Reactions to stress Flashcards
name the 3 core features of PTSD
Symptoms present for >1 month
- avoidance - of reminders of event, sense of ‘numbness’ and emotional blunting, detachment from other people
- hyperarousal - hypervigilance, insomnia, enhanced startle reaction
- intrusions - flashbacks, nightmares
Anxiety, depression, suicidal ideation, DSH and substance abuse may also be present.
suggest possible management options for PTSD
- trauma-focused CBT
- EMDR
- consider venlafaxine or SSRI if person has preference for drug Tx
- consider risperidone in addition to psychological Tx if disabling Sx (e.g. hyperarousal and psychotic Sx) + Sx have not responded to other Tx
suggest possible predisposing factors for PTSD
- Hx of mood/anxiety disorders
- Hx of trauma
- female gender
- lower IQ
- lack of social support
- FHx/genetics
- neuroticism
what are the features of an acute stress reaction?
- anxiety (response to threatening experiences) and/or depression (response to loss)
- insomnia and poor concentration
- numbness/restlessness
- coping strategies, esp. avoidance, +/- defence mechanisms, esp. denial
- sweating, palpitations, tremor
Usually subside within hrs to days after exceptional physical/mental stress
suggest possible management options for acute stress reaction
- watchful waiting - as most will resolve over time
2. brief trauma-focused CBT if needed
What is a coping strategy? When can it be maladaptive?
Activity (of which person is aware) to reduce the impact of stressful events, thus attenuating emotional/somatic response. Can be:
- problem-solving strategies e.g. seeking help/info
- emotion-reducing strategies e.g. venting emotion
Maladaptive coping strategies reduce emotional response in short term but cause greater difficulties in long term e.g.
- alcohol/drugs
- self harm e.g. OD or self-injury
- aggressive behaviour
What is a defense mechanism?
Unconscious responses to external stressors or anxiety from internal conflict e.g. denial, displacement, projection, regression, repression…
