TOPIC 3 - stress related disorders

Question 1

trauma

Answer 1

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

Question 2

complex trauma

Answer 2

multiple traumatic events or prolonged exposure to trauma

Question 3

complex trauma may develop from

Answer 3

maltreatment, neglect, physical or sexual abuse, domestic violence

Question 4

emotional immediate responses

Answer 4

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

Question 5

emotional delayed responses

Answer 5

Irritability and/or hostility
Depression
Mood swings, instability
Anxiety
Fear of trauma recurrence
Grief reactions
Shame Feelings of fragility and/or vulnerability
Emotional detachment

Question 6

cognitive immediate responses

Answer 6

Difficulty concentrating
Rumination or racing thoughts
Distortion of time and space
Memory problems
Strong identification with victims

Question 7

cognitive delayed responses

Answer 7

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

Question 8

behavioral immediate responses

Answer 8

Startled reaction
Restlessness
Sleep and appetite disturbances
Difficulty expressing oneself
Argumentative behavior
Increased use of alcohol, drugs, and tobacco
Withdrawal and apathy
Avoidant behaviors

Question 9

behavioral delayed responses

Answer 9

Avoidance of event reminders
Social relationship disturbances
Decreased activity level
Engagement in high-risk behaviors
Increased use of alcohol and drugs
Withdrawal

Question 10

focus of trauma informed care

Answer 10

how trauma may affect an individuals life and his or response to behavioral health services from prevention through treatment

Question 11

three elements of trauma informed approach

Answer 11

realizing the prevalence of trauma, recognizing how trauma affects all individuals within the program, responding by putting this knowledge into practice

Question 12

4 stress related disorders

Answer 12

reactive attachment disorder, post traumatic stress disorder, rape trauma syndrome, dissociative disorders

Question 13

reactive attachment disorder

Answer 13

consistent pattern of inhibited, emotionally withdrawn behavior
child rarely seeks comfort or responds to comforting

Question 14

precipitations of reactive attachment disorder

Answer 14

events or circumstances that overwhelm the child or adolescent and that often threatens or causes serious injury, neglect, or death

Question 15

reactive attachment disorder may resemble

Answer 15

autism spectrum disorder, depression, disruptive mood dysregulation disorder

Question 16

symptoms of reactive attachment disorder

Answer 16

Limited positive affect
Irritability
Sadness
Fearfulness
Minimal social responsiveness

Question 17

causes of reactive attachment disorder

Answer 17

Inconsistent care
Frequent changes in caregivers
Living in foster homes or orphanages

Question 18

treatment for reactive attachment disorder

Answer 18

individual and family therapy
medication for underlying depression or anxiety
bibliotherapy

involves both the child who has been diagnosed and their current caregivers

Question 19

influences and causes of post traumatic stress disorder

Answer 19

genetics and brain area differences

Question 20

symptoms of ptsd

Answer 20

may feel stressed or frightened even when they are no longer in danger

Question 21

genes involved in ptsd

Answer 21

stathmin
gastrin releasing peptide
5-HTTLPR

Question 22

brain structures involved in ptsd

Answer 22

amygdala - role in emotion, learning, memory, and fear acquisition
pre frontal cortex - decision making, problem solving, judgment

Question 23

ptsd signs and symptoms

Answer 23

reexperiencing, avoidance, negative change in cognition and mood, hyperarrousal and negative behaviors
regression (in children under the age of 6)

Question 24

re-experiencing symptoms

Answer 24

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.

Question 25

avoidance behaviors

Answer 25

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

Question 26

symptoms of hyperarrousal

Answer 26

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.

Question 27

symptoms specific to children with ptsd

Answer 27

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.

Question 28

medications for ptsd

Answer 28

SSRI’s - reduce anxiety and control obsessive thinking
prazosin - lessen the severity and frequency of PTSD related nightmares

Question 29

psychotherapy for ptsd

Answer 29

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

Question 30

types of dissociative disorders

Answer 30

depersonalization/derealization, dissociative amnesia (with or without fugue), dissociative identity disorder

Question 31

healthy forms of dissociation

Answer 31

zoning out, daydreaming, fantasizing

Question 32

depersonalization disorder

Answer 32

Recurrent periods of feeling unreal, detached, outside the body, dreamlike, numb, or with a distorted sense of time or visual perception.

Question 33

derealization disorder

Answer 33

Recurrent periods of feeling that one’s surroundings are not real or “right”

Question 34

treatment of depersonalization disorders

Answer 34

address all stresses associated with the onset of the disorder

psychotherapy, talk therapy, CBT, clinical hypnosis
rarely meds

Question 35

dissociative amnesia

Answer 35

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.

Question 36

treatment for dissociative amnesia

Answer 36

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

Question 37

dissociative amnesia with fugue

Answer 37

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

Question 38

treatment for dissociative amnesia with fugue

Answer 38

come to terms with stress and trauma that triggered fugue

develop new coping methods

CBT, clinical hypnosis

Question 39

dissociative identity disorder

Answer 39

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.

Question 40

treatment for DID

Answer 40

Effective treatment includes talk therapy or psychotherapy, hypnotherapy, and adjunctive therapies such as art or movement therapy.