Crisis and trauma Flashcards
post traumatic stress disorder
Individual results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual’s functioning and physical, social, emotional, or spiritual well-being
PTSD
-An extremely distressing experience that causes severe emotional shock & may have long lasting psychological effects.
It can be a single event
more often than not it is multiple events over time (complex, prolonged trauma)
An interpersonal violence or violation, especially at the hands of authority/trust figure is especially damaging
*child abuse
torture (long time kidnapping)
Trauma
a psychological response to an identifiable stressor or stressors
Adjustment disorder
the condition or process of deterioration with age
senescence
mental, emotional, or physical experienced by an individual in response to stimuli; from the external or internal environment.
Stress
is the development of characteristic symptoms following exposure to an extreme traumatic stressor involving personal threat to physical integrity or to the integrity of others.
-symptoms may begin within the first 3 months after the trauma or there may be a delay of several months or even years
PTSD
A disorder similar in terms of precipitating traumatic events and symptomatology to PTSD is
ASD acute stress disorder
psychosocial theory
learning theory
cognitive theory
biological influences
Treatment modalities for trauma-related disorders
Treatment disorders for this include individual psychotherapy, family therapy, behavior therapy, self-help groups, crisis intervention, and medications to treat anxiety or depression.
Adjustment disorders
this includes cognitive therapy, prolonged exposure therapy (PE), group/family therapy, eye movement desensitization and reprocessing (EMDR), and psychopharmacology
Treatment modalities for PTSD
accompanying panic, stress, and depression immediately following a traumatic event.
-occurs right after the event*this is normal
May include painful guilt feelings.
Can be accompanied by substance abuse; self-medicating. drink too much. *Can last up to the first 30 days.
Acute stress disorder
Living through dangerous events and traumas
Having a hx of mental illness; can’t process trauma with a mental illness
Getting hurt
Seeing people hurt or killed
Feeling horror, helplessness, or extreme fear
Having little or no social support after the event *crucial to move past event
Dealing with extra stress after the event, such as loss of a loved one, pain and injury or loss of a job or home.
PTSD: Risk factors
Involves several experiences that interfere with an individuals ability to function:
Re-experiencing symptoms
Avoidance symptoms
Hyper-arousal
Occurs when anxiety about events last longer than 30 days (more than 30 days considered this)
PTSD
Reseach and individuals who have experienced prolonged and repeated interpersonal trauma in adulthood has found that CPTSD can occur when there is no history of childhood abuse.
- neurobiological processes involved in processing aversive stimuli
- Exposure based therapies appear to be effective
Prolonged and repeated interpersonal trauma in adulthood.
Complex PTSD-CPTSD
reliving trauma over and over again, physical symptoms as well. ie racing heart or sweating
- bad dreams
- frightening thoughts
PTSD: re-experiencing symptoms
staying away from places, events or objects that are reminders of the experience.
Feeling emotionally numb.
Feeling strong guilt, depression or worry
Losing interest in activities that were enjoyable in the past.
Having trouble remembering the dangerous events.
PTSD: Avoidance Symptoms
easily startled
feeling tense or “on edge”
having difficult sleeping, and/or having angry outbursts.
PTSD: Hyper-arousal
Bedwetting
forgetting how or being able to talk
acting out the scary event during playtime
being unusually clingy with a parent or other adult.
Children’s reactions to PTSD
To be diagnosed with PTSD, a person must have all of the following for at least 1 month:
- at least one re-experiencing symptom
- at least three avoidance symptoms
- at least two hyperarousal symptoms
- Symptoms that make it hard to go about daily life, go to school or work, be with friends, and take care of importat tasks.
Diagnosis of PTSD
finding a support group after traumatic event
feeling good about one’s own actions in the face of danger (helpful)
having a coping strategy, or a way of getting through the bad event and learning from it.
being able to act and respond effectively despite feeling fear.
Seeking out support from other people. part of process.
PTSD: resilience factors
this therapy helps people make sense of the bad memories. Sometimes people remember the event differently than how it happened. They may feel guilt or shame about what is not their fault. The therapist helps people with PTSD look at what happened in a realistic way
Cognitive restructuring
teaches relaxation, relies on theory we can’t be relaxed and anxious at the same time.
systematic desensitization
therapist floods person with images and stimuli to evoke anxiety, the more anxiety produced and dealt with the faster the healing.
Implosion therapy
rapid eye movements
looking left to right; following therapists fingers while taking deep breaths and talking about the trauma.
