PSYU3337 Trauma and Stressor-related disorders Flashcards
What are the different types of trauma and stressor-related disorders?
- Post traumatic stress disorder
- acute stress disorder
- adjustment disorder
- reactive attachment disorder
- disinhibited social engagement disorder
The reason why they are lumped together is because these disorders are the only ones that seem to have an identifiable event that initiates the disorder.
Outline PTSD
- exposure to actual / threatened death or violence
- intrusion symptoms: occurrent, involuntary and intrusive thoughts about the trauma (sensory, emotional and physiological components - could be recurrent dreams, dissociative reactions)
- persistent avoidance symptoms: avoiding external reminders (the place where the trauma happened) and internal reminders (fragmented memories of the trauma)
- marked alterations in arousal and reactivity associated with the trauma (persistent negative beliefs)
- > 1 month
PTSD prevalence
6.8% (life)
- 61% of adults have been exposed to trauma, and of that, 20% of women developed PTSD and 8% of men
- case study in Detroit - 90% of people had experienced a trauma, 13% of women developed PTSD, 6% of men
- women are more susceptible to developing PTSD, but also the norm is for people to adapt after experiencing a trauma
PTSD Risk factors
- rates are higher (20%) in vocations with increased risk of traumatic exposure (vets, police, firefighters, emergency medical personnel)
- highest rates of PTSD occur after rape, military combat, genocide, ethnically motivated imprisonment
- being in close proximity to the trauma and the frequency of trauma
Cognitive components of PTSD
Disruptions in cognition or memory:
- problems remembering and forgetting trauma
- the memory encoded at the time of trauma is poorly elaborated and integrated with other memories - and as a result we get a poor autobiographical memory and the memory fragments have a ‘here-and-now’ quality
Alter beliefs about the self, world, others
- i am vulnerable, incompetent
- the world is unpredictable, dangerous
More disorganised trauma narratives are associated with greater PTSD symptom severity
- trauma narratives of PTSD people contain more sensory details than trauma survivors without PTSD - emotional stroop test
Treatment of PTSD
Psychological first aid
- ensure immediate and ongoing safety, provide physical and emotional support
- have survivors tell you their immediate needs
Treatment:
- trauma focused therapy: CBT (psychoeducation about trauma responses, anxiety management, exposure and cognitive restructuring
- teach kids how to regulate emotions and behaviors first
What are the differences between PTSD and Acute Stress Disorder
For ASD:
- presence of 9+ symptoms
- minimum 3 days and maximum 4 weeks of disturbance
For PTSD:
- presence of 1 of 4 means (from Intrusion, Avoidance, 2+ physiological arousal, 2+ negative alterations)
Outline Adjustment Disorder
- development of emotional or behavioural symptoms in response to an identifiable stressor (not a trauma)
- 3 months!
- once the stressor and its consequences have terminated, the symptoms do not persist for more than 6 months
Prevalence of adjustment disorder
- 5-20% of outpatients have this diagnosis
- 50% of those in hospital settings
- there has not be a single epidemiological study
Outline Reactive Attachment Disorder
- consistent pattern of inhibited, emotionally withdrawn behaviour toward adult caregivers, manifested by both:
–> child rarely seeks comfort when distressed
–> child rarely responds to comfort when distressed - persistent social and emotion disturbance
- child has experienced extreme insufficient care and this insufficient care is thought to be responsible for the child’s symptoms
- can’t meet criteria for autism
- needs to be >9 months, needs to occur before 5 yrs old
Disinhibited Social Engagement Disorder
- pattern of behaviour in which a child actively approaches and interacts with unfamiliar adults in uncharacteristic ways (being overly familiar with their behaviour, having a diminished ‘checking back’ with caregiver)
- child has experienced extreme insufficient care and this is thought to be responsible for the child’s symptoms
- must be at least > 9 months
What differentiates acute stress disorder from PTSD?
PTSD requires 4 symptoms, ASD requires 9 symptoms.
PTSD has to have had symptoms lasting for > 1 month, whereas ASD has to have symptoms more than 3 days since the event and at most, 4 weeks of disturbances.
What risk factors make it more likely someone will develop PTSD after a trauma?
Risk factors include:
- increased frequency / increase proximity to the trauma
- not having psychological first aid support immediately after the trauma
- being in vocations with increased risk of traumatic exposure
- being a rape, military combat/captivity, ethnically motivated imprisonment and genocide survivor
What is the diagnosis for a person who experiences impairing anxious or depressive reactions to life stressor?
Adjustment disorder - development of emotional / behavioural symptoms within 3 months of the onset of the stressor
When caregivers provide insufficient care to their children, what two disorders can develop that pertain to how the child interacts with other people?
Reactive Attachment Disorder -> emotionally withdrawn behaviour (rarely seeking or responding to comfort when distressed)
Disinhibited social engagement disorder -> pattern of behaviour in which a child actively approaches and interacts with unfamiliar adults in uncharacteristic ways)
