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Case Files Psychiatry > Trauma and Stress Disorders > Flashcards

Trauma and Stress Disorders Flashcards

1
Q

What other critera must be present?

A

Avoidance

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2
Q

What examples of negative alterations in thinking and mood that can be associated with PTSD?

A
  1. Can remeber the event
  2. Negative beliefs about self, others, or world
  3. Blaming self or others
  4. Negative emotional state
  5. Detachment
  6. Inability to experince positive emotions
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3
Q

What are examples of increased arousal associated with PTSD?

A
  1. Irritability or angry outbursts
  2. Reckelss or destructive behavior
  3. Hypervigilance
  4. Startle response
  5. Concentration problems
  6. Sleep distrubance
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4
Q

How long do the symptoms need to be present to make a dx of PTSD?

A

1+ months

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5
Q

What are the broad critera considered for PTSD?

A
  1. Exposure
  2. Reexperiencing (1)
  3. Avoidance
  4. Negative alterations in thinking or mood (2)
  5. Increased arousal (2)
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6
Q

What are the risk factors for PTSD?

A
  1. Female
  2. Childhood emotional problems
  3. Previous psychiatric illness
  4. Lower education level or SES
  5. Exposure
  6. Family psychiatric history
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7
Q

What are common comorbidities in patients with PTSD?

A

MDD
Anxiety
Substance absue

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8
Q

What should be on the DDX for someone with PTSD?

A
  1. Partial complex seizures
  2. GAD or panic disorder
  3. MDD
  4. Borderline personality disorder
  5. Dissociative disorders
  6. Acute inoxication or withdrawal
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9
Q

What is the treatment appraoch for PTSD?

A

Mutimodal

  • Pharmacotherapy
  • Psychotherapy
  • Social intervention
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10
Q

What medications are primarily used to treat PTSD?

A

SSRIs

  • Sertraline
  • Paroxetine
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11
Q

What medications are particulary good at reducing symptoms clusters associated with PTSD (reexperiencing, avoidance, alterations in cognition and mood, hyperarousal)?

A

SNRIs

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12
Q

How long may it take to see a full response from pharmacotherapy when treating PTSD?

A

24 weeks

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13
Q

What medication is really good at treating nightmares, reexperiences, and arousal symptoms clusters associated with PTSD?

A

Prazosin

- Alpha 1 blocker

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14
Q

What psychotherapy has been used to treat PTSD?

A

CBT

  • Cognitive processing therapy
  • Prolonged exposure therapy
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15
Q

How is social intervention used to treat PTSD?

A

Shelter
Food
Clothing
ie give a sense of safety and security

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16
Q

What should be the first treatment intervention in trauma-realted disorders?

A

Establish safety

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17
Q

Withing what timeframe does the stressor have to happen inorder for it to be considered the source of the patients adjustment disorder?

A

3 months

18
Q

How long do the symptoms have to resolve after the stressor is removed?

A

6 months

19
Q

What are some specifiers for adjustment disorder?

A

With:

  • Anxiety
  • Depressed mood
  • Mixed anxiety and depressed mood
  • Disturbance of conduct
20
Q

What qualifys symptoms as clinically significant?

A

Marked impact on functioning in a variety of settings

21
Q

What is the basis of supportive psychotherapy?

A

Patients are taught how to confront issues

  • Phobias
  • Stressors
22
Q

When is it appropiate to make the dx of MDD instead of adjustment disorder with depressed mood even if a stressor is present?

A

Marked difficulties are present

- SiG E CAPS

23
Q

In children with depression, what emotion is often present instead of depressed mood?

A

Irritablity or anger

24
Q

What is the treatment of choice for adjustment disorders?

A

Psychotherapy

- Supportive

25
Q

What other techinques can be used to treat adjustment disorder, especially for actue stressors?

A

Relaxation training
Reassurance
Environmental modification

26
Q

Perception that the environement is somehow different or strange, although the individual cannot account for the changes.

A

Derealization

27
Q

Memory loss of some component of an event, which in the case of ASD is usually traumatic.

A

Dissociative amnesia

28
Q

What are the core components of ASD?

A
  1. Exposure
  2. Intense fear and feelings of helplessness
  3. Dissociative symptoms
29
Q

What activates the fear response in ASD?

ie physiological basis

A

Hypothalamic-pituitary-adrenal axis

Locus ceruleus/norepinephrine system

30
Q

What are the time constraints on ASD?

A

Occurs within 4 weeks

Lasts at least 3 days

31
Q

What are the 5 categorical symtpoms involved in making an ASD dx?

A
  1. Intrusion symptoms
  2. Negative mood
  3. Dissociative symptoms
  4. Avoidance symptoms
  5. Arousal symptoms
32
Q

How many symptoms must be present from any of the categories?

A

9

33
Q

ASD intrusion symptoms

A

Memories
Dreams
Reoccurring- as in the event is reoccurring
Response to external cues

34
Q

ASD negative mood

A

Inability to feel positive emotions

35
Q

ASD dissociative symptoms

A

Altered sense of reality

Amnesia related to the event

36
Q

ASD avoidance symptoms

A

Avoid memories, thoughts, or feelings

Avoid external reminders

37
Q

ASD arousal symptoms

A 
Sleep disturbance
Irritabile or angery outburst
Hypervigilance
Concentration
Startle response
38
Q

What areas need to investigated when someone has a traumatic event?

A
  1. Head injury
  2. Substance abuse- Self-treatment
    - Cocaine
  3. Panic disorder
  4. Dissociative disorders
  5. Malingering
39
Q

What is the main treatment for ASD?

A 
Supportive intervention
- Family
- Religion
- Community
Education
- Symptoms
- Coping skills
Critical incident stress debriefing
- Talking about the event and processing the thoughts
40
Q

What can be used to treat insomnia and hypervigilance associated with ASD?

A

Hypnotics
Anxiolytics
Beta-blockers

41
Q

What are some examples of reexperiencing associated with PTSD?

A
  1. Intrusive memories
  2. Distressing dreams
  3. Flashbacks
  4. Distress when exposed to cues
  5. Physiological reactions when exposed to cues

Case Files Psychiatry (10 decks)

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