Francine Shapiro
Theory REM sleep; brain able to process and deal with subconscious while in REM sleep
EMDR; eye movement desensitization and reprocessing for PTSD patients
Non traditional treatment
The successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feeling, and behaviors taht are age-appropriate and congruent with local and cultural norms
Mental health
Maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are incongruent with the local and cultural norms and interfere with the individuals social, occupational, or physical functioning.
Mental Illness
the inability of the general population to understand the motivation behind the behavior
incomprehensibility
the “normality” of behavior is determined by the culture
Cultural relativity
hans Selye defined stress as “the state manifested by a specific syndrome which cinsists of all the nonspecifically induced changes within a biologic system”
“Fight or Flight” syndrome
Physical responses
Alarm reaction stage
Stage of resistance
Stage of exhaustion
Seyle’s General Adaptation Syndrome
Immediate response
Sustained response
-Sustained physical responses to stress promote susceptibility to many diseases of adaptation
The Fight or Flight Syndrome
Anxiety and Grief; have been described as two major, primary psychological response patterns to stress.
- A variety of thoughts, feelings, and behaviors are assoc. with ex. of these response patterns.
- Adaptation is determined by the extent to which the thoughts, feelings, and behaviors interfere with an individuals functioning.
Psychological Responses
A diffuse apprehension that is vague in nature and is assoc. with feelings of uncertainty and helplessness.
Extremely common in our society.
Mild anxiety is adaptive and can provide motivation for survival.
Anxiety
Mild: seldom a problem
Moderate: perceptual field diminishes
Severe: perceptual field is so diminished that concentration centers on one detail only or on many extraneous details
Panic: the most intense state
Peplau’s Four Levels of Anxiety
At the mild level, individuals employ various coping mechanisms to deal with stress. A few of these include eating, drinking, sleeping, physical exercise, smoking, crying, laughing, and talking to persons with whom they feel comfortable.
Mild anxiety
Compensation Denial Displacement Identification Intellectualization Introjection Isolation Projection Rationalization Reaction formation Regression Sublimation Suppression Undoing
Defense mechanisms for protection at the mild to moderate anxiety level
extended periods of functioning at the panic level of anxiety may result in... ex. of psychotic disorders schizophrenia schizoaffective disorder delusional disorders
psychotic behavior
The subjective state of emotional, physical and social responses to the loss of a valued entity. The loss may be real or perceived.
Grief
Denial Anger Bargaining Depression Acceptance
Elisabeth Kubler-Ross
5 Stages of Grief
the experiencing of the grief process before the actual loss occurs
Anticipatory grief
length of the grief process is entirely individual. It can last from a few weeks to years. It is influenced by a number of factors.
Resolution
The experience of guilt for having had a “love-hate” relationship with the lost entity. Guilt often lengthens the grieving process.
Anticipatory grieving is thought to shorten the grief response when the loss actually occurs.
Grief response is extended when ind. exp. a number of losses.
Resolution is thought to occur when ind is able to look back on relationship of lost one, and accept both pleasures and disappointments.
Grief and Resolution
Prolonged response
Delayed/inhibited response
Distorted response
Maladaptive Grief Responses
characterized by intense preoccupation with memories of the lost person years after the loss has occured
Prolonged grief
sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause.
panic anxiety
negiotiating the terms and conditions of a transaction.
bargaining
feelings of severe despondency and dejection
depression
when someone defends themselves against an unpleasant impulse by denying their existence in themselves and attributing them to others
projection
means organizing something into a logically coherent system.
rationalization
the actions of consenting to receive or undertake something offered
acceptance
pt-initiated threat of harm to self, health care personnel, or others in the pts. sphere of influence ie suicide, homicide, and other forms of violence
psychiatric emergency
refers to the wide spectrum of techniques and psychotherapies aimed @ controlling a persons level of stress, esp chronic stress, usually for the purpose of improving everyday functioning.
Stress management
response to external situational stressor. ie. abuse
dispositional/situational crisis
how your body responds to stress. alarm/resistance stage. heart works harder
factors such as age & health influence the stress response as do coping skills. Chronic stress increases chance of illness
Stage of Exhaustion
the act of suppressing something. stopping, reduction
suppression
feeling lack of control over normal life-cycle transition. ex. losing a parent as a child
Crisis of anticipated life
situation that triggers emotions r/t unresolved life conflicts from developmental issues. ex. hx of rape now hesitant in marriage
maturational (developmental) crisis
bc of unexpected external stress which the person feels they have little or no control and is overwhelmed/ defeated by.
crisis of traumatic stress
“psychologically healthy, fully human, highly evolved, and fully mature”
maslow description of self-actualization as a state of being
individual under stress for a long period of time hormones released.
the sustained response.
a diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness. 4 levels mild moderate severe panic
anxiety
seldom a problem. assoc with tension exp. day to day living. Prepares people for action. sharpens senses. increases motivation for productivity, increases the perceptual field.
mild anxiety
extent of perceptual field diminishes. less alert. attention span and concentration decreases, assistance with problem solving maybe required. increased muscular tension and restlessness.
moderate anxiety
attention span limited, perceptual field greatly diminished-one detail or many extraneous details.
