Exam 3 Stress, PTSD, Dissociative Disorders

Question 1

These are examples of what disorder?

• Reexperiencing
• Avoidance
• Hyperarousal
• Anxiety
• Detachment
  Symptoms for at least 3 days but not
  more than 1 month

Answer 1

Acute anxiety disorder

Question 2

What are findings related to acute stress syndrome?

What do people with this experience?
Think mental symptoms

Answer 2

ay have flashbacks
* Nightmares
* Mood may be depressed, anxious or irritable
* May verbalizes feelings of guilt related to event
* Hypervigilance
* Sleep & appetite disturbances
* Risk for SUICIDE!!

Question 3

What are interventions for acute stress syndrome?

Answer 3

Trust, safety, reassurance
 Suicide precautions – Assault precautions
 Medication (SSRI)
 CBT, EMDR, Prolonged Exposure Therapy

Question 4

What are s/s of PTSD?

Answer 4

Reexperiencing the trauma through
nightmares or intrusive thoughts
* Avoidance
* Negative cognition or thoughts
* Being on guard/hypervigilance

Symptoms for longer than 1 month

Question 5

What are findings of PTSD?

Answer 5

• Hyperarousal vs. detachment
• Can be seen with other disorders – anxiety,
  dissociative, depression
• Similar to ASD - just lasting longer!

Question 6

What are nursing interventions for PTSD?

Answer 6

Trust, safety, reassurance
 Suicide precautions – Assault precautions
 Medication (SSRI)
 CBT, EMDR, Prolonged Exposure Therapy
 Adaptive Disclosure used with military
 Meds & Therapy TOGETHER better than
either alone!

Question 7

What age group is most likely to develop PTSD from a traumatic event?

(also at higher risk for suicide)

Answer 7

adolescents

Question 8

What is reactive attachment disorder?

Answer 8

• Usually presents before age 5
• Response to childhood trauma
• Neglect – grossly pathogenic care
• Sad, irritable or afraid
• Does not connect with primary
  caregiver as expected – minimal
  socialization with others

Question 9

What is disinhibited social engagement disorder?

Answer 9

• Unselective socialization – treats strangers like
  primary caregivers
• Product of grossly deficient parenting or
  institutionalization
• Approaches strangers freely – not common at
  their age (no fear)

Question 10

What is dissociative amnesia?

Answer 10

• Not able to remember details of
  personal life or of traumatic
  event(s)
• Special version of this is the
  Dissociative Fugue
• Amount of memory loss can
  vary, and duration of that loss
  can be days, weeks, years or
  forever

Question 11

What is depersonalization/derealization?

Answer 11

Depersonalization refers to feeling like one is
outside of your own body. Sometimes this is
expressed as feeling like one is floating above their
own body.
*
Derealization is described as the environment
feels unreal – perhaps foggy or like a dream or
somehow fake.

Question 12

What is a dissociative fugue?

Answer 12

period of time where you lose autobiographical memories
occurs in people who suffer trauma
some cases have lasted as long as 4 years

Question 13

What is dissociative identity disorder?

Answer 13

Mind splits into different personalities that can take over as a result of trauma

Question 14

What are examples common stressors?

Answer 14

• Childhood trauma, physical abuse, sexual assault, IPV, neglect
• Financial, homelessness, incarceration, major life changes
• Physiological issues, poor sleep/nutrition, illnesses, pain
• Social elements such as isolation, conflicts, grief, “bullying

Question 15

What assessment tool do we use for stress?

Answer 15

Perceived Stress Scale

Question 16

What does stress do?

Answer 16

Can elicit defense mechanisms: trying to protect self from anxiety as a result of stressors
* Stress can cause anxiety