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DSM5 > Trauma and stress > Flashcards

Trauma and stress Flashcards

1
Q

main characteristic of reactive attachment disorder

A

consistent, inhibited emotional withdrawal toward caregivers manifested by
-rarely/minimally seeks comfort
-rarely/minimally responds to comfort

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2
Q

social/emotional disturbance criteria for reactive attachment disorder, of which you must have 2

A

-minimal social/emotional responsiveness to others
-limited positive affect
-episodes of unexplained irritability, sadness, or fearfulness during nonthreatening interactions with caregivers

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3
Q

manifestations of patterns of extreme insufficiency of care for reactive attachment disorder of which you must have 1

A

-social neglect/deprivation (consistently not having basic emotional needs met)
-repeated changes in caregivers
-raised in a setting with minimal opportunity to form attachments with caregivers

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4
Q

other criteria for reactive attachment disorder

A

-criteria not met for autism
-disturbance before age 5
-developmental age of at least 9 months
-insufficient care presumed cause of disturbed behavior

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5
Q

what constitutes persistent and severe reactive attachment disorder

A

persistent - present for at least 12 months
severe - all symptoms at high levels

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6
Q

risk factor for reactive attachment disorder

A

serious social neglect is a requirement and only known risk factor

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7
Q

functional consequences of reactive attachment disorder

A

significantly impair child’s ability to relate to others and associated with impairment across many domains of

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8
Q

symptoms comorbid with reactive attachment disorder

A

cognitive/language delays
stereotypies
malnutrition

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9
Q

disinhibited social engagement disorder

A

child inappropriately interacts with strangers as if they are familiar with

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10
Q

criteria for manifestations of inappropriate interactions with adults in disinhibited social engagement disorder, of which you must have 2

A

-no restraint when interacting with unfamiliar adults
-overly familiar verbal/physical behavior
-not checking back with caregivers after wandering away
-willingness to go with unfamiliar adult without hesitation

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11
Q

types of insufficient care that can lead to disinhibited social engagement disorder

A

social neglect/deprivation
repeated changes in caregivers
raised with little opportunity to form attachments

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12
Q

other criteria for disinhibited social engagement disorder

A

-behaviors nor limited to impulsivity
-lack of care presumed to cause behavior disturbance
-developmental age of at least 9 months
-specify is persistent or severe

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13
Q

associated features of disinhibited social engagement disorder

A

-may have developmental/language delays
-may have malnutrition
-s/s persist once neglect no longer present

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14
Q

diagnostic criteria for PTSD in patients older than 6

A

-exposure to actual/threatened death, serious injury, or sexual violence
-1 or more intrusion symptoms associated with traumatic event
-persistent avoidance of stimuli associated w/ trauma
-negative alterations in mood/cognitions
-marked alteration in arousal/reactivity associated with trauma

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15
Q

how can the traumatic exposure occur in PTSD in patients over 6, of which there must be at least 1

A

-directly experiencing
-witnessing event in person
-learning event happened to a family member/close friend
-experiencing repeated exposure to traumatic details

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16
Q

what are the 5 intrusion symptoms associated with traumatic event in PTSD (of which you must have at least 1)

A

-recurrent, involuntary, intrusive memories
-recurring distressing dreams
-dissociative reactions
-intense psychological distress r/t internal/external cues of trauma
-marked physiological reactions to internal/external cues of trauma

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17
Q

how many negative alterations in cognitions/mood are required for dx of PTSD

A

at least 2

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18
Q

evidence of persistent avoidance of stimuli associated with trauma required for PTSD dx (must have at least 1)

A

-avoidance of memories, thoughts, feelings associated w/ event
-avoidance of external reminders of the event

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19
Q

7 negative alterations in cognitions/mood require for PTSD dx (need at least 2)

A

-unable to remember important aspects of event
-negative beliefs about one’s self, other, or the world
-self-blame for the event
-persistent negative emotional state
-loss of interest/participation in significant activities
-feeling detached from others
-inability to experience positive emotions

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20
Q

how many alterations in arousal/reactivity are required for PTSD dx

A

at least 2

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21
Q

6 types of alterations in arousal/reactivity associated with traumatic event

A

-irritable behavior/angry outbursts
-reckless/self-destructive behavior
-hypervigilance
-exaggerated startle response
-concentration problems
-sleep disturbance

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22
Q

how long must sx be present for dx of PTSD

A

at least 1 month

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23
Q

how many persistent avoidance/negative alteration in cognition/mood criteria must be met for dx of PTSD in children under 6

A

at least 1

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24
Q

types of persistent avoidance in patients under 6

A

-avoiding activities, places, reminders of trauma
-avoiding people, conversations, interpersonal situations that remind of trauma

