PSYCH - Stress, PTSD, & Crisis Intervention Flashcards
Definition of stress
feeling of emotional or physical tension; any event or thought that causes feelings of anger, frustration or nervousness
What are the two types of stress?
Acute and chronic stress
Definition: Acute Stress
- ST symptoms that develop quickly and do not last for long time periods
- usually in response to negative events but can be bouts of excitement
- experienced by EVERYONE at some time or another
Definition: Chronic Stress
- prolonged and constant feeling of stress; Sx last for long periods of time
- some people may become so adapted to chronic stress that they do not realize they have it
- can lead to serious health problems
Is stress as a concept absolute or relative to each individual?
relative
What can cause stress?
anything that incites the fight or flight response in the body
What is meta-cognition?
understanding one’s own thought processes (and the patterns behind them)
a management strategy for stress
What is Acute Sress Disorder and what is it also known ?
- aka Critical Incident Stress
- Defined as: “the development of specific fear behaviours that last 3 days to 1 month after a traumatic event. These symptoms always occur after the patient experienced or witnessed death or threat of death, serious injury or sexual assault”
- a psychological and/or physical response to a traumatic event
List 7 examples of critical incidents.
Anything that is death/threatening of death or some serious shit
- MVCs
- rape/sexual assault
- witnessing a death/assault
- natural disaster
- hostage situations
- violent crimes
- loss of patient after rescue attempts
Effects of Critical Incident Stress
- feeling overwhelmed, inability to cope with regular activities
- dramatic changes in attitudes/beliefs towards work(place)
- anger, rage, shame, humiliation
- restlessness, fatigue
- guilt, grief
- sleeping/eating disturbances
- paranoia, hypervigilance
- concentration/anxiety problems
- social withdrawal
- flashbacks
- suicide
Definition of Critical Incident Stress Management (CISM)
an intervention protocol developed specifically for dealing with traumatic events
- a formal, highly structured and professionally recognized process for helping those involved in a critical incident to share their experiences, vent emotions, learn about stress reactions and symptoms and given referral for further help if required
- not psychotherapy
- confidential, voluntary, educative process
- somtimes called “psychological first aid”
Types of interventions for critical incidents
1) Debriefing
2) Defusing
3) Grief and Loss session
4) Crisis Management Briefing
5) Critical Incident Adjustment Support
6) Pre-Crisis Education
Descibe the following intervention: Debriefing
What does this entail?
- discussing the experience typically shortly after the event
- designed to be psychologically safe environments where the individual(s) is/are able to vent and address concerns
- ideally held between 24-72 hours after incident
Descibe the following intervention: Defusing
What does this entail?
- shorter, less formal version of debriefing
- confidential and voluntary opportunity to learn about stress and discuss feelings about the incident
- lasts ~30-60 minutes, best conducted between 1-4 hours after incident
Descibe the following intervention: Grief and Loss Session
What does this entail?
- individual or group session following a death
- assists ppl in understanding response to grief, and creates a platform for people involved to discuss the circumstances of the death
Descibe the following intervention: Crisis Management Briefing
What does this entail?
- a large homogenous group intervention used before, during, and after crisis to present facts, facilitate a brief, controlled discussion, Q&A and info on stress survival skills and or available support services
- may be repeated as situation changes
Descibe the following intervention: Critical Incident Adjustment Support
What does this entail?
provides multi-faceted humanitarian assistance to individual, families or groups for coping with the aftermath of an incident and overcoming impact of a death/injury
Describe the following intervention: Pre-Crisis Education
- includes incident awareness, crisis response strategies and develops stress management coping skills that can prevent major problems should an incident occur
- format: employee handbook, e-book and/or workshops and training seminars
What sorts of interventions do paramedics typicall utilize?
debriefing (both normal and crisis management)
defusing
courtesy calls
Other options: telephone hotlines, meds, CBT, LT counseling
Define PTSD
- psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or serious injury
What % of the general population has PTSD, and in which population is it more common?
- 9% of general population
- affects 2x women
- common with other psych disorders: anxiety, mood, personality and substance use disorders
What are the 4 categories of risk factors for developing PTSD?
1. historial (pre-trauma) - family psych hx, family instability, personality disorders/traits, past hx of PTSD or trauma
2. severity of current trauma - perceived severity of event and how long the trauma was sustained
3. psychological response during trauma - the level of perceived threat; may have dissociative symptoms during or immediately after the event
4. life stressors and social support - level of support from social networks after event, resiliency
What is the diasthesis-stress model (factor that causes PTSD)?
- suggests that people with an underlying diathesis (strong predisposition), for PTSD are more likely than those without the diathesis to develop the disorder when faced with stressful events (may only need moderately severe trauma to develop disorder)
- statistically, most people do not have strong predispositions for the disorder and are resilient to stress
