Stress And Trauma Flashcards
Immediate reaction to stressor
Acute
Ongoing reaction to same or multiple stressor
Chronic
Time-Limited
Acute
Persistent
Chronic
Flight/Fight/Freeze/Fawn
Acute
Toxic-Stress
Chronic
Physiological
Acute
Chronic
Risk for MH Concern
Acute
Chronic
PTSD is cause by ?
Acute
Sympathetic-Adrenal Medullary (SAM)
Acute
Faster Response
Acute
Norepinephrine & Epinephrine
Acute
Hypothalamic-Pituitary-Adrenal (HPA) Axis
Chronic
Slower Response
Chronic
Cortisol
Chronic
HPA Axis
Chronic
SAM
Acute
Rasie blood pressure dercrease bowels
Acute
Hans Selye General Adaptation Syndrome in order
a. Exhaustion Stage
b. Good Health
c. Breakdown (burnout)
d. Resistance Stage
e. Alarm Stage
b.
e.
d.
a.
c.
Same & Steady
Homeostasis
Day to day maintenance of bodily functions
Homeostasis
Environment is predictable
Homeostasis
Standard understanding of bodily regulation
Homeostasis
explains the expected ranges for vital signs
Homeostasis
Different & Steady
Allostasis
Adaptation made in changing environment
Allostasis
Changing stressors resulting in changing baseline
Allostasis
hronic stress may result in higher baseline blood pressure in anticipation for stressful event
Allostasis
Exercise
Allostasis
Not inherently a problem or harmful
Allostasis
A way to figuratively quantify the amount of stress an individual has accumulated
Allostatic Load
Associated biomarkers in research
Allostatic Load
Stressor may no longer be present, but physiological effects persist
Allostatic Load
Elevated inflammatory response
Allostatic Load
Deals with rthritis, arterial disease, diabetes, abdominal fat, IBD
Allostatic Load
Loss of bone density
Allostatic Load
Hypertension
Allostatic Load
hyperlipidemia
Allostatic Load
Impacting Factors
Allostatic Load
- T
- S
- P
- C
- B
- Type
- Support
- Perception
- Coping
- Biology
mpacting Factors
Allostatic Load
Epi/Genetics, SNS sensitivity, HPA activity
- Type
- Support
- Perception
- Coping
- Biology
- Biology
Adaptation & Resiliency
Learning – change behavior for future stressor based on this experience
Adaptation
Adaptation & Resiliency
Social – strengthen bonds with others
Adaptation
Adaptation & Resiliency
Biology – return to homeostasis with removal of stressor
Adaptation
Adaptation & Resiliency
Capacity to withstand stress & mobilize healthy coping strategies
Resiliency
Adaptation & Resiliency
Can increase with time and adequate support
Resiliency
Behavioral or cognitive process done consciously or unconsciously in response to a stressor
Coping Strategies
Reaching out to a friend
Avoid stressor
Assuming worst possible outcome
Use of psychoactive substance
Exercising
Coping Strategies
A model about levels of stress from daily challengles, Moderate stress, and distress. Also talks about a person being calm to terror analysing from resilent to sensititized.
Bruce Perry’s Model
Trauma informed Care 4 R’s
R
R
R
R
Realize
Recognize
Respond
Resist
The widespread impact of trauma and understand potential paths for recovery
Realize
Recognize
Respond
Resist
Realize
The signs and symptoms of trauma in clients
Realize
Recognize
Respond
Resist
Recognize
Fully integrating knowledge about trauma into practice
Realize
Recognize
Respond
Resist
Respond
Avoid re-traumatization of patients
Realize
Recognize
Respond
Resist
Resist
Inconsistent caregiving (Reactive Attachment Disorder)
Criteria ? Stress DSM
Criteria A
Exposure to actual or threatened death, serious injury, or sexual violence (PTSD, Acute Stress Disorder)
Criteria ? Stress DSM
Criteria A
“Identifiable stressor” (Adjustment Disorders, Other Specified or Unspecified Trauma- and Stressor Related Disorder)
Criteria ? Stress DSM
Criteria A
Death of loved one (Prolonged Grief Disorder)
Criteria ? Stress DSM
Criteria A
Recurrent intrusive memories and distressing dreams
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
a. Intrusion
Dissociative reaction when pt has flashbacks
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
a. Intrusion
Psychological distress & Physiological reaction when reminded of event.
