Trauma and Stress Related Disorders Flashcards
Characteristics of Stress/Trauma
May experience anxiety, insomnia, difficulty coping, grief, etc.
Some individuals have problems coping, managing stress and emotions, or resuming daily activities.
Acute Stress Disorder
Reexperiencing, avoidance, hyperarousal
When does acute stress disorder occur?
Occurs 3 days to 4 weeks after trauma
What is a precursor to PTSD
Acute Stress Disorder
If acute stress lasts more than 4 weeks, what disorder are we looking at?
PTSD
According to the DSM-V, the diagnostic criteria for PTSD the duration of
Posttraumatic Stress Disorder – PTSD is?
According to the DSM-V, the diagnostic criteria for PTSD “The duration of the disturbance is more than 1 month”
PTSD
Disturbing pattern of behavior demonstrated by someone who has experienced, witnessed, or been confronted with traumatic event
How can the traumatic event for someone with ptsd be described?
Event poses actual or threatened death or serious injury
What are the responses to PTSD?
Intense fear
Helplessness
Terror
Subcategories of symptoms of PTSD
Being on guard/hyperarousal
Reexperiencing the trauma
Avoidance
Negative congition/thoughts
Disturbance is more than 1 month
What does rexperiencing the trauma include?
Dreams
Flashbacks (acting or feeling like trauma reoccurring)
Intrusive, recurrent thoughts
Etiology of PTSD
A causative trauma
Lack of social support, previous psychiatric history/personality factors can increase risk
What group of people are most likely to develop PTSD?
Adolescents are more likely to develop PTSD than are children or adults.
The Adolescent is at a increased risk for the following:
Suicide
Substance abuse
Poor interpersonal relationships
Poor physical health
Academic problems
Cultural Considerations of PTSD
Posttraumatic stress disorder (PTSD) is a universal phenomenon.
What would lead to a lesser frequency of being diagnosed with PTSD?
Stronger sense of self and cultural identity = less frequently diagnosed with PTSD, better long-term outcomes
PTSD Treatment Options
Counseling and therapy (individual or group)
Medications (especially targeting specific issues)
CBT/CPT (Cognitive
Processing Therapy)
Exposure therapy
Relaxation techniques
What is the gold standard treatment for PTSD?
Cognitive Therapy
Dissociative Symptoms
The presence of two or more distinct personality states.
Why do Dissociative Symptoms occur?
Subconscious defense mechanism used to prevent recognition of a horrific or traumatic event
When can dissociative symptoms occur?
Can occur during and after event
What is an essential feature of dissociative symptoms?
Essential feature: disruption in usually integrated functions of consciousness, memory, identity, environmental perception
How does the onset of dissociative symptoms occur?
Onset can be sudden or gradual.
Dissociative symptoms interfere with:
Relationships
Ability to function (activities of daily living)
Ability to cope
What kind of clients are seen with dissociative symptoms?
Clients with PTSD
Four main types of dissociative symptoms
- Dissociative amnesia
- Dissociative identity disorder
- Depersonalization/Derealization disorder
- Dissociative Fugue
- Dissociative amnesia
(condition in which a person cannot remember important information about his or her life)
- Dissociative identity disorder
(formerly multiple personality disorder)
- Depersonalization/Derealization disorder
(periods of feeling disconnected or detached from one’s body and thoughts or you have a sense that things around you aren’t real, or both
- Dissociative Fugue
the person with memory loss travels or wanders.
Dissociative Treatment Options
Individual therapy
Group therapy
Medications (for anxiety or depression or both)
What is the focus of group therapy in dissociative treatment
Group therapy
Focus in therapy is on reassociation
Trauma and Stressor-Related Assessment: What is NOT necessary
Not necessary or desirable for client to detail specific events of abuse or trauma*
What is the general appearance/motor of someone with trauma/stress?
Client often appears hyperalert.
Client may have discomfort with physical closeness.
Client may appear anxious or agitated.
What is the mood/affect of someone with Trauma/stress?
Can range from passive to angry, frightened, agitated, hostile
What is the thought process/content of someone with Trauma/stress?
Experience nightmares, flashbacks, intrusive thoughts, hallucinations, self-destructive thoughts, fantasies
What is the sensorium and intellectual process of someone with stress/trauma
Oriented to reality except during flashback
Memory gaps
Intrusive thoughts/ideas of self-harm
What is the judgement and insight of someone with stress/trauma?
May report little idea of relationship between trauma and symptoms
Others may be quite knowledgeable.
Decision-making ability may be impaired.
What is the self concept of someone with trauma/stress?
Low self-esteem
See self as worthless
How are the roles and relationships of someone with stress/trauma?
Problems with authority
Close relationships difficult or impossible
Physiological concerns of someone with stress/trauma?
Difficulty sleeping
Change in appetite
Alcohol and drug use
Trauma and Stressor-Related Outcomes
Physical safety
Distinguish ideas of self-harm versus taking action
Demonstrate healthy, effective stress management
Nondestructive expression of emotions
Social support system
Trauma and Stressor-Related Outcomes and Interventions
Grounding techniques
Encourage journaling of feelings
Utilize distractions and relaxation techniques
Refer to client as “survivor” rather than “victim”
Grounding Techniques
Helpful with dissociation or flashback.
Remind the person that he or she is present, is an adult, and is safe.
Increase contact with reality.
Diminish the dissociative experience by focusing on current experiences.
Focus the client in the present.
Medication prescribed for nightmares associated with PTSD?
Prazosin
Side effects of Prazosin?
Dizziness, headache, blurred vision
Life threatening side effects of Prozosin?
Syncope with sudden loss of consciousness with rapid dose increases or the introduction of antihypertensive
FRA approved medications for PTSD?
Paroxetine
Sertraline
Self Awareness Issues
Deal with own personal feelings about traumatic events, abuse, and natural disasters.
Convey empathy.
Remain nonjudgmental.