Physical symptoms: headache, palpatations, insomnia, emotional symptoms: discomfort
Severe anxiety
Most intense state. Unable to focus on even one detail. Hallucinations or delusions may occur.
- Wild desperate actions. Communication with others ineffective.
- feelings of terror, convinced they are “going crazy”-losing control emotionally weak. Prolonged Panic anxiety can lead to emotional exhaustion and can be life threatening.
Panic anxiety.
sleeping, eating, physical exercise, smoking, crying, yawning, drinking, daydreaming, laughing, cursing, pacing, foot swinging, fidgeting, nail biting, finger tapping, talking to friends
Relief of mild anxiety
covering up a real or perceived weakness by emphasizing a trait one considers more desirable.
Compensation; ego defense mech. mild/moderate anxiety
refusing to acknowledge the existence of a real situation or the feelings assoc. with it.
Denial; ego defense mech. mild/moderate anxiety
the transfer of feelings from one target to another that is considered less threatening or that is neutral
Displacement; ego defense. mild/moderate anxiety
attempting to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors
rationalization; ego defense; mild/moderate anxiety
preventing unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors
reaction formation; ego defense mild/moderate anxiety
responding to stress by retreating to an earlier level of development and the comfort measures assoc. with that level of functioning.
Regression; ego defense; mild/ moderate anxiety
an attempt to increase self worth by acquiring certain attrubutes and characteristics of an individual one admires
Identification; ego defense mild/moderate anxiety
an attempt to avoid expressing actual emotions assoc. with a stressful situation by using the intellectual processes of logic, reasoning, and analysis
intellectualization; ego defense mild/ moderate anxiety
intergrating the beliefs and values of another ind. into ones own ego structure. ie. children and parent values
introjection; ego defense; mild/moderate anxiety
separating a thought or memory from the feeling tone or emotion assoc with it.
isolation; ego defense; mild/moderate anxiety
attributing feelings or impulses unacceptable to one’s self to another person
Projection; ego defense; mild/moderate anxiety
involuntarily blocking unpleasant feelings and experiences from one’s awareness.
Repression; ego defense; mild/moderate anxiety
rechanneling of drives or impulses that are personally or socially unacceptable into activities that are constructive
sublimation; ego defense; mild/moderate anxiety
MADD
the voluntary blocking of unpleasant feelings and experiences from ones awareness.
suppression; ego defense; mild/moderate anxiety
symbolically negating or canceling out an experience that one finds intolerable
undoing; ego defense; mild/moderate anxiety
Neurosis: psychiatric disturbances; more serious level of psychosis
obsession, compulsion
phobia, sexual dysfuntion
Severe Anxiety
disorder which the characteristics features are symptoms of anxiety and avoidance behaviors
severe anxiety
characteristic features are physical symptoms for which there is no demonstrable organic pathology.
Somatic Symptom disorder; severe anxiety
feature a disruption in the usually intergrated functions of consciousness, memory, identity or perception of the environment. Dd
dissociative disorder; severe anxiety
“a severe mental disorder characterized by gross impairment in reality, typically manifested by delusions, hallucinations, disorganized speech or catatonic behavior.
May lose contact with reality
emotional tone, flat, bland affect
Panic Anxiety Psychosis
feelings and behaviors that ind. exp in response to a real, or perceived or anticipated loss. Stage 1 Denial Stage 2 Anger Stage 3 Bargaining Stage 4 Depression Stage 5 Acceptance
5 stages of grief
occurs which for some ind. presents an impossible task of grief work
bereavement overload
fixed in the anger stage of grieving
distorted response
Requires problem solving skills that are often diminished by the level of anxiety accompanying disequilibrium.
Crisis Intervention
A sudden event in ones’ life that disturbs homeostasis, during which usual coping mechanisms cannot resolve the problem
Crisis
Phase I Exposure to precipitating stressors
Phase II: Previous problem-solving techniques don[‘t relieve the stress, anxiety increases
Phase III: internal and external resources are called on to resolve problem and relieve discomfort
Phase IV: If resolution does not occur in previous phases “the tension mounts beyond a further threshold or its burden increases” Anxiety may reach panic levels
Phases of a Crisis
