Clinical Approach to Trauma and Stress Disorders Flashcards
What is posttraumatic stress disorder?
- Person exposed to a traumatic event in which both were present:
1. Person experienced/witnessed actual or threatened death/injury/integrity of self or others - Persistently re-experience traumatic event
- Persistent avoidance of stimuli associated with trauma
- Persistent symptoms of increased arousal such as difficulty sleeping, irritability, difficulty concentrating, hypervigilance
What are some negative cognitions with posttraumatic stress disorder?
- Persistent and distorted sense of blame of self or others
- Estrangement from others
- Markedly diminished interest in activities
- Inability to remember key aspects of the event
How long is the duration of disturbance and symptoms in PTSD?
- More than 1 month
- will have clinically significant distress and impairs function
What are some neurobiological abnormalities seen in PTSD?
- HPA axis (hyperactive or increased autonomic nervous system response)
- Brain imaging (amygdala, prefrontal cortex, hippocampus)
- Neurotransmitters (NE, Dopamine, and endogenous opioids)
What are some treatment options for PTSD?
- SSRIs
- Cognitive processing therapy (support groups and EMDR)
- Increased risk of substance abuse (avoid addictive Rx such as benzodiazepines
What is acute stress disorder?
- Symptoms similar to PTSD
- Duration is different (3 days to 1 month after trauma exposure)
What are adjustment disorders?
- Development of emotional/behavioral symptoms in response to identifiable stressor; occurring within 3 months of stressor
- Not normal grief or bereavement
What do adjustment disorders result in?
- One or both:
1. Significant distress out of proportion to severity of stressor
2. Impairment in functioning
How long do adjustment disorders usually last?
- No longer than 6 months
What is seen in adjustment disorders with depressed mood?
- Low mood
- Tearfulness or feelings of hopelessness are predominant
What is seen in adjustment disorders with anxiety?
- Nervousness
- Worry
- Jitteriness
- Separation anxiety is predominant
What is seen in adjustment disorders with mixed anxiety and depressed mood?
- Combination of depression and anxiety is predominant
What is seen in adjustment disorders with disturbance of conduct?
- Disturbance of conduct is predominant
What is seen in adjustment disorders with mixed disturbance of emotions and conduct?
- Both emotional symptoms and a disturbance of conduct are predominant
What are some somatoform disorders?
- Somatic symptom disorder (pain disorder)
- Conversion disorder
- Illness anxiety disorder (hypochondriasis)
- Body dysmorphic disorder
- Somatoform disorder, NOS