Trauma And Stressor-related Disorders

Question 0

What are the main criteria of acute stress disorder?

Answer 0

*Exposure to actual or threatened death, serious injury or sexual violation in 1 or more ways: directly experiencing the event; witnessing in person the even occurring to others; learning that an event occurred to a close family member or friend (must have been violent or accidental); experiencing repeated extreme exposure to details of a traumatic event e.g. 1st responders- note not through electronic media unless is work related
*Presence of 9 or more symptoms from any of the 5 categories
Intrusion symptoms: recurrent, involuntary distressing memories of the event; recurrent distressing dreams related to the event; dissociative reactions (e.g. Flashbacks); intense or prolonged psychological distress or marked physiological reactions in response to internal or external cues that symbolise or resemble an aspect of the traumatic event
Negative mood: persistent inability to experience positive emotions
Dissociative symptoms: an altered sense of reality of surroundings or person; inability to remember an important aspect of the event
Avoidance symptoms: efforts to avoid distressing memories, thoughts or feelings about or associated with the event; efforts to avoid external reminders that arouse distressing memories, feelings or thoughts about the event
Arousal symptoms: sleep disturbance; irritable behaviour and angry outbursts; hyper vigilance; problems with concentration; exaggerated startle response
*Duration is 3 days to 1 month

Question 1

What are the main diagnostic criteria for post traumatic stress disorder?

Answer 1

• Exposure to actual or threatened death, serious injury or sexual violence in 1 or more of the following ways: directly experiencing a traumatic event; witnessing it; learning that it occurred to a close family member or friend; experiencing exposure to details of a traumatic event
• Presence of 1 or more intrusion symptoms: recurrent, involuntary distressing memories; recurrent distressing dreams related to the trauma; dissociative reactions (e.g flashbacks); psychological distress at exposure to internal or external cues that symbolise an aspect of the traumatic event; marked physiological reactions to internal or external cues that symbolise the traumatic event
• Persistent avoidance of stimuli associated with the traumatic event as evidence by 1 or both: avoidance of distressing memories,thoughts or feelings associated with the traumatic event; avoidance of external reminders of the event
• Negative alterations in cognitions and mood associated with the event, beginning or worsening after the event as evidenced by 2 or more: inability to remember important aspects of the event; persistent and exaggerated beliefs or expectations about oneself, others or the world; persistent distorted cognitions about the cause or consequence of the event that lead the person to blame themselves or others; persistent negative emotional state; markedly diminished interest or participation in significant activities; feelings of detachment from others; persistent inability to experience positive emotions
• Marked alterations in arousal and reactivity associated with the traumatic event beginning or worsening after the event, as evidenced by 2 or more: Irritable behaviour and angry outburts; reckless or self-destructive behaviour; hyper vigilance; exaggerated startle response; problems with concentration; sleep disturbance
• Duration is more than 1 month
• Causes clinically significant distress or impairment in functioning
• Not due to effects of a substance

Question 2

What are the main diagnostic criteria for adjustment disorders?

Answer 2

• The development of emotional or behavioural symptoms in response to an identifiable stressor occurring within 3 months of the onset of the stressor
• These symptoms or behaviours are clinically significant, as evidenced by 1 or both: marked distress that is out of proportion to the severity or intensity of the stressor; significant impairment in functioning
• Does not meet criteria for another mental disorder or not merely an exacerbation of a predicting mental disorder
• The symptoms do not represent normal bereavement
• Once the stressor or it’s consequences have terminated, the symptoms do not persist for more than an additional 6 months