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
a. Intrusion
? of thoughts and feeling resembling event
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
b. Avoidance
? Of reminders (ppl, places, activities, situation) resembling event
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
b. Avoidance
Can not remember event details
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
c. Negative Cognition & Mood Changes
Persistent negative beliefs of oneself
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
c. Negative Cognition & Mood Changes
Self blame about causing event
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
c. Negative Cognition & Mood Changes
Persistant negative emotional state - anger, fear
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
c. Negative Cognition & Mood Changes
Detachment from other
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
c. Negative Cognition & Mood Changes
Hard to experience positive emotions
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
c. Negative Cognition & Mood Changes
Irritable and Angry outburst
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
d. Altered Arousal & Reactivity
Recklessness and Hypervigilance
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
d. Altered Arousal & Reactivity
Starlie Response
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
d. Altered Arousal & Reactivity
is an involuntary, rapid reflex reaction triggered by a sudden, unexpected stimulus, causing muscle contraction, increased heart rate, and activation of the body’s “fight or flight” response.
Starle Response
Concentration Difficulties
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
d. Altered Arousal & Reactivity
Sleep Distrubances
a. Intrusion
b. Avoidance
c. Negative Cognition & Mood Changes
d. Altered Arousal & Reactivity
d. Altered Arousal & Reactivity
Post-Traumatic Stress Disorder: Diagnostic Criteria
Duration ? month
> 1
Greater
Post-Traumatic Stress Disorder: Diagnostic Criteria
Significant ? impairment
Distress or functional
Post-Traumatic Stress Disorder: Diagnostic Criteria
Not due to ?
substance or medical condition
Intrusions into awareness and behavior preventing one from accessing information or controlling mental functioning
a. Acute Stress Disorder
b. Dissociative Disorders
b. Dissociative Disorders
A disconnection between patient’s perceptual experience and reality
a. Acute Stress Disorder
b. Dissociative Disorders
b. Dissociative Disorders
Often present with PTSD (but does not have to be)
a. Acute Stress Disorder
b. Dissociative Disorders
b. Dissociative Disorders
Depersonalization
Derealization
a. Acute Stress Disorder
b. Dissociative Disorders
b. Dissociative Disorders
Sensation of being detached or outside of one’s body or thinking
a. Depersonalization
b. Derealization
a. Depersonalization
Sensation that surroundings are not real, distant, dreaming
a. Depersonalization
b. Derealization
b. Derealization
IPV/SA
Interpersonal Violence
Organized Violence
Participation in crime
Interpersonal Trauma
is associated with which disorder
PTSD
PTSD risk factors
3 of trauma
Violence/Trauma that is interpersonal in nature and intentional
Familial dysfunction/disturbance
Poor ?
Extent, duration, intensity
social support
PTSD risk factors
History of trauma in childhood
? of the trauma
Pre-existing ?
Concurrent ?
Perception
mental illness
TBI
Just read over several times
Psychosocial Interventions
Trauma-Focused CBT
Exposure Response Therapy
Acceptance and Commitment
Eye Movement Desensitization and Reprocessing
Trauma Resiliency Model (CRM sister)
Family therapies
Support Groups
Psychoeducation & stress management
Read
Psychopharm
FDA Approved Medications
? & ?
Sertraline & Paroxetine
Sertraline
Zoloft
Paroxetine
Paxil
Psychopharm
? for nightmares
Prazosin
Treats PTSD but off label and help with nightmares
Prazosin
Duration between 3 days-1month
Acute Stress Disorder
Acute Stress Disorder
Duration between ?
3 days-1month
Duration of symptoms greater than a month?
PTSD
Significant Distress or functional impairment
Not due to substance or medical condition
PTSD and ASD
This disorder does not have criteria a for stress d/o
Dissociative Disorders
Commonly have etiological trauma
(the cause or causes of a disease)
Dissociative Disorders
Formerly called multiple personality disorder
Dissociative Disorders
At least two distinct personality or identity states
Dissociative Disorders
Inability to recall
Dissociative amnesia
Being detached from one’s body or reality
Depersonalization/derealization disorder