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Behavioral Medicine > Trauma and Stressor Related Disorders > Flashcards

Trauma and Stressor Related Disorders Flashcards

1
Q

Trauma or stressor related disorders deals with disorders linked to early social ______ and lifetime prevalence of trauma exposure in North America is ____ to ____ %

A

neglect; 39; 74

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2
Q

What are vulnerable groups

A
  1. Youth
  2. Women 2x greater risk of dev PTSD with best. lifetime prevalence of 8-10 % vs men 4-5%
  3. Injured and medically ill
  4. elders
  5. military populations
  6. disaster survivors
  7. survivors of genocide
  8. people with serious mental illness
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3
Q

Reactive attachment disorder is now the emotionally withdrawn or _____

A

inhibited

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4
Q

Disinhibited Social Engagement Disorder is now the Indiscriminately social or ____

A

disinhibited

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5
Q

Describe reactive attachment disorder

A

A pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, manifested by both the child rarely seeking comfort when distressed or the child rarely responding to comfort when distressed. The disturbance is evident before age 5 and the child has a developmental age of at least 9 months.

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6
Q

RAD is ____ even in severely neglected kids. Often co occurs with developmental delay, signs of neglect and stereotypes. Only known risk is _____ neglect

A

rare; social

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7
Q

What are treatment options for RAD

A
  1. responsive and consistent caretakers
  2. encourage forming attachments
  3. positively stimulating environment
  4. provide for childs safety
  5. when older psychoeducation and psychotherapy
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8
Q

What is Disinhibited Social Engagement Disorder

A
  1. child actively approaches and interacts with unfamiliar adults and exhibits willingness to go off with an unfamiliar adult with minimal or no hesitation.
  2. Child has experienced social neglect/deprivation, repeated changes of primary caregivers to form stable attachments
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9
Q

Treatment for DSED is directed towards interpersonal functioning and improving ______

A

relatedness

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10
Q

What is criteria for PTSD older than 6 yoa

A
  1. Exposure to actual or threatened death, serious injury, or sexual violence in one or more of the following ways:
    - directly experiencing traumatic event
    - witnessing in person the events as it occurred.
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11
Q

What symptoms associated with the traumatic events occur after the event

A
  1. recurrent, involuntary and intrusive distressing memories of the traumatic event.
  2. recurrent dreams
  3. dissociative reactions/flashbacks
  4. Avoidance of or efforts to avoid disstressing memories with the event
  5. Avoidance of external reminders
  6. Inability to remember an important aspect of the event
  7. Negative beliefs about oneself, others or the world
  8. Feelings of detachment
  9. Inability to experience happiness
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12
Q

Duration of PTSD or the disturbance has to last more than ____ month

A

1

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13
Q

What is the biology of PTSD

A
  1. Heightened autonomic system
  2. Diminished volumes of hippocampus and anterior cingulate cortex.
  3. Amygdala and dorsal anterior cingulate cortex are hyperresoponsive
  4. Hyporesponsive ventromedial prefrontal cortex (which inhibits amygdala)
  5. Lower neuroactive steroids allopregnanolone and pregnanolone
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14
Q

what are risk factors for PTSD

A
  1. Physical assault
  2. rape
  3. female gender
  4. low socioeconomic and educational levels
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15
Q

what is the prevalence of PTSD

A

6.8% of americans

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16
Q

what is the prognosis of PTSD

A

50% recover within 3 months

  • 1/3 ind’s had symptoms for over 60 months
  • median time to remission is about 25 months.
17
Q

what is treatment option for PTSD

A
  1. Psychotherapy:
    - Early intervention and prevention : supportive care and CBT
    - Trauma focused CBT (imagining drama happen again/virtually back in combat situation), prolonged exposure therapy, and cognitive processing therapy
    - eye movement desensitization and reprocessing
  2. Medication:
    - SSRI or SNRI
    - Prazosin (anti hypertensive)
    - Atypical antipsychotics?
    - Avoid benzodiazepines!
18
Q

What is the criteria for PTSD for 6 and younger?

A
  1. exposure to actual or threatened death, serious injury or sexual violence
  2. Persistent avoidance of stimuli: avoid activities, places or physical reminders of the event.
  3. Negative Alterations in Cognitions: Inc frequency of negative emotional states, socially withdrawn behavior
19
Q

What is the criteria for Acute Stress Disorder

A

exposure to actual or threatened death, serious injury or sexual violation in:

  1. directly experiencing the traumatic event.
  2. learning event occurred to close family member or close friend.
    * event must have been violent or accidental
20
Q

What are intrusion symptoms of Acute Stress Disorder

A
  1. recurrent, intrusive memories of event.
  2. recurrent dreams
  3. Flashbacks
  4. prolonged psychological distress or marked physiological reactions
21
Q

what are negative mood symptoms of acute stress disorder

A

inability to experience positive emotions

22
Q

what are dissociative symptoms of ASD

A
  1. Altered sense of reality of ones surroundings or oneself

2. Inability to reemeber an important aspect of the event due to dissociative amnesia

23
Q

what are avoidance symptoms

A
  1. efforts to avoid distressing memories, or feelings about the event.
  2. Effors to avoid external reminders
24
Q

what are arousal symptoms of ASD

A
  1. sleep disturbance
  2. irritable behavior and angry outbursts
  3. hypervigilance
  4. probe with concentration
  5. exaggerated startle response
25
Q

what is the duration of the disturbance in ASD

A

3 days to 1 month after trauma exposure.

26
Q

what are treatment options for ASD

A
  1. Psychotherapy: TF- CBT, hypnosis

2. Medication : non recommended

27
Q

what are adjustment disorders

A
  1. the dev of emotional or behavioral symptoms in response to an identifiable stressors occurring within 3 months o the onset of the stressor.
  2. marked distress that is out of proportion to the severity or intensity of the stressor
28
Q

what are treatment options for adjustment disorders

A
  1. psycotherapy:
    - Cognitive
    - Psychodynamic
    - Behavioral
    - Interpersonal
    - Mindfullness based
    - Exercise
    - Problem solving
    - Support groups
29
Q

what medication is used for adjustment disorders

A
  1. benzodiazepines (not for ASD or PTSD)
  2. Trazodone for insomnia
  3. Kava kava
30
Q

What are ex of “other specified trauma and stressor related disorder”

A
  1. adjustment like disorders with delayed onset of symptoms that occur more than 3 months after the stressor.
  2. Adjustment like disorders with prolonged duration of more than 6 months without prolonged duration of stressor
31
Q

When does the category of unspecified trauma and stressor related disorder occur

A

when there is insufficient info to make a more specific diagnosis such as in the ER.

Behavioral Medicine (13 decks)

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