Stress-Related D/o

Question 1

____-____% of acute stress d/o lead to PTSD

Answer 1

25-30%

Question 2

What is an acute stress d/o resultant from? (x3)

Answer 2

Exposure to actual or threatened death, serious injury, or sexual violation, in 1+:
Direct experience or witnessing in person, events occurring to others
Learning about something violent or accidental happening to a loved one
Extreme or repeated exposure to aversive details of traumatic events (1st responders, child abuse investigators, crime scene investigators)

Question 3

T/F: Media exposure does not apply as an acute stress d/o, unless the exposure is work-related

Answer 3

True

Question 4

To be dx’d with an acute stress d/o, at least __(#)__ sx must be present for ___-___ days

Answer 4

Presence of at least 9 of the following sx, for 3-30 days

Question 5

What are the 5 categories of stress d/o sx?

Answer 5

Intrusion, Negative, Avoidant, Dissociative, Arousal

Question 6

What are 4 examples of Intrusion sx?

Answer 6

Intrusive Thoughts or Memories
Recurrent dream/nightmare (>2x)
Flashbacks (dissociative sx)
Intense psychological distress to environmental reminders/cues

Question 7

What is an example of a negative mood sx?

Answer 7

Anhedonia

Question 8

Describe what avoidance sx could be characterized by?

Answer 8

Avoiding reminders/distressing memories/ thoughts/feelings related to the event

Question 9

What are some examples of dissociative sx?

Answer 9

Derealization or Depersonalization

Cannot remember important aspects of trauma (not due to meds/substance, TBI)

Question 10

What are some examples of arousal sx? Which sx is seen specifically in pts with PTSD?

Answer 10

Insomnia
Irritable behavior + angry outbursts w/ little or no provocation
Hypervigilance, problems w/ concentration
Exaggerated startle response (seen specifically in PTSD)

Question 11

What is the dx of Unspecified Trauma/Stressor Related D/o dependent upon? In what setting is this diagnosis usually made?

Answer 11

Characteristic sx predominate, do not meet criteria for another d/o, info/context is missing
Provisional dx pending further eval, usually used for acute presentations in ER

Question 12

To have a dx of other specified stressor related d/o, characteristic sx must predominate, and the patient does not meet criteria for _________ d/o. These pts will have a delayed onset of adjustment sx for ____ months of stressor, and prolonged duration of sx _____ months after stressor.

Answer 12

Trauma/Stressor Related d/o

Delayed onset of adjustment sx >3 mo of stressor, prolonged duration (sx >6 mo after stressor)

Question 13

Two examples of “other specified stressor related d/o” include _____ and _____

Answer 13

Culture-Bound Syndromes (Ataque de nervios or Koro), Persistent Complex Bereavement

Question 14

Reactive attachment d/o, otherwise known as Disinhibited social engagement d/o, is a dx of individuals ____ y/o, and is characterized by what?

Answer 14

<18 y/o (pediatric dx)

Reflections of Relational Trauma (especially in the 1st year of life)
Typically occur in contexts of early life neglect
Seen in some children w/ frequent changes in caregivers (foster care), extended placements in institutional settings
Reactive attachment

Question 15

Reactive attachment is characterized by what two qualities?

Answer 15

Minimal social/emotional responsiveness

Disturbed interpersonal relatedness

Question 16

What is meant by Disinhibited Social Engagement? What will the patient behave like?

Answer 16

indiscriminate attachment behavior (they love you, but just met you)

Question 17

What is adjustment d/o? (definition, time frame for dx, description of s/disturbances)

Answer 17

Development of emotional/behavioral sx in response to identifiable stressor occurring w/in 3 mo of stressor onset
Sx do not persist >6 months after stressor terminated

Sx out of proportion to severity/intensity of stressor, when context and culture are taken into account
Sx do not represent normal bereavement
Sx impair social, occupational, other areas of fxning

Disturbance does not meet criteria for another mental d/o and not merely exacerbation of a pre-existing mental d/o

Question 18

What are 6 examples of specific adjustment d/o?

Answer 18

W/ mixed anxiety/depressed mood
W/ anxiety
W/ disturbance in conduct
W/ depressed mood
W/ mixed disturbance of emotions and conduct
Unspecified