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Mental health > Stress-related disorders > Flashcards

Stress-related disorders Flashcards

1
Q

Name the three types of stress-related disorders

A
  • Acute stress disorder
  • Adjustment disorder
  • PTSD
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2
Q

What is acute stress disorder?

A
  • Severe stress (9+) symptoms from the following categories:
    • Intrusion
    • Negative mood
    • Dissociation
    • Avoidance
    • Arousal
  • Occurs within one month of a traumatic event
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3
Q

Define Post Traumatic Stress Disorder

A
  • Severe psychological disturbance
  • Following a traumatic event
  • Characterised by involuntary re-experiencing
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4
Q

What is a traumatic event?

A
  • Exceptionally threatening/catastrophic stressful event
  • Likely to cause pervasive distress in almost anyone
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5
Q

Outline the DSM-5 criteria for PTSD

A

Following, causing significant distress/impairment, for >1/12:

  • Exposure to traumatic event: directly or indirectly
  • Intrusion symptoms; persistent re-experiencing
  • Avoidance of trauma-related cognitive or objects
  • Negative alterations in cognitions and mood
  • Alterations in arousal and reactivity

Not due to medication; substance use; or other illness

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6
Q

Name two common comorbidities seen with PTSD

A
  • Depression
  • Substance misuse
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7
Q

Give one intrusion symptom of PTSD

A

Persistent re-experience of traumative event by:

  • Unwanted upsetting memories
  • Nightmares
  • Flashbacks
  • Emotional distress after exposure to reminders
  • Physical reactivity after exposure to reminders
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8
Q

Provide two negative alterations in cognitions and mood seen with PTSD

A
  • Inability to recall key features of the trauma
  • Overly negative thoughts and assumptions of self/world
  • Exaggerated blame of self/others for causing the trauma
  • Negative affect
  • Anhedonia
  • Feeling isolated
  • Difficulty experiencing positive affect
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9
Q

List three alterations in arousal and reactivity seen with PTSD

A
  • Irritability; aggression
  • Risky or destructive behaviour
  • Hypervigilance
  • Heightened startle reaction
  • Difficulty concentrating
  • Difficulty sleeping
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10
Q

List four risk factors for PTSD

A
  • Low education; lower social class
  • Female gender
  • Low self-esteem; neurotic traits
  • PMH or FHx of mental health problems
  • Previous traumatic events
  • Afro-carribean/Hispanic
  • Excessive alcohol use
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11
Q

List two protective factors for PTSD

A
  • High IQ; Higher social class
  • Male gender
  • Psychopathic traits
    • Lack of empathy, guilt, remorse; shallow affect/mood
  • Chance to view body of dead relative/friend
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12
Q

Outline the management of PTSD

A

Reassure that PTSD is a treatable condition

  • Psychotherapy
    • Trauma-focused CBT (within 3/12)
    • Eye-movement desensitisation reprocessing (after 3/12)
    • Psychodynamic therapy
  • Medical: consider if preference to drug treatment
    • Venlafaxine (SNRI); sertraline or paroxetine (SSRI)
    • Antipsychotics if disabling symptoms
  • Social
    • Peer support
    • Carer support/education
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13
Q

What antidepressants are recommended for PTSD?

A
  • SNRI: Venlafaxine
  • SSRI: Sertraline; paroxetine
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14
Q

When is active monitoring appropriate for PTSD?

A

Consider for people with subthreshold symptoms within 1/12 of traumatic a event

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15
Q

What are adjustment disorders

A

A group of stress-related symptoms that appear after a stressor, causing significant distress/impairment due to coping difficulties.

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16
Q

Outline the DSM-5 criteria for adjustment disorders

A
  • Emotional/behavioural symptoms develop in response to identifiable stressor
  • Within 3/12 of onset of stressor
  • Plus, either
    • Marked distress out of proportion to stressor
    • Significant functional impairment
  • Not represented by normal bereavement
  • Symptoms persist for <6/12 after termination of stressor
17
Q

What management options exist for adjustment disorders?

A
  • Supportive psychotherapy
  • Antidepressants; anxiolytics; hypnotics
18
Q

Define bereavement

A

Any loss event, usually the death of someone

19
Q

Define grief

A

Feelings, thoughts, and behaviour associated with bereavement

20
Q

Give three symptoms of normal grief

A

Typical symptoms following bereavement:

  • Disbelief
  • Shock; numbness
  • Anger; guilt; sadness
  • Disturbed sleep and appetite
  • Hallucinations (image/voice of deceased)
21
Q

What is the duration of normal grief?

A

Typically up to 12 months

22
Q

List three symptoms of abnormal grief

A
  • Preoccupations with feelings of worthlessness
  • Thoughts of death
  • Excessive guilt
  • Psychomotor retardation
  • Delayed grief
  • Prolonged functional impairment
  • Hallucinations (besides image/voice of deceased)
23
Q

Name three risk factors for depression following bereavement

A
  • Previous Hx of depression
  • Intense grief or depressive symptoms early in grief reaction
  • Little social support
  • Inexperience with death
  • Traumatic or unexpected death
24
Q

What management can be given for abnormal grief?

A
  • Consider antidepressants
  • Culturally appropriate supportive counselling

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