Lecture 6- Trauma and stressor related disorders Flashcards
List the 5 trauma and stressor related disorders in the DSM 5
PTSD acute stress disorder adjustment disorders reactive attachment disorder disinhibited social engagement disorder
what is important aspects that differentiate these disorders??
a stressful or traumatic life event
Criteria A for PTSD:
A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways: (have to have this for PTSD diagnosis)
◦ Directly experiencing the traumatic event(s).
◦ Witnessing, in person, the event(s) as it occurred to
others.
◦ Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.
◦ Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse).
criteria B for PTSD
B. Intrusion symptoms (1 or more needed)
◦ Memories, dreams, flashbacks of the event
C. Persistent avoidance of stimuli (1+)
◦ memories etc, or external reminders of the event
D. Negative changes in cognition, mood (2+) ◦ Fear, negative beliefs about self, others, the world
E. Changes in arousal, reactivity (2 +)
◦ Anger, recklessness, self-destructive acts, sleep
disturbance
Duration of symptoms is 1 month or more
B criteria for PTSD- One or more of the following intrusion symptoms associated with the traumatic event(s): begin to occur after the event
o Recurrent, involuntary, intrusive distressing memories.
o Recurrent distressing dreams related to the event(s).
o Dissociative reactions (e.g., flashbacks) the individual feels or acts as if the traumatic event(s) were recurring.
o Intense or prolonged psychological distress at exposure to internal or external cues that are reminders of the traumatic event(s).
o Marked physiological reactions to internal or external cues that are reminders of the traumatic event(s).
criteria C- PTSD
C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following:
o Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
o Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). avoid things associated with event- gets generalised. Knives- avoid your own kitchen. Rape- cant have naked showers
Criteria D- PTSD
D. Negative alterations in cognitions and mood, evidenced by two (or more) of the following:
o Inability to remember an important aspect of the event(s) (due to dissociative amnesia, not to other factors such as injury, alcohol).
o Persistent and exaggerated negative beliefs about oneself, others, or the world (e.g.,“I am bad,”“No one can be trusted”).
o Persistent, distorted cognitions about the causes/consequences of the event(s) that lead the individual to blame him/herself or others. ( I shouldn’t have gone- self blame and hate )
o Persistent negative emotions (e.g.,fear, horror, anger, guilt, shame).
o Markedly diminished interest or participation in significant activities.
o Feelings of detachment or estrangement from others.
o Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).
criteria E- PTSD
E. Marked alterations in arousal and reactivity, as evidenced by two (or more) of the following:
o Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.
o Reckless or self-destructive behavior. – strongly observed in PTSD! Especially in veterans –reckless driving/ destroying r/ships
o Hypervigilance.
o Exaggerated startle response.
o Problems with concentration.
o Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).
F. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month
G. Causes clinically significant distress or impairment
in acute stress disorder- what time frame after the stressor event does it occur?
3 days to 1 month after
if symptoms don’t resolve after 1 month then the diagnosis of ACD changes to ..
PTSD
what does dissociative symptoms mean?
when looking at life is like watching a movie- you’re not really there
list the 5 dissociative symptoms
depersonalisation derealisation numbing reduced awareness dissociative amnesia
what are ACD symptoms indicative of??
PTSD
in the immediate post trauma phase, most people ..
get over it
what are the risks for pre trauma factors in ACD??
- childhood trauma
- prior psychiatric history
- family instability
- substance abuse
- socio economic disadvantage
