Trauma and Stressor-related disorders Flashcards
What are individual traumas/stressors?
- abuse
- illness
- victim of crime (robbery, etc.)
What are group traumas/stressors?
- War/terrrorist attack
- natural disaster
- community loss (death of prominent citizen)
What are the characteristics of stress/trauma?
- poor coping
- difficulty managing stress
- emotional difficulties
- difficulty resuming activities of daily life
- other symptoms: anxiety, insomnia, grief
What are psychiatric problems related to trauma/stress?
- adjustment disorder
- depression
- complicated grieving
- acute stress disorder
- posttraumatic stress disorder
- dissociative disorder
a disturbing pattern of behavior demonstrated by someone who has experienced, witnessed, or been confronted with a traumatic event such as a natural disaster, combat or an assault
PTSD
What occurs when a person is experiencing PTSD?
- Intense memories of the trauma
- Dreams/nightmares
- Flashbacks
- Intense, recurrent, intrusive thoughts
- Emotional numbing
- Increased irritability
- Hyperarousal
What are the three major elements of PTSD?
- Dreams or intrusive, recurrent thoughts of the trauma
- Emotional numbing (feeling detached from others)
- Hyperarousal (being on guard, irritable) symptoms that arise from high levels of anxiety, including insomnia, irritability, anger, outbursts, watchfulness, suspiciousness, and distrustfulness
event that occurred <3 months
acute stress disorders
event occurred >3 months ago
PTSD
- chronic in nature with periods of exacerbation during increased stress
- can lead to other psychiatric disorders such as depression, anxiety, and substance abuse.
PTSD
a group of symptoms, such as stress, feeling sad, or hopeless, and physical symptoms that occur following a stressful life event; the reaction is stronger than would be expected for the event that occurred
adjustment disorder
occur before the age of 5 years in response to the trauma of child abuse or neglect, called grossly pathogenic care. The child shows disturbed, inappropriate social relatedness in most situations.
Reactive attachment disorder (RAD) and Disinhibited social engagement disorder (DSED)
exhibits minimal social and emotional responses to others, lacks a positive affect, and may be sad, irritable, or afraid for no apparent reason
reactive attachment disorder
exhibits unselective socialization, allowing or tolerating social interaction with caregivers and strangers alike. They lack the hesitation in approaching or talking to strangers evident in most children their age
Disinhibited social engagement disorder (DSED)
Risk factors for PTSD
- Directly involved in the traumatic event
- Experiences of physical injury
- Loss of loved one(s)
- Lack of social supports
- Pervious psychiatric history or personality factors
Adolescents suffering from PTSD have increased risk for the following:
Suicide Substance abuse Poor social supports Academic problems Health concerns
What are some PTSD treatment options?
- Psychotherapy (individual or group)
- Medications (antidepressants, anxiolytics, sleep aids)
- Self-help groups
- Exposure therapy
- Relaxation techniques
- Adaptive disclosure
- Cognitive processing therapy
- Mental health promotion
A subconscious defense mechanism used to prevent recognition of a horrific or traumatic event
*** phenomena involves detachment from realit- rather than a loss of reality as in psychosis
dissociation
*This allows the person to forget or remove himself or herself from the painful situation or memory of the situation
dissociation
how is dissociation characterized?
Disruption in integration disorders use dissociation, a defense mechanism, pathologically and involuntarily
What are the types of dissociative disorders?
- Dissociative amnesia
- Dissociative identity disorder (formerly multiple personality disorder):
- Depersonalization/derealization disorder:
The client cannot remember important personal information
Dissociative amnesia
The client displays two or more distinct identities or personalities
Dissociative identity disorder (formerly multiple personality disorder)
The client has a persistent or recurrent feeling of being detached from his or her mental processes or body
Depersonalization/derealization disorder
Dissociative disorder leads to disturbance in the following
*Relationships
*Ability to function (activities of daily living)
*Ability to cope
People with PTSD often experience dissociative symptoms
Treatment options for dissociative disorder
Individual therapy
Group therapy
Focus in therapy is on reassociation
Medications (antidepressants, anxiolytics)
What are the goals of treatment for dissociative disorder?
- Improve quality of life
- Improve functional abilities
- Decrease symptoms
- Can range from passive to angry, frightened, agitated, hostile
- Experience nightmares, flashbacks, intrusive thoughts, hallucinations, self-destructive thoughts, fantasies
- memory gaps; poor decision making
dissociative disorder
What are the outcome goals for dissociative disorder?
- Refer to patient as “survivor” rather than “victim”
- Identification of flashback triggers
- Encourage journaling of feelings
- Utilize distractions and relaxation techniques
Maladaptive or Dysfunctional Personality Traits
Irresponsible, not accountable for own actions Risk-taking, thrill-seeking behaviors Mistrust Exhibitionism Dependency Eccentric perceptions Negative behavior toward others Anger and/or hostility Irritable/labile moods Lack of guilt, remorse or emotionally cold, and uncaring Impulsive, poor judgment
is characterized by a pervasive pattern of depressive cognitions and behaviors
depressive behavior
is characterized by a negative attitude and a pervasive pattern of passive resistance to demands for adequate social and occupational performance
passive-aggressive behavior
Temperament (harm avoidance, novelty seeking, reward dependence, persistence)
biologic theories
Character
Self-directedness (responsible, goal oriented)
Cooperativeness (integral part of society)
Self-transcendence (integral part of the universe)
Psychodynamic theories
