Chapter 7 - Trauma and Dissociation Flashcards
What is new about the disorders related to trauma and dissociation?
-they are new being grouped together in DSM 5
What are trauma and stressor disorders?
-disorders that develop after a stressful or traumatic life event
What disorders fall under trauma and stressor disorders? (4)
-childhood attachment disorders
-PSTD
-acute stress disorder
-adjustment disorders
When did PTSD first show up in the DSM?
-DSM 3 following the Vietnam war
What is the clinical description of PTSD? Define both criteria A and B. (6)
- 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
What do we define trauma as occurring in the PTSD definition?
-exposure to actual or threatened death, serious injury, or sexual violence (direct experience, witnessing the event, learning of the event)
What is delayed expression of PTSD?
-expression of PTSD 6 months or even a year after the event
How do younger children show PTSD differently?
-bed wetting, separation fears, hard time remembering (avoidant), may reenact some of the trauma through play
Approximately what percentage of acute stress disorder patients develop PTSD?
-50%, some people who develop PTSD may not meet the criteria for acute stress disorder first
What percentage of people who have been sexually assaulted develop PTSD?
-approx 1/3
What percentage of Canadian auto accident victims develop PTSD?
-15-20%
What percent of the Canadian armed forces develop PTSD?
-11%
What percentage of the general population develop PTSD?
-8%
Which brain structure issues would result in PTSD
-amygdala or hippocampus differences
If there is a threat to someone’s life and they are injured, do they have higher rates of PTSD?
-yes, and if they are only injured rather than threatened they have a higher rate too
What are four treatments for PTSD? (4)
-imaginal exposure (being exposed to your thoughts and feelings)
-cognitive therapy
-EMDR
-SSRIs
What is the invictus games?
-event for those who are in the army, first responders
When is PTSD considered chronic?
-when PTSD lasts longer than 3 months
When did prolonged grief disorder become an official diagnosis? What is prolonged grief disorder? (2)
-in DSM 5,
-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
What are adjustment disorders? How long do they last? (2)
-reaction to life stressors that seem to be over the top
-begin within 3 months and last up to 6 months
What are the attachment disorders related to trauma? (2)
-reactive attachment disorder
-disinhibited social engagement disorder
What is reactive attachment disorder?
-the child very seldom seeks out a caregiver for protection and support or responds to caregivers and they have had extreme neglect or abuse
What is disinhibited social engagement disorder? Example? (2)
-the child shows no inhibitions to approaching adults
Example: they attach just about to anyone, to strangers
What are the three dissociative disorders? (3)
-depersonalization/derealization disorder
-dissociative amnesia
-DID
What is dissociation?
-disruption in the normal integration of consciousness and sense of who we are
What is depersonalization? Example. (2)
-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
Describe depersonalization-derealization disorder. (3)
-severe feelings of detachment
-significant distress
-rare; onset follows traumatic event
What can depersonalization-derealization disorder cause? Symptoms? (4)
-cognitive and perceptual deficits occur
-mind emptiness
-deficits in emotional regulation
-dysregulation in the HPA axis
What is generalized dissociative amnesia?
-inability to remember anything, including identity (general means not just one specific point in time)
What is localized/selective amnesia?
-inability to remember specific events (usually traumatic)
What is dissociative fugue?
-when you have amnesia and you wonder off and go somewhere else, may have another identity
What is dissociative trance disorder?
-in a trance like state, it is undesirable, sometimes believed to be possessed by spirit (subtype of DID)
Is dissociation a state or a trait?
-a state, a way of dealing with extreme trauma
Some people have suggested that those who experience dissociation are what?
-more suggestible
