TOPIC 3 - stress related disorders Flashcards
trauma
results from an event or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individuals functioning and physical, social, emotional, or spiritual wellbeing
complex trauma
multiple traumatic events or prolonged exposure to trauma
complex trauma may develop from
maltreatment, neglect, physical or sexual abuse, domestic violence
emotional immediate responses
Immediate
Numbness and detachment
Anxiety or severe fear
Guilt (including survivor guilt)
Exhilaration as a result of surviving
Anger
Sadness
Helplessness
Depersonalization
Disorientation
Feeling out of control
Denial
Constriction of feelings
Feeling overwhelmed
emotional delayed responses
Irritability and/or hostility
Depression
Mood swings, instability
Anxiety
Fear of trauma recurrence
Grief reactions
Shame Feelings of fragility and/or vulnerability
Emotional detachment
cognitive immediate responses
Difficulty concentrating
Rumination or racing thoughts
Distortion of time and space
Memory problems
Strong identification with victims
cognitive delayed responses
Intrusive memories or flashbacks
Reactivation of previous traumatic events
Self-blame
Preoccupation with event
Difficulty making decisions
Magical thinking
Belief that feelings or memories are dangerous
Generalization of triggers
Suicidal thinking
behavioral immediate responses
Startled reaction
Restlessness
Sleep and appetite disturbances
Difficulty expressing oneself
Argumentative behavior
Increased use of alcohol, drugs, and tobacco
Withdrawal and apathy
Avoidant behaviors
behavioral delayed responses
Avoidance of event reminders
Social relationship disturbances
Decreased activity level
Engagement in high-risk behaviors
Increased use of alcohol and drugs
Withdrawal
focus of trauma informed care
how trauma may affect an individuals life and his or response to behavioral health services from prevention through treatment
three elements of trauma informed approach
realizing the prevalence of trauma, recognizing how trauma affects all individuals within the program, responding by putting this knowledge into practice
4 stress related disorders
reactive attachment disorder, post traumatic stress disorder, rape trauma syndrome, dissociative disorders
reactive attachment disorder
consistent pattern of inhibited, emotionally withdrawn behavior
child rarely seeks comfort or responds to comforting
precipitations of reactive attachment disorder
events or circumstances that overwhelm the child or adolescent and that often threatens or causes serious injury, neglect, or death
reactive attachment disorder may resemble
autism spectrum disorder, depression, disruptive mood dysregulation disorder
symptoms of reactive attachment disorder
Limited positive affect
Irritability
Sadness
Fearfulness
Minimal social responsiveness
causes of reactive attachment disorder
Inconsistent care
Frequent changes in caregivers
Living in foster homes or orphanages
treatment for reactive attachment disorder
individual and family therapy
medication for underlying depression or anxiety
bibliotherapy
involves both the child who has been diagnosed and their current caregivers
influences and causes of post traumatic stress disorder
genetics and brain area differences
symptoms of ptsd
may feel stressed or frightened even when they are no longer in danger
genes involved in ptsd
stathmin
gastrin releasing peptide
5-HTTLPR
brain structures involved in ptsd
amygdala - role in emotion, learning, memory, and fear acquisition
pre frontal cortex - decision making, problem solving, judgment
ptsd signs and symptoms
reexperiencing, avoidance, negative change in cognition and mood, hyperarrousal and negative behaviors
regression (in children under the age of 6)
re-experiencing symptoms
Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
Bad dreams
Frightening thoughts.
Re-experiencing symptoms may cause problems in a person’s everyday routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing.
avoidance behaviors
Staying away from places, events, or objects that are reminders of the experience
Feeling emotionally numb
Feeling strong guilt, depression, or worry
Losing interest in activities that were enjoyable in the past
Having trouble remembering the dangerous event.
Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car
symptoms of hyperarrousal
Being easily startled
Feeling tense or “on edge”
Having difficulty sleeping, and/or having angry outbursts.
Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating.
It’s natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months.
symptoms specific to children with ptsd
Bedwetting, when they’d learned how to use the toilet before
Forgetting how or being unable to talk
Acting out the scary event during playtime
Being unusually clingy with a parent or other adult.
Older children and teens usually show symptoms more like those seen in adults. They may also develop disruptive, disrespectful, or destructive behaviors. Older children and teens may feel guilty for not preventing injury or deaths. They may also have thoughts of revenge.
medications for ptsd
SSRI’s - reduce anxiety and control obsessive thinking
prazosin - lessen the severity and frequency of PTSD related nightmares
psychotherapy for ptsd
exposure therapy: face and control fear
cognitive restructuring: make sense of bad memories
stress inoculation training: teaching how to reduce anxiety
EMDR: rapid eye movement transfers information from non-hippocampus dependent area in the amygdala to the verbally accessible memory area in the hippocampus to complete the processing of the trauma
types of dissociative disorders
depersonalization/derealization, dissociative amnesia (with or without fugue), dissociative identity disorder
healthy forms of dissociation
zoning out, daydreaming, fantasizing
depersonalization disorder
Recurrent periods of feeling unreal, detached, outside the body, dreamlike, numb, or with a distorted sense of time or visual perception.
derealization disorder
Recurrent periods of feeling that one’s surroundings are not real or “right”
treatment of depersonalization disorders
address all stresses associated with the onset of the disorder
psychotherapy, talk therapy, CBT, clinical hypnosis
rarely meds
dissociative amnesia
Psychologically-induced memory loss and inability to recall important personal information after a severe stressor
includes gaps in memory for long periods of time of memories involving the traumatic event.
treatment for dissociative amnesia
first goal is to relieve symptoms
aims at safely expressing and processing painful memories, developing new coping skills, restoring function, and improving painful memories
CBT, family therapy, clinical hypnosis
dissociative amnesia with fugue
Sudden, temporary loss of personal identity and impulsively wandering or traveling away from home or work. Triggered by a traumatic event.
Some individuals start “new lives” in whatever place they end up; this is particularly distressing to their loved ones when the individual is finally located and appears to have “moved on” with their life
treatment for dissociative amnesia with fugue
come to terms with stress and trauma that triggered fugue
develop new coping methods
CBT, clinical hypnosis
dissociative identity disorder
DID is the presence of two or more personality states that control behavior
Each alternate personality (alter) has its own pattern of perceiving, affect, cognition, behavior, and memories. Severe sexual, physical, and/or psychologic trauma in childhood predisposes an individual to DID.
treatment for DID
Effective treatment includes talk therapy or psychotherapy, hypnotherapy, and adjunctive therapies such as art or movement therapy.
