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Behavior Med Test 3 > Trauma and Stress Related Disorders > Flashcards

Trauma and Stress Related Disorders Flashcards

1
Q

trauma / stress related disorders higher prevalence in men or women

A

women

aslo in military and populations exposed to war

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2
Q

PTSD prevalence in ppl exposed to war, US, and wordwide and 12 mofor US

A

war: 30%
US: 8-10%
Worldwide: 5%
12 mo in US: 5%

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3
Q

3 categories of RF for trauma / stress disorders

A

Trauma characteristics
Pre-Trauma individual vulnerabilities
Post Trauma factors

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4
Q

3 ex of trauma characteristics

A
  1. severity (type/intensity of trauma)
  2. Proximity (to perpetrator, distance)
  3. duration (# events, repeated deployements)
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5
Q

3 ex of pre trauma RF

A

Prior trauma / childhood adversity
lower cognitive abilities
pre-existing anxiety or depression

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6
Q

Post trauma factors 3

A

social support / treatment
early sx of numbing, re-experience, etc
substance abuse

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7
Q

7 trauma / stress related disorders

A
  1. reactive attachment disorder
  2. Disinhibited social engagement disorder
  3. adjustment disorder
  4. acute stress disorder
  5. Other specified
  6. Other unspecified
  7. PTSD
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8
Q

peds dxs that reflect relational trauma 2..

A

reactive attachment disorder

disinhibited social engagement disorder

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9
Q

minimal social / emotional response with disturbed interpersonal relatedness

A

reactive attachment

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10
Q

disinhibited social engagement

A

indiscriminate attachment behavior, overly relational

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11
Q

frequent changes in caregivers (foster care) or extended time in institutional settings…

A

can lead to reactive attachment or disinhibited social engagement disorder etc..

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12
Q

5 criteria for adujustment disorder

A
  1. dev. of emotional/behave sx in response to stressor w/in 3 mo of that stressor’s onset
  2. sx out of proportion of stressor when context considered
  3. impair social/occupational functioning
  4. not due to another disorder
  5. sx not normal bereavement and do not persist beyond 6 mo after stressor ends
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13
Q

5 specifiers for adjustment disorders

A
  1. depressed mood / anxiety
  2. mixeted anity and depressed
  3. disturbance in conduct
  4. mixed disturbance of emotions and conduct
  5. unspecified
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14
Q

___ is like PTSD but just shorter time frame

A

acute stress disorder

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15
Q

exposure to actual or threatened death, serious injury, sexual violation in more than 1 of 4 ways

A

actue stress disorder with:

  1. direct experience
  2. witness in person to events occurring to others
  3. learning about violence or accidental happing to others
  4. extreme or repeated exposure to trauma
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16
Q

what does not apply to acute stress disorder?

A

media exposure to trauma –individual has control over that, can stop watching etc.

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17
Q

5 categories of sx of acute stress disorder

A
  1. intrusion sx
  2. negative mood
  3. dissociative sx
  4. avoidance sx
  5. arousal sx
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18
Q

ex of intrusion sx

A
  1. intrusive thougths / memories
  2. recurrent dreams or nightmares (more than 2)
  3. flashbacks
  4. intense psych reminders or cues
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19
Q

ex negative mood

A

persistent inability to experience positive emotions

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20
Q

ex dissociative sx

A

derealization
depersonalization
cant remember aspects of trauma (not due to TBI or meds)

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21
Q

ex avoidance sx

A
  1. avoid triggers / reminders of event

2. avoid memories / thougths/ feelings related to event

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22
Q

arousal sx

A 
insomnia 
irritable behavior / outbursts 
hypervigilance 
problem concentrate 
exaggerated startle
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23
Q

what is number one most common arousal sx

A

insomnia

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24
Q

what is most common presentation of acute stress disorder

A

arousal sx (insomnia, concentration issues etc)

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25
Q

___ is the term given to disorders that have characteristic sx predominating but do not meet criteria for any trauma or stressor related disorder

A

other specified

26
Q

unspecified is a term given when..

