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Psych II > Trauma And Stress D/o, Other d/o > Flashcards

Trauma And Stress D/o, Other d/o Flashcards

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1
Q

Essentials of diagnosis for trauma and stress related d/o?

A
  • Exposure to traumatic event
  • flashbacks/nightmares
  • avoidance symptoms
  • increased vigilance
  • symptoms impair functioning
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2
Q

What is reactive attachment d/o?

A
  • Inhibited emotionally withdrawn behavior toward adults
  • social and emotional disturbance
  • pattern of extremes of insufficient care
  • not ASD
  • age between 9mo and 5years
  • persistent x 12 months
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3
Q

Reactive attachment d/o persistent social and emotional disturbance must have at least 2 of?

A

Minimal social and emotional responsiveness to others

  • limited pos affect
  • episodes of unexplained irritability, sadness or fearfulness that are evident during non-threatening interactions w adults
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4
Q

The reactive attachment d/o emotional extremes require 2 of?

A
  • Social neglect/deprivation in basic emotional needs for comfort
  • repeated changes in caregivers (unstable)
  • rearing in settings that limit opportunities for attachments (institutions)
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5
Q

What is disinhibited social engagement d/o?

A

Child approaches/interacts w unfamiliar adults w 2 of:

  • no inhibition of approaching unfamiliar adults
  • overly familiar verbal/physical (not age appropriate)
  • not checking back w parents
  • willingness to go off w unfamiliar adult

Child has experienced pattern of extremes of insufficient care evidenced by 1 of:

  • social neglect/deprivation of needs of comfort
  • changes in caregiver
  • institutions
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6
Q

PTSD is characterized by?

A

Characterized by re-experiencing a traumatic event and decreased responsiveness and avoidance of current events associated w trauma

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7
Q

Clinical findings of PTSD?

A

Hx of exposure to real/perceived event

  • life threat
  • serious inj
  • sex

Physiologic hyperarousal
Symptoms x 1 month
Dissociative symptoms

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8
Q

Physiologic hyperarousal w PTSD can include?

A
  • startle
  • illusions
  • overgeneralized associations
  • sleep prob
  • nightmares
  • dreams
  • difficulty concentrating
  • hyperalertness
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9
Q

What are the dissociative symptoms w PTSD?

A

Depersonalizatioin - feeling detached (outside observer of one’s own thoughts)

Derealization - experiences unreliability of surroundings (dream like)

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10
Q

PTSD must include 9 or more symptoms in what categories?

A
  • intrusion
  • negative mood
  • dissociative
  • avoidance
  • Arousal
  • beginning or worsening after event
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11
Q

DDX for PTSD?

A

Acute stress d/o (time shorter 3-30 days)

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12
Q

PTSD is often comorbid w?

A

Often comorbid w:

  • Depression
  • Panic d/o

Self therapy w

  • ETOH
  • drugs
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13
Q

FDA pharm tx for PTSD?

A

SSRI are the only class of meds that are FDA approved

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14
Q

Tx for PSTD?

A

Psychotherapy (the sooner the better)

  • brief 8-12 sessions
  • treat the substance abuse
Pharmacotherapy
- SSRI 
- B blockers (propanolol)
- A blockers (clonidine - nightmares)
- antiseizure meds - carbamazepine (impulsivity/anger)
Benzo’s - (anxiety, panic)
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15
Q

What SSRI’s are best for PTSD?

A

Sertraline
Paroxetine

Are both fda approved

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16
Q

Prognosis for PTSD?

A

1/2 experience chronic PTSD

Prognosis is better if they we not already crazy

17
Q

What is Acute stress disorder?

A

PTSD but shorter timeline

3-30 days

18
Q

What is adjustment disorder?

A

Anxiety or depression reaction to an identifiable source that is out of proportion

19
Q

What constitutes a stressful event for adjustment disorder??

A

Nothing it is specific to the individual

- stress caused by the overwhelming of the adaptive capabilities of the individual

20
Q

What is the onset of adjustment disorder?

A

Emotional or behavioral symptoms w/in 3 months of the onset of the stressor

21
Q

Clinical findings for adjustment disorder?

A
  • Stressed, anxious or depressed
  • Physical symptoms
  • Eating/drinking
  • Running away
  • Anxiety
  • Dreams
22
Q

Ddx for adjustment d/o?

A 
Anxiety
Mood 
Bereavement
Acute stress disorder 
PTSD

The stressor for adjustment d/o is usually less than that of ASD or PTSD

23
Q

Tx for adjustment disorder?

A 
Behavioral - stress reduction techniques
Social - fix your life/job
Psychological - not usually required
Pharm
- sedatives (lorazepam) for anxiety
- SSRI’s because we give those for everything
24
Q

Prognosis for adjustment disorder?

A

Take away the stressor and they get better quickly

25
Q

Child maltreatment types:

A

Injury inflicted by someone who has responsibility for the child
- abuse whether or not they intended injury

Sexual abuse
- any sex act to provide gratification of caregiver

26
Q

Child neglect?

A

Egregious act of omission by caregiver that deprives child of basic age-appropriate needs leading to psychological harm to the child

27
Q

Types of child neglect?

A

Abandonment
Lack of supervision
Failure to attend emotional needs

Failure to provide:

  • education
  • medical care
  • nourishment
  • shelter
  • clothing
28
Q

What is child psychological abuse?

A

Verbal or symbolic acts

  • berating
  • disparaging
  • humiliating
  • threatening
  • etc
29
Q

Adult maltreatment and neglect classifications

A

Spouse/partner

Non-spouse/partner

30
Q

Adult maltreatment and neglect types?

A
  • violence
  • sexual violence
  • neglect
  • egregious act or omission (deprives dependent parter of needs)
  • psychological (non verbal or symbolic)
31
Q

What is non-adherence to medical tx?

A

Focus of clinical attention is non-adherence to an important aspect of treatment for a mental d/o or another medical condition

32
Q

Reasons for non-adherence to med treatment?

A
  • discomfort
  • $$
  • personal/religious
  • age related debility
  • mental d/o
33
Q

When is non-adherance to medical treatment considered

A

When problem warrants independent clinical attention

34
Q

When to suspect malingering?

A

Any combo of:

  • current legal stuff going on
  • marked discrepancy between S and O
  • lack of cooperation/compliance w exam/treatment
  • antisocial personality
35
Q

Malingering includes?

A

Motivation for symptoms

  • external incentive
  • getting out of stuff

Contrast w factitious d/o where there is no incentive

36
Q

W TBI look for?

A

Criteria are met for mild/maj neurocognitive d/o

Evidence of injury to brain injury w 1 (+) of:

  • LOC
  • post traumatic amnesia
  • disorientation/confustion
  • neurologic signs of injury
37
Q

When does TBI present?

A

Immediately after injury or recovery and persists past post injury phase

38
Q

Tx for TBI?

A

Find out

Psych II (10 decks)

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