan than ptsd
cumulative disorder (there is a build up) multiple traumas experienced
Trauma and Stressor-Related Disorders
-New to DSM-5
-Disorders that develop after a stressful or traumatic life event
-Includes;
-Childhood attachment disorders
-Post-traumatic stress disorder (PTSD)
-Acute stress disorder
Post Traumatic Stress Disorder (PTSD)
-Enduring, distressing emotional disorder that follows
exposure to a severe helplessness or fear inducing threat. The victim re-experiences the
trauma, avoids stimuli associated with it, and develops a numbing of responsiveness and
an increased vigilance and arousal
- long-lasting severe emotional reactions persist leading to post-traumatic stress disorder
Clinical Description of PTSD
-Fear of re-experiencing a traumatic event
-Rape, war, life-threatening situation, etc.
-Nightmares or flashbacks
-Avoidance of the intense feelings of the event through emotional numbing
-Acute, chronic, delayed-onset
Acute Stress Disorder
-Severe reaction immediately following a terrifying event, often including amnesia about the event, emotional numbing, and derealization. Many survivors later
develop post-traumatic stress disorder
-aprox 50% od patients develop PTSD
- less than a moth after even
PTSD in Children
-Children’s memories of traumatic events:
-Become embellished over years
-Bed-wetting, separation fears
PTSD Causes
- Cause has to be a traumatic experience
-Biological, psychological, social vulnerabilities
-Intensity and severity of trauma
-No or little social support system
-Damaged hippocampus (we are not sure if trauma damages the hippocampus or if the damaged hippocampus causes trauma
PTSD Treatment
-Imaginal exposure, coping skills (Gradual exposure is the key)
-Cognitive therapy
-Constructivist-narrative approach
-Eye-movement desensitization and reprocessing (EMDR)
-SSRIs (Prozac, Praxil) to relieve anxiety
Constructive-narrative Approach
Therapist assists clients in reconstructing their ‘story’ about
the traumatic event - changing the meaning that the clients have attached to the traumatic event and helping them develop adaptive coping strategies and a sense of survivorship.
Eye Movement Desensitization and Reprocessing (EMDR)
While in therapy and thinking
about their traumatic experience, clients are asked to follow the therapist’s moving fingers with their eyes, all the while keeping the image of the trauma in mind. This facilitates rapid reprocessing of the traumatic event
Flashback
When memories occur very suddenly and the survivors find themselves reliving the
event
Delayed PTSD
Individuals show few, if any, symptoms immediately or for months after the trauma, but at least six months later, and perhaps years afterward, develop full blown PTSD
Prolonged Exposure Therapy
develop a narrative with the trauma survivor of the traumatic
experience and to expose the patient for extended periods of time to that narrative
Derealization
-Persistent or recurrent experiences of unreality of surroundings (ie; the
world around the individual is experienced as unreal, dreamlike, distant, or distorted
- Detached from the world
Depersonalization
-Persistent or recurrent experiences of feeling detached from, and as if one were an outside observer of one’s mental processes of body (ie; feeling as though one were in a dream, feeling a sense of unreality of self or of time moving slow
- detached from yourself
Prolonged Grief Disorder
-Prolonged adaptation to loss associated with intense longing for
and preoccupation with the deceased, leading to difficulty moving on with life even after a year or more has passed
-Difference between prolonged grief and acute grief
Adjustment Disorder
Anxious or depressive reactions to life stress that are generally milder
than in acute stress disorder or ptsd but are nevertheless impairing in terms of interfering with work or school performance, interpersonal relationships, or other areas of living
Attachment Disorders
Developmentally inappropriate behaviors in which a child is unable or unwilling to form normal attachment relationships with caregiving adults
Two Types of Attachment Disorders
- Reactive Attachment Disorder
- Disinhibited Social Engagement Disorder
Reactive Attachment Disorder
Attachment disorder in which a child with disturbed behavior
neither seeks out a caregiver nor responds to offers of help from one; fearfulness and sadness are often evident
Disinhibited Social Engagement Disorder
Condition in which a child shows no inhibitions what so ever in approaching adults
Dissociative Disorders
Disorders in which individuals feel detached from themselves or their
surroundings, reality, experience, and identity may disintegrate
Stressor Related Disorders
- Prolonged Grief Disorder
- Adjustment Disorder
- Attachment Disorders
Depersonalization-derealization Disorder
-Dissociative disorder in which feelings of depersonalization are so severe they dominate the client’s life and prevent normal functioning
-Outside observer of own body or mind
- Rare; onset usually in adolescence
-No conclusive evidence regarding effectiveness of psychological and drug treatments
Dissociative Amnesia
Dissociative disorder featuring the inability to recall personal
information, usually of a stressful or traumatic nature
Generalized Amnesia
Condition in which a person loses memory of all personal information,
including their own identity
Local/Selective Amnesia
Memory loss limited to specific times and events, particularly traumatic events
Dissociative Fugue
Dissociative disorder featuring sudden, unexpected travel away from home, along with inability to recall the past, sometimes with assumption of a new identity
Amok
Trans-like state where you perform heinous behaviour
Dissociative Trans Disorder (DTD)
Altered state of consciousness in which the person believes firmly that he or she is possessed by spirits; considered a disorder only where there is distress and dysfunction (Type of DID)
Dissociative Identity Disorder (DID)
Formerly known as multiple personality disorder, a disorder in which as many as one hundred personalities or fragments of personalities coexist within one body and mind
Alters
Shorthand term for alter egos, the different personalities or identities in dissociative identity disorder
Host
The identity that is first to seek treatment but is seldom the original identity of the person
Switch
The transition from one personality to the next
Chronic PTSD onset
3 months or more
DID Causes and Onset
-Onset in childhood; lasts a lifetime
-Childhood abuse: physical and sexual
-Take on different identities as escape is not possible
-Escape sought from physical and emotional pain
-DID may be a sub-type of PTSD
-suggestibility
-Autohypnotic Model
-Roles of heredity and environment debated
-Temporal lobe epileptic seizures can be associated with dissociative symptoms
-Sleep deprivation
-Symptoms worsen when person is tired
-real and false memories
Autohypnotic model
suggestible people may use dissociation as a defence against trauma
Real and False Memories
-may be due to trauma
Memories could be a result of suggestions from therapists
-could be falsely created through hypnosis - can create alters through problematic therapudic intervention
DID Treatment
-Long-term psychotherapy
Reintegrate separate personalities
22% success rate
-Treatment of associated trauma similar to post-traumatic stress disorder
2 Types of Dissociative Amnesia
-Dissociative fugue
-Dissociative trance disorder
Interpersonality Amnesia
events experiences by a particular personality state or identity are
retrievable by the same identity but not a different one