A

characteristic sx predominate BUT do not meet criteria for another disorder, and information or context is missing

27
Q

__ is typically used for acute presentations of stress disorder in ER

A

unspecified

28
Q

2 examples of other disorders

A
  1. ataque de nervios

2. Koro

29
Q

ataque de nervios

A

Hispanic female hysterical reaction

culture bound reaction

30
Q

koro

A

Asian culture (china), only men, dissociative / depersonalized belief that their penis is shrinking into their body

31
Q

almond shaped , emotional center of brain

A

amygdala

32
Q

seahorse, key in forming new memories

A

hippocampus

33
Q

sensory way station, coordinates motor output

A

thalamus

34
Q

how are short term memories converted to long and what part of brain does this?

A

via Long term potentiation

via hippocampus

35
Q

__starts SNS response via hypothalamus

A

amygdala

36
Q

connects NS to endocrine system

A

hypothalamus

37
Q

regulates autonomic nervous system

A

hypothalamus

38
Q

regulates temperature, hunger, thirst, attachment, circadian rhythms etc.

A

hypothalamus

39
Q

executive branch of limbic system

A

cingulate cortex

40
Q

what does autonomic nervous sys dysregulation lead to?

A
  1. overactive SNS

2. Excessive parasympathetic tone (rest and digest)

41
Q

__ is cytotoxic to hippocampus therefore interferes with encoding / retrieving memories

A

cortisol

42
Q

in PTSD there is ___ and ___ of systemic feedback loops

A

dysfunction and dysregulation

43
Q

increased DA and NE leads to

A

hyperarousal / startle

44
Q

serotonin decreases __ which interfers with__

A

5ht, limbic system

45
Q

amino acids such as a decrease in __ leads to?

A

decrease in GABA leads to anxiety which = increased glutamate = dissociation

46
Q

increased peptides suh as beta endorphins in CSF leads to

A

numbing and dissociation

47
Q

3 portions of anatomy that are altered with stress / trauma disorders

A
  1. amygdala: increased activity and reactivity
  2. hippocampus: decreased volume and activity
  3. cortex: decreased volume, reduced fear inhibition
48
Q

PTSD sx # criteria

A

1+ intrusive sx
1+ avoidance sx
2+ negative alterations in mood / cognition
2+ alerations in arousal / reactivity

sx cause disturbance for over 1 mo

49
Q

PTSD with dissociative sx

A

if depersonalization / derealization are persistent or recurrent

50
Q

PTSD with delayed expression

A

if full criteria not met until after 6 mo from traumatic event

51
Q

PTSD in kids under 6 may show up as..

A 
in play re-enactment 
social withdrawl 
play constriction 
somatic sx: stomachache 
new separation fears 
regressive behavior
52
Q

what are 4 ex of s/s that indicate dysregulated stress response

A
  1. HTN or CVD
  2. HA
  3. Peptic ulcer
  4. IBS
53
Q

t/f hippocampal atrophy may correlate with intensity of PTSD sx

A

true

54
Q

t/f H-P-A axis activity likely abnormal in PTSD

A

true

55
Q

highest incidence of suicide is..

A

45-64 yo white males

56
Q

suicide risk increase if fhx + for sucidie ?

A

true

57
Q

most important single predictor of suicide

A

direct verbal warning or statement

58
Q

2 EBM therapies for individuals with PTSD

A

TF-CBT: trauma focused CBT

EMDR: eye mvmt desensitization and reprocessing

59
Q

7 med options for PTSD

A
  1. antidepressants
  2. alpha receptor modulators
  3. beta blockers
  4. benzodiazepine
  5. buspirone
  6. anticonvulsants (mood stabilizers)
  7. antipsychotics (neuroleptics)
60
Q

the only 2 FDA approved meds for ptsd

A

sertraline (Zoloft)

paroxetine (paxil)

Behavior Med Test 3 (3 decks)

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