Trauma Ralated Stressor Disorder

Question 0

These are disorders in which exposure to
a traumatic or stressful event is listed explicitly as a diagnostic criterion including reactive attachment disorder, disinhibited social engagement disorder, posttraumatic stress disor­der (PTSD), acute stress disorder, and adjustment disorders

Answer 0

Trauma and Stressor Related Disorder

Question 1

Why does Trauma and Stressor Related Disorders were categorized separately from anxiety disorders?

Answer 1

Because many individuals who have been exposed to a traumatic or stressful event exhibit a phenotype in which, rather than anxiety- or fear-based symp­toms, the most prominent clinical characteristics are anhedonic and dysphoric symptoms, externalizing angry and aggressive symptoms, or dissociative symptoms.

Question 2

It is characterized by a pattern of markedly disturbed and developmentally inappropriate attachment behaviors, in which a child rarely or minimally turns preferentially to an attachment figure for comfort, support, protection, and nurturance. The essential feature is absent or grossly underdeveloped at­tachment between the child and putative caregiving adults.

Answer 2

Reactive attachment disorder of infancy or early childhood

Question 3

Key features of reactive attachment disorder with regards comfort seeking and response to comforting behaviors.

Answer 3

When distressed, they show no consistent
effort to obtain comfort, support, nurturance, or protection from caregivers and they do not respond more than minimally to com­forting efforts of caregivers.

Question 4

Whyy does reactive attachment disorder diagnosed only for children of at least 9 months old?

Answer 4

A diagnosis of reactive attachment disorder should not be

made in children who are developmentally unable to form selective attachments.

Question 5

What is the diagnostic requirement for children wit reactive attachment disorder?

Answer 5

Serious social neglect

Question 6

How does children with reactive attachment disoder differ from other children?

Answer 6

Children with reactive attachment disorder show lack of preferred attachment despite having attained a developmental age of at least 9 months.

Question 7

Essential feature of disinbited social engagement disorder

Answer 7

The essential feature of disinhibited social engagement disorder is a pattern of behavior that involves culturally inappropriate, overly familiar behavior with relative strangers.

Question 8

How does symptom of disinhibited social engagement disorder manifest in middle childhood?

Answer 8

In middle childhood, clinical features manifest as

verbal and physical overfamiliarity as well as inauthentic expression of emotions.

Question 9

Key feature of adjustment disorder

Answer 9

The presence of emotional or behavioral symptoms in response to an identifiable stressor is the essential feature of adjustment disorders.

Question 10

Essential Feature of PTSD

Answer 10

The essential feature of posttraumatic stress disorder (PTSD) is the development of char­acteristic symptoms following exposure to one or more traumatic events.

Question 11

What are the various clinical presentation of PTSD?

Answer 11

In some individuals, fear-based re-experiencing, emotional, and behavioral symptoms may predominate. In others, anhedonic or dysphoric mood states and negative cognitions may be most distressing. In some other individuals, arousal and reactive-externalizing symptoms are prominent, while in others, dissociative symptoms predominate. Finally, some individuals exhibit combina­tions of these symptom patterns.

Question 12

Exposure to traumatic events or criterion A of PTSD involves?

Answer 12

1. Directly experiencing the traumatic event(s).
2. Witnessing, in person, the event(s) as it occurred to others.
3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.
4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains: police officers repeatedly exposed to details of child abuse).

Question 13

What are the the intrusion symptoms of PTSD?

Answer 13

1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).
2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).
3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.)
4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
5. Marked physiological reactions to internal or external cues that symbolize or re­semble an aspect of the traumatic event(s).

Question 14

What are the avoidance symptoms of PTSD?

Answer 14

1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feel­ings about or closely associated with the traumatic event(s).

Question 15

What are the arousal and reactivity symptoms of PTSD?

Answer 15

1. Irritable behavior and angry outbursts (with little or no provocation) typically ex­pressed as verbal or physical aggression toward people or objects.
2. Reckless or self-destructive behavior.
3. Hypervigilance.
4. Exaggerated startle response.
5. Problems with concentration.
6. Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

Question 16

It is the persistent or recurrent experiences of feeling detached from,
and as if one were an outside observer of, one’s mental processes or body (e.g., feeling as though one were in a dream; feeling a sense of unreality of self or body or of time moving slowly).

Answer 16

Depersonalization

Question 17

It is the persistent or recurrent experiences of unreality of surroundings (e.g., the world around the individual is experienced as unreal, dreamlike, distant, or distorted).

Answer 17

Derealization

Question 18

How does intrusion in PTSD differs from depressive rumination?

Answer 18

Intrusive recollections in PTSD are distinguished from depressive rumination in that they apply only to involuntary and intrusive distressing memories. The emphasis is on recurrent memories of the event that usually include sensory, emotional, or physiological behavioral components.

Question 19

A PTSD where some symptoms typically appear immediately and that the delay is in meeting full criteria.

Answer 19

Delayed Expression PTSD

Question 20

What are the temperamental pretraumatic factors of PTSD?

Answer 20

These include childhood emotional problems by age 6 years (e.g., prior
traumatic exposure, externalizing or anxiety problems) and prior mental disorders (e.g., panic disorder, depressive disorder, PTSD, or obsessive-compulsive disorder [OCD]).

Question 21

Pretraumatic Environmental Factors of PTSD

Answer 21

These include lower socioeconomic status; lower education; exposure to prior trauma (especially during childhood); childhood adversity (e.g., economic depriva­tion, family dysfunction, parental separation or death); cultural characteristics (e.g., fatal­istic or self-blaming coping strategies); lower intelligence; minority racial/ ethnic status; and a family psychiatric history. Social support prior to event exposure is protective.

Question 22

Peritraumatic Environmental Factors of PTSD

Answer 22

These include severity (dose) of the trauma (the greater the magnitude
of trauma, the greater the likelihood of PTSD), perceived life threat, personal injury, in­terpersonal violence (particularly trauma perpetrated by a caregiver or involving a wit­nessed threat to a caregiver in children), and, for military personnel, being a perpetrator, witnessing atrocities, or killing the enemy. Finally, dissociation that occurs during the trauma
and persists afterward is a risk factor.

Question 23

Postraumatic Factors of PTSD

Answer 23

These include negative appraisals, inappropriate coping strategies,
and development of acute stress disorder, subsequent exposure to repeated upsetting reminders, subsequent adverse life events, and financial or other trauma-related losses. Social support (includ­ing family stability, for children) is a protective factor that moderates outcome after trauma.

Question 24

What are the disorders included in TSRD?

Answer 24

Reactive Attachment Disorder (RAD)
Disinhibited Social Engagement Disorder (DSED)
Posttraumatic Stress Disorder (PTSD)
Acute Stress Disorder (ASD),
Adjustment Disorders
Other specified trauma-and stressor-related disorders
Unspecified trauma- and stressor-related disorder.

Question 25

How long does normative trauma last?

Answer 25

two to three days

Question 26

In the trauma- and stressor-related disorders, anxiety may

ormaynotbepresent.True or False?

Answer 26

True