Trauma and stressor-related disorders Flashcards
definition: reactive attachment disorder
A - pattern of inhibited and emotional withdrawn behavior toward adult (not seeking care when distressed)
B - persistent social and emotinoal disturbance characterized by
C - child has experienced extremes of insufficient care as evidenced by
D - disturbances in (A) began after lack of adequate care in (C)
definition: disinhibited social engagement disorder
A - child actively approaches and interacts with unfamiliar adults and exhibits 2 or more of:
- lack of reticence in approaching unfamiliar adults
- overly familiar verbal or physical behavior
- diminished checking with adult caregiver after venturing away
- willingness to go off with unfamiliar adult with no hesitation
B - behaviors in A not limited to impulsivity
C - child has experienced extremes of insufficient care as evidenced by
D - disturbances in A began after lack of adequate care in C
what is the treatment of reactive attachment and disinhibited social engagement disorders?
- first ascertaining whether child can be kept safe in house
- family therapy focused on developing appropriate parenting skills and increasing positive bonding interactions
- pyschosocial interventions to address unmet basic needs in family
what are the criteria for PTSD diagnosis?
- exposure to actual or threatened death, serious injury, or sexual violence
- intrusion symptoms associated with, and beginning after, an event
- persistent avoidance of stimuli associated with event
- negative alterations in cognitions and mood
- alterations in arousal and reactivity
- duration over 1 month
multiple symptoms needed in all categories needed for diagnosis
what are the dissociative symptoms associated with PTSD?
- depersonalization
- derealization
50% of PTSD patients have remission within what time frame?
3-12 months
what are the psychotherapy treatment options for PTSD?
- trauma-focused CBT (first line)
- re-exposure to traumatic memories is the bedrock, but exposure must be therapeutic (goal is to extinguish link between trauma-related stimuli and the fear response)
what are the psychotherapy options for PTSD?
- SSRIs / SNRIs (first line)
- prazosin (a1 blocker) for reducing nightmares
- AVOID benzos
what is the central characteristic of complex PTSD?
chronic trauma involving totalitarian control for an extended time period (months to years)
what is acute distress disorder?
the symptoms / events that lead to PTSD
definition: adjustment disorders
- emotional or behavioral symptoms in response to an identifiable stressor occurring within 3 months of stressor’s onset
what are the symptoms in adjustment disorder?
- distress out of proportion to the severity or intensity of the stressor
- impairment in social, work, and other important areas
- not indicative of normal bereavement
- symptoms resolve within 6 months of when stressor ends
what is the treatment of choice for adjustment disorders?
psychotherapy
definition: BASK model of dissociation
separation of the normal connection between:
- behavior
- affect
- sensation
- knowledge
definition: dissociative identity disorder
- disruption of identity - 2 or more personality states involving discontinuity in sense of self and agency, and accompanied by related alterations in affect, consciousness, memory, perception, cognition, and/or sensory motor function
- gaps in recall of events, personal info, and/or traumatic events, not ordinary forgetting
- distress and/or impairment across one’s life
- not a normal part of accepted cultural or religious practices
