Trauma and Stress-Related Disorders Flashcards
Define PTSD
exposed to traumatic event (witnessed, experienced death, injury)
re-experience event
avoid stimuli
increased arousal (diff sleeping, irritable, diff concentrating, hypervigilance)
Negative cognitions (distorted blame of self or others, estrangement, diminished interest in activities, inability to remember key aspects of event)
How long does PTSD last?
duration of disturbance AND sx is more than 1 month
–>if event happened 3 months ago but sx started 2 weeks ago, wouldn’t be PTSD yet
clinically significant distress and impairs fxn
PTSD treatment
SSRIs
cognitive processing therapy
–> support groups
–> eye movement desensitization and reprocessing (EMDR)
increased risk of substance abuse, so avoid addictive prescriptions (benzos)
What neuro structures are involved in PTSD?
HPA axis, hyperactive, increases autonomic NS response
amygdala (fear, anxiety)
prefrontal cortex (abnormal, usually dampens amygdala)
hippocampus (memory)
NTs (norepi, dopamine, endogenous opioids
Define acute stress disorder
sx similar to PTSD but duration is different
–> 3 days to 1 month (but not longer) after trauma exposure
Describe adjustment disorders
development of emotional/behavioral sx in response to identifiable stressor
–> occurs within 3 month of stressor
results in:
- significant distress out of proportion to severity of stressor
- impairment in functioning
*** not normal grief or bereavement, does not persist beyond 6 months
What is somatic sx disorder?
focusing on sx every day (disproportionate and persistent thoughts about seriousness of sx) and is debilitating but not finding anything on exam to explain it
high level of anxiety about health or sx
pain disorder common
Tmt for somatoform disorder
pain management, neuro, psych
–>team management
CBT
hypnosis
anti-anxiety meds (clonazepam for conversion disorder)
Describe conversion disorder (functional neuro sx disorder)
traumatic event–> 1+ sx that appear to be neuro in origin
not faking, believe sx
can’t find cause
paresthesias, weakness, paralysis, pseudoseizures, involuntary movements, blindness or mutism, stuttering
Describe illness anxiety disorder
AKA hypochondriac
high level of anxiety for at least 6 months, preoccupation with having or getting a serious illness
care seeking or avoidant
Describe factitious disorder
voluntary control of sx
self-inject feces or saliva
bizarre or unusual sx
Munchausen’s and by proxy
Define dissociative disorders
amnesia: info regarding to trauma
fugue: sudden, unexpected travel away from home (inability to recall one’s past or personal identity)
identity disorder: aka multiple personality, often survivors of sexual abuse
depersonalization disorder (living in dream state, outside looking in)