25
Q

negative alterations in cognition/emotional in patients under 6

A

-increased frequency of negative emotional states
-dimininshed interest/participation in significant activities
-socially withdrawn behavior
-persistent reduction in positive emotion expression

26
Q

how many alterations in arousal/reactivity are required for PTSD dx in patients under 6

A

at least 2

27
Q

PTSD-qualifying alterations in arousal/mood in patients under 6

A

-irritable behavior/angry outbursts
-hypervigilance
-exaggerated startle response
-concentration problems
-sleep disturbance

28
Q

when do PTSD sx typically begin

A

within 3 months of traumatic event

29
Q

what is often initial dx of PTSD

A

acute stress disorder until sx have been present for 1 month

30
Q

PTSD presentation in non-western cultures

A

less avoidance and more somatic complaints

31
Q

Which gender is PTSD more prevalent in

A

females

32
Q

dx if PTSD criteria is met other than severity of stressor

A

adjustment disorder

33
Q

duration of acute stress disorder

A

3 days - 1 month following traumatic event

34
Q

what if criteria for PTSD and MDD is met

A

give both dx

35
Q

what if criteria is met for PTSD and a dissociative disorder

A

dx is PTSD w/ dissociative features

36
Q

what are common PTSD comorbidities in children

A

ODD and separation anxiety

37
Q

diagnostic criteria for acute stress disorder

A

-same exposure as PTSD
-9 symptoms out of any of the 5 categories
-3 days - 1 month

38
Q

symptoms categories for the 9 symptoms required for acute stress disorder dx

A

intrusive symptoms
negative mood
dissociative symptoms
avoidance symptoms
arousal symptoms

39
Q

intrusive symptoms r/t acute stress disorder

A

-recurrent, involuntary, intrusive thoughts about event
-recurrent distressing dreams r/t event
-dissociative reactions (flashbacks)
-intense psychological distress/physiological reaction to internal/external cues r/t trauma

40
Q

negative mood symptom r/t acute stress disorder

A

persistent inability to experience positive emotions

41
Q

dissociative symptoms associated with acute stress disorder

A

-altered sense of reality about oneself or surroundings
-inability to remember aspects of event

42
Q

avoidance symptoms associated with acute stress disorder

A

avoids memories of event
avoid external reminders of event

43
Q

arousal symptoms associated with acute stress disorder

A

-sleep disturbance
-irritable behavior/angry outbursts
-hypervigilance
-concentration problems
-exaggerated startle response

44
Q

common presentations of acute stress disorder in children

A

-reexperience trauma through repetitive play
-may become preoccupied with reminders of trauma
-may have excessively bright affect
nightmares may not be r/t trauma

45
Q

what differentiates panic attacks from panic disorder from those in acute stress disorder

A

in panic disorder there is also worry about having panic attacks

46
Q

diagnostic criteria for adjustment disorder

A

-emotional/behavioral responses to a stressor
-does not meet criteria for another mental disorder
-is not an exacerbation of another mental disorder

47
Q

when do emotional/behavioral symptoms emerge in response to stressor in adjustment disorder

A

within 3 months of stressor onset

48
Q

what determines if symptoms in adjustment disorder are clinically significant

A

-distress is out of proportion to severity of stressore
-there is significant impairment in functioning

49
Q

how long can symptoms last after removal of stressor in adjustment disorder

A

no more than 6 months

50
Q

6 specifiers for adjustment disorder

A

-with depressed mood
-with anxiety
-w/ mixed anxiety/depressed mood
-with conduct disturbance
-with mixed disturbance of emotions/conduct
-unspecified

51
Q

duration of acute and persistent adjustment disorder

A

acute: less than 6 months
persistent: longer than 6 months

52
Q

when can symptoms in adjustment disorder last longer than 6 months

A

if it is a chronic stressor

53
Q

what if criteria is met for adjustment disorder and MDD

A

only MDD. Cannot have both dx

54
Q

what differentiates normative stress reaction from adjustment disorder

A

adjustment disorder if distress is out of proportion w/ stressor or when stressor is before functional impairment

55
Q

diagnostic criteria for prolonged grief disorder

A

-death at least 12 months ago
-grief response present nearly every day for last month
-3 out of 8 symptoms present

56
Q

what are the 2 ways grief response is characterized after death in prolonged grief disorder

A

-intense yearning/longing for deceased
-preoccupation w/ thoughts/memories of deceased

57
Q

what are the 8 symptoms that qualify for prolonged grief disorder (must have at least 3)

A

-identity disruption
-marked disbelief about death
-avoidance of reminders person is dead
-intense emotional pain
-difficulty reintegrating into relationships/activities
-emotional numbness
-feeling that life is meaningless
-intense lonliness

58
Q

most common comorbidities with prolonged grief disorder

A

MDD, PTSD, substance use

DSM5 (18 decks)

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