Stress and trauma disorders

Question 1

Reactive Attachment Disorder

Answer 1

A. A consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, manifested by both the following

1. The child rarely or minimally seeks comfort when distressed
2. or responds to comfort when distressed

B. A persistent social and emotional disturbance characterized by at least 2 of the following

1. minimal social and emotional responsiveness to others
2. limited positive affect
3. episodes of unexplained irritability, sadness, or fearfulness that are evident even during nonthreatening interactions with adult caregivers

C. The child has experieced a patten of extremes of insufficient care with at least 1 of the following

1. social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met y adults
2. Repeated changes of primary caregiivers that limit opportunities to form stable attachments
3. Rearing in unusual settings to limit chances to form selective attachments

D. The care in criterion c is presumed to be responsible for the disturbed behavior

E. Not autism spectrum disorder

F. disturbance seen before 5

G. Developmental age of at least 9 months

Question 2

Disinhibited Social Engagement Disorder

Answer 2

A. A pattern of behavior in which a child actively approaches and interacts with unfamiliar adults and has at least 2 of these

1. reduced or absent reticence in approaching and interacting with unfamiliar adults
2. overy familiar verbal or physical behavior
3. diminshed or absent checking back with adult caregiver after venturing away
4. willingness to go off with unfamiliar adult with minimal or no hesitation

B. the behaviors in A arent due to impulsivity (like ADHD) but more socially disinhibited behavior

C. Child has experienced a pattern of extremes of insufficient care as evidenced by at least one of these

1. Social neglect or deprevation in the form of presistant lack of basic emotional needs for comfort, stimulartion,and affection by caregiving adult
2. Repeated changes of primary caregiver that limit ability to form stable attachments
3. Rearing in unusual settings that limit opportunities

D. Care in C is presumed to be responsibke for the behavior

E. Child has a developmental age of at least 9 months

Question 3

PTSD criteria

Answer 3

A. Exposure to actual or threatened death, serious injury, or sexual violence in one or more fo these

1. directly expeirencing traumatic events
2. witnessing in person the event as it occurred to others
3. Learning that the traumatic evets occured to close family member or friend, in this case must have been violent or accidental
4. Experiencing repeated or extreme exposure to aversive details of the traumatic events (cops, first responders)

B. Presence of one or more of the following instrusion symptoms associated with the events begining after the traumatic events

1. Reccurent, involuntary, and intrusive distressing memories
2. recurrent ddistressing dreams about the event
3. Dissociate reactions (flashbacks) in which the individual feels or acts as if it were recurring
4. Intense or prolonged psychological distress to internal or external cues that are symbolic
5. Marked physiological reactions to internal cures that symbolize or resemble and aspect of the trauma

C. Persisnt avoidence of stimuli associated with the traumatic even starting after it occured, showed by one or both of these

1. avoidence or efforts to avoid distressing memories, thoughts, or feelings about events
2. avoidence or efforts to avoid external reminders (people, places, objects, situations) that arrouse distressing memories

D. Negative alterations in cognitions and mood associated with the events with two or more of these

1. inability to remember an important aspect of the traumatic event
2. Persitent or exaggerated negative beliefs or expectations about oneself or others or the world
3. persistend distorted cognitions about the cause or consequences of the event
4. persistent negative emotional state
5. markedly diminished interest or participation in significant activities
6. Feelings of detachment or estrangement from people
7. Persistent inability to experience pisitive emotions

E. Marked alterations in arousal and reactivity associated with the traumatic event

1. Irritable behavior and angry outbursts (w/ no reason) verbal or physical agression
2. reckless or self destructive behavior
3. hyperviligence
4. Exaggerated startle response
5. Problems wiith concentration
6. Sleep disturbance

F. Duration of the disturbance is MORE THAN A MONTH

G. Clinically sinificant distrss

H. Not due to substance

Question 4

PTSD Specifiers

Answer 4

depersonalization: feeling detached from mental processes or body
derealization: experiences of unreality or dreamline

Question 5

Adjustment disorder Criteria

Answer 5

A. The development of emotional or behavioral symptoms to an identifiable stressor within 3 MONTHS of stressor

B.Clinically significnt in one or both of these ways

1. marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the external context, and the cultural factors that might influce severity and presentation
2. Significant impairment in functioning

C. The stress related disturbance does not meet the criteria for another mental disorder

D. Symptoms are not normal bereavement

E. Once the stressor or consequences have terminated the symptoms dont persist for more than an additional 6 MONTHS

Question 6

Adjustment Disorder Specifiers

Answer 6

with depressed mood (low mood tearfulness or feelings of hopelessness)

with anxiety (nervoisness, worry)

with mixed anxiety and depressed mood

with disturbance of conduct