Trauma and Stress Flashcards
Adjustment order?
not able to adjust to change
stressor needed -w/in 3 mo
- depressed mood
- fired from job 3 mo ago –> withdrawn
- overwhelmed that no one will hire pt
- does not meet criteria for MDD
- PE and neuro norm
adjustment dissorder
Adjustment disorder - caution?
SUICIDAL RISK IS HIGH
Adjustment disorder - timeline?
resolves in 6 mo
Adjustment disorder - RF?
children and adult: war, natural disasters = TRAUMATIC EVENT
abuse, neglect, etc
military
elderly
Adjustment disorder - tx?
brief therapies
antidepressants
avoid benzos d/t risk for abuse
Adjustment disorder - prognosis?
adolescents may develop major mood and anxiety disorder: suicidality substance use or impulsive behavior
- depressed mood
- raped 1 yr ago: nightmares
- trouble concentrating
- trouble w/ marriage (emotionally)
- PE: norm
- denies pyschotic (hallucination)/suicidal/homicidal - attacker would die horrible death
post traumatic stress disorder
PTSD?
IMMEDIATELY after exposure (life threatening) for at least 1 mo
LIFE THREATENING!!!
PTSD - ‘exposure’?
direct: participating
witness: witness incident
learned: a loved one’s incident affects you
repeated exposure: continuously exposed to victims of incidents
PTSD - sx?
intrusion sx
avoidance of stimuli
negative cognition/mood alterations
marked arousal/reactivity alterations
PTSD - intrusion sx?
recurrent and involuntary memories recurrent dreams dissociative rxns (flashbacks) coming out of the blue physical and psychological response
PTSD - tx?
SSRI/SNRI (sertraline, fluoxetine, paroxetine, venlafaxine)
weigh benefits to risk: suicidality, QTc prolongation
AVOID BENZO: increase PTSD, interfere w/ psychotherapies
- depressed mood
- left her job 1 wk ago: filed sexual misconduct charges
- insomnia
- irritability
- feeling of guilt
- worthlessness
- avoids coworker
- relationship probs w/ bf
- brain fog
- replay incident
- talking about it makes her naseous
Acute stress disorder
Acute stress disorder - dx?
like PTSD sx that happens for at least 3 days up to a mo
longer than 1 mo: PTSD
Acute stress disorder - sx?
9 or more sx in five major areas:
- intrusion
- avoidance
- dissociative
- negative alterations in cognition/mood (fear, horror, detachment)
- marked arousal and reactivity (self destructive, sleep disturbance, concentration probs)
Childhood disorders?
- reactive attachment disorder
- disinhibited social engagement disorder
Acute stress disorder - tx?
CBT
+/- SNR
Reactive attachment disorder and disinhibited social engagement disorder?
social neglect
changes in caregivers
orphanages
child and family services systems
Reactive attachment disorder?
lack of attachments to caregivers
age 9mo - 5 yrs old
negative emotion displays
dampened positive affect (in kids: damper on positivity –> could be seen as irritability)
Disinhibited social engagement?
attachments with EVERYONE
age 9mo to adolescence
high risk of abuse and abductions
