Clin- Trauma + Stress related disorders

Question 1

What are the main features of PTSD?

Answer 1

• person is exposed to a traumatic event in which both were present: person experienced/witnessed actual or threatened death/injury/integrity of self or others
• person RE-EXPERIENCES traumatic event
• persistent AVOIDANCE of stimuli associated with trauma
• persistent symptoms of INCREASED AROUSAL (difficulty sleeeping, irritability, difficulty concentrating, hypervigilance)

Question 2

What are some negative cognitions seen in PTSD?

Answer 2

persistent and distorted sense of blame of self or others

estrangement from others

markedly diminished interest in activities

inability to remember key aspects of event

Question 3

PTSD duration:

Answer 3

duration of disturbance + symptoms > 1 month

clinically significant distress + impairs function

Question 4

How would you treat PTSD?

Answer 4

SSRIs

Cognitive Processing therapy (support groups + eye movement desensitization and reprocessing (EMDR))

avoid addictive Rx such as benzos bc increased risk of substance abuse

Question 5

What is the prevalence rate of PTSD?

Answer 5

3rd most prevalent psychiatric diagnosis among veterans using VA hospitals

Question 6

Out of half of veterans that seek treatment how many get “minimally adequate” treatment?

Answer 6

only half

Question 7

How many of the Iraq and Afghanistan veterans with PTSD seek treatment?

Answer 7

50%

Question 8

What’s the difference between PTSD and acute stress disorder?

Answer 8

duration is different!

Acute stress disorder: 3 days - 1 month

(PTSD is >1 mo)

Question 9

What is an adjustment disorder?

Answer 9

development of emotional/behavioral symptoms in response to identifiable stressor;

within 3 months of stressor

Question 10

What do adjustment disorders result in:

Answer 10

• significant distress out of proportion to severity of stressor
• impairment in functioning

-not normal grief or bereavement; usually does NOT persist >6 months

Question 11

What are the syxs of adjustment disorders w/ depressed mood:

Answer 11

low mood, tearfulness, or feelings of hopelessness are predominant

Question 12

What are the syxs of adjustment disorders w/ anxiety:

Answer 12

nervousness, worry, jitteriness, or separation anxiety is predominant

Question 13

What are the syxs of adjustment disorders w/ mixed and anxiety and depressed mood:

Answer 13

combination of depression + anxiety is predominant

Question 14

What are the syxs of adjustment disorders w/ disturbance of conduct:

Answer 14

disturbance of conduct is predominant

Question 15

What are the syxs of adjustment disorders w/ mixed disturbance of emotions and conduct:

Answer 15

both emotional symptoms (ex. depression, anxiety) and a disturbance of conduct are predominant

Question 16

What are the disorders that fall under somatoform disorders?

Answer 16

somatic symptom disorders (pain disorder)
conversion disorder
pain disorder
illness anxiety disorder (hypochondriasis)
Body dysmorphic disorder
Somatoform disorder, NOS

Question 17

Diagnostic criteria for conversion disorder (functional neurological symptom disorder):

NOTE: THIS IS A LOT SORRY LOL

Answer 17

• one or more symptoms or deficits affecting voluntary motor or sensory function that suggest a neurological or other general medical condition
• psychological factors are judged to be associated with the symptom or deficit bc the initiation or exacerbation of the syx or deficit is preceded by conflicts or other stressors
• symptom or deficit is not intentionally produced or feigned (factitious disorder)
• syx or deficit cannot be fully explained by general medial condition
• syx or deficit causes clinically signif distress or impairment in social, occupational or impairment in social, occupational or other impt areas of functioning or warrants medical attention
• the symptom or deficit is not limited to pain or sexual dysfxn, does not occur exclusively during course of somatization disorder, and is not better accounted for by another mental disorder

Question 18

Conversion disorder symptoms:

Answer 18

• paresthesias + anesthesias
• weakness
• paralysis
• pseudoseizures/psychogenic seizures
• involuntary movements (ex. tremors, tics)
• sensory disturbances (blindness, mutism)

Question 19

What is a factitious disorder?

Answer 19

voluntary control of symptoms, self-injected feces or saliva, bizarre or unusual symptoms

types: Munchausen, Munchausen by proxy (intentional symptoms in another individual- child usually)

Question 20

What is the treatment for somatoform disorder?

Answer 20

• establish well-established therapeutic relationship
• team approach: pain management, neurology, psychiaty
• CBT
• hypnosis
• anti-anxiety meds (clonazepam)

Question 21

What are the types of dissociative disorders?

Answer 21

-dissociative amnesia, dissociative fugue, dissociative identity disorder, depersonalization disorder, dissociative disorder, NOS

Question 22

What is dissociative amnesia?

Answer 22

inability to recall impt personal info; usually info regarding traumatic experience

Question 23

What is dissociative fugue?

Answer 23

• sudden, unexpected travel away from home

- inability to recall one’s past/personal identity

Question 24

What is dissociative identity disorder?

Answer 24

“multiple personality disorder”

-often survivors of sexual abuse

Question 25

What are other impulse control disorders? (i dont think on exam, he said “extra” i believe)

Answer 25

intermittent explosive disorders, kleptomania, pyromania, pathological gambling, trichotillomania, impulse control disorder