Chapter 7 - Trauma and Dissociation

Question 1

What is new about the disorders related to trauma and dissociation?

Answer 1

-they are new being grouped together in DSM 5

Question 2

What are trauma and stressor disorders?

Answer 2

-disorders that develop after a stressful or traumatic life event

Question 3

What disorders fall under trauma and stressor disorders? (4)

Answer 3

-childhood attachment disorders
-PSTD
-acute stress disorder
-adjustment disorders

Question 4

When did PTSD first show up in the DSM?

Answer 4

-DSM 3 following the Vietnam war

Question 5

What is the clinical description of PTSD? Define both criteria A and B. (5)

Answer 5

Criteria A: Trauma has occurred
Criteria B: More than a month
-fear of re-experiencing a traumatic event (cognitive re-experiencing)
-nightmares or flashbacks
-avoidance of the intense feelings of the event (avoidance) through emotional numbing (numbing)
-acute, chronic, delayed-onset

Question 6

What do we define trauma as occurring in the PTSD definition?

Answer 6

-exposure to actual or threatened, directly, witnessing or learning it has occurred to someone close to you, or repeated

Question 7

What is delayed expression of PTSD?

Answer 7

-expression of PTSD 6 months or even a year after the event

Question 8

How do younger children show PTSD differently?

Answer 8

-bed wetting, separation fears, hard time remembering (avoidant), may reenact some of the trauma through play

Question 9

Approximately what percentage of acute stress disorder patients develop PTSD?

Answer 9

-50%, some people who develop PTSD may not meet the criteria for acute stress disorder first

Question 10

What percentage of people who have been sexually assaulted develop PTSD?

Answer 10

-approx 1/3

Question 11

What percentage of Canadian auto accident victims develop PTSD?

Answer 11

-15-20%

Question 12

What percent of the Canadian armed forces develop PTSD?

Answer 12

-11%

Question 13

What percentage of the general population develop PTSD?

Answer 13

-8%

Question 14

Which brain structure issues would result in PTSD

Answer 14

-amygdala or hippocampus differences

Question 15

If there is a threat to someone’s life and they are injured, do they have higher rates of PTSD?

Answer 15

-yes, and if they are only injured rather than threatened they have a higher rate too

Question 16

What are four treatments for PTSD? (4)

Answer 16

-imaginal exposure (being exposed to your thoughts and feelings)
-cognitive therapy
-EMDR
-SSRIs

Question 17

What is the invictus games?

Answer 17

-event for those who are in the army, first responders

Question 18

When is PTSD considered chronic?

Answer 18

-when PTSD lasts longer than 3 months

Question 19

When did prolonged grief disorder become an official diagnosis? What is prolonged grief disorder? (2)

Answer 19

-only in DSM 5 became an official diagnosis, death of a loved one at least a year ago.
-Since the death an individual has one or both of these symptoms: intense yearning and long for the dead person that has not diminished and preoccupation with thoughts/memories of the deceased person

Question 20

What are adjustment disorders? How long do they last? (2)

Answer 20

-reaction to life stressors that seem to be over the top
-begin within 3 months and last up to 6 months

Question 21

What are the attachment disorders related to trauma? (2)

Answer 21

-reactive attachment disorder
-disinhibited social engagement disorder

Question 22

What is reactive attachment disorder?

Answer 22

-the child very seldom seeks out a caregiver for protection and support or responds to caregivers and they have had extreme neglect or abuse

Question 23

What is disinhibited social engagement disorder? Example? (2)

Answer 23

-the child shows no inhibitions to approaching adults
Example: they attach just about to anyone, to strangers

Question 24

What are the three dissociative disorders? (3)

Answer 24

-depersonalization/derealization disorder
-dissociative amnesia
-DID

Question 25

What is dissociation?

Answer 25

-disruption in the normal integration of consciousness and sense of who we are

Question 26

What is depersonalization? Example. (2)

Answer 26

-recurrent experiences of feeling detached from oneself, as if you’re an outside observer
Example: feeling like you are in a dream, feeling a sense of unreality or like time is moving slowly

Question 27

Describe depersonalization-derealization disorder. (3)

Answer 27

-severe feelings of detachment
-significant distress
-rare; onset follows traumatic event

Question 28

What can depersonalization-derealization disorder cause? Symptoms? (4)

Answer 28

-cognitive and perceptual deficits occur
-mind emptiness
-deficits in emotional regulation
-dysregulation in the HPA axis

Question 29

What is generalized dissociative amnesia?

Answer 29

-inability to remember anything, including identity (general means not just one specific point in time)

Question 30

What is localized/selective amnesia?

Answer 30

-inability to remember specific events (usually traumatic)

Question 31

What is dissociative fugue?

Answer 31

-when you have amnesia and you wonder off and go somewhere else, may have another identity

Question 32

What is dissociative trance disorder?

Answer 32

-in a trance like state, it is undesirable, sometimes believed to be possessed by spirit (subtype of DID)

Question 33

Is dissociation a state or a trait?

Answer 33

-a state, a way of dealing with extreme trauma

Question 34

Some people have suggested that those who experience dissociation are what?

Answer 34

-more suggestible