Trauma AND Stress related disorders

Question 1

response to the traumatic event must include———-/————–

Answer 1

intense fear and horror

Question 2

ASD
both event and Sx occur (duration )

Answer 2

less than 1 mth
ptsd any time in the past Sx more than 1 mth

Question 3

e lifetime incidence of PTSD is estimated———-to ———– and the lifetime prevalence of PTSD is estimated to
be about —- of general population. * The lifetime prevalence rate is —– in women and —— in men

Answer 3

9 to 15%
8%
10%
4%

Question 4

• The most important risk factors are 1——2——3—–
  familial Hx ofdepression can raise the risk of devoloping PTSD

Answer 4

severity, duration, and proximity of a person’s exposure to the actual
trauma

Question 5

The stressor alone does not suffice to cause the disorder

Answer 5

***t must involve intense fear or horror.
events that happened before and after the trauma.

Question 6

THEROTICAL SYSTEMS involved in ptsd

Answer 6

1-the noradrenergic and endogenous opiate systems, as well
as the 2–HPA axis
++3-increased activity and responsiveness of
the autonomic nervous system, as evidenced by elevated heart rates and
blood pressure readings and by abnormal sleep architecture

Question 7

PREDISPOSING FACTORS IN PTSD:

Answer 7

1. Presence of childhood trauma.
2. Borderline, paranoid, dependent, or antisocial personality disorder traits.
3. Inadequate family or peer support system.
4. Female gender.
5. Genetic vulnerability to psychiatric illness.
6. Recent stressful life changes.
7. Recent excessive alcohol intake.
8. Perception of an external locus of control (natural cause) rather than an
   internal one (human cause

Question 8

dsm-5 criteria

Answer 8

1-Exposure to actual or threatened death, serious injury, or sexual violence in one
2-Presence of one (or more) of the following intrusion symptoms associated
with the traumatic event(s)
3-persistance avoidance of stimuli associated with the traumatic event(s)
4-Negative alterations in cognitions and mood associated with the beginning
or worsening after the traumatic event(s)
5- Marked alterations in arousal and reactivity associated with the traumatic
event(s)
6-Duration of the disturbance (Criteria B, C, D, and E) is more that 1 Month.
G.
7-The disturbance cause clinically significant distress or impairment in
social, occupational, or other important areas of functioning.
H.
8-The disturbance is not attributable to the physiological effectsof a
substance (e.g. medication, alcohol) or another medical condition

Question 9

Comorbidity rates are high among patients with PTSD, with about two thirds
having at least two other disorders.
* Common comorbid conditions include
-

Answer 9

deprssive/bipolar/

Question 10

COURSE AND PROGNOSIS
Untreated
mild symptoms,
moderate symptoms

Answer 10

, about 30 percent of patients recover completely, 40 percent continue to
have mild symptoms, 20 percent continue to have moderate symptoms, and 10
percent remain unchanged or become worse

Question 11

• After 1 year, about —– percent of patients will recover

Answer 11

50

Question 12

good prognosis is predicted by:

Answer 12

1. Rapid onset of the symptoms.
2. Short duration of the symptoms(less than 6 months)
3. Good premorbid functioning. 4. Strong social support.
4. The absence of other psychiatric, medical, or substance-related disorder or
   other risk factors

Question 13

Tx gold standard

Answer 13

Eye Movement desensitization and reprocessing

Question 14

Pharmacotherapy:

Answer 14

1. SSRIs (Sertraline and Paroxetine).
2. TCAs (Imipramine and Amitriptyline).
3. Prazosin (for treating disturbing dreams and nightmares)
4. Benzodiazepines (for acute anxiety) * are not preferred because of high rates of dependence
   among patients.
5. Adjunctive atypical antipsychotics (risperidone, olanzapine) * Psychotherapeutic interventions (behavior therapy, cognitive therapy and hypnosis)

Question 15

DSM-5 DIAGNOSTIC CRITERIA FOR
ADJUSTMENT DISORDERS

Answer 15

A. The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s).
B. These symptoms or behaviors are clinically significant, as evidenced by one or both of the following:
1. Marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the
external context and the cultural factors that might influence symptoms severity and presentation.
2. Significant impairment in social, occupational or other areas of functioning.
C. The stress-related disturbance does not meet the criteria for another mental disorder and is not merely an
exacerbation of a preexisting mental disorder.
D. The symptoms do not represent normal bereavement.
E. Once the stressor or its consequences have terminated, the symptoms do not persist for more that 6 months.
DIFFERENTIAL DIAGNOSIS

Question 16

Adolescents typically require a ———time to recover than adults
Risk for suicide, especially in adolescent patients with————–subtype.(comorbid
diagnosis of substance abuse and personality disorder increase the risk of suicide

Answer 16

longer
depressed mood

Question 17

DSM-5 DIAGNOSTIC CRITERIA FOR ACUTE STRESS
DISORDER

Answer 17

1-Exposure to actual or threatened death, serious injury, or sexual violation in one (or
more) of the following ways
2-Presence of nine (or more) of the following symptoms from any of the five
categories of intrusion, negative mood, dissociation, avoidance, and arousal,
beginning or worsening after the traumatic event(s) occurred:
3-Duration of the disturbance (symptoms in Criterion B) is 3 days to 1 month
after trauma exposure.
4-The disturbance causes clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
5. The disturbance is not attributable to the physiological effects of a substance
(e.g., medication or alcohol) or another medical condition