Trauma & Stress-Related Disorders & Dissociative Disorders

Question 1

PTSD

Answer 1

• Anytime a trauma occurs, the potential to develop PTSD exists
• Feelings of helplessness/powerlessness
• S/S usually begin 1st 3 mnths after trauma; however there may be a delay of months

Question 2

PTSD Symptoms

Answer 2

• Incrd arousal
• Hyper alertness
• Numbing of emotions
• May see aggressie or bizarre behaviors
• Startled response
• Nightmares
• Drug/acohol use
• May experience flashbacks; re-experience the event

Question 3

Acute Stress Disorder (ASD)

Answer 3

• As a result of:
  > witnessing or experiencing a violent or gruesome death of or by an intimate
  > repeated exposure to aversive details of the event
  > EX: 1st responders who collect body parts, or police officers repeatedly exposed to details of child abuse

Question 4

ASD Symptoms

Answer 4

• Intrusive symptoms
• Dissociative symps
• Avoidance symps
• Arousal symps
• By definition, ASD resolves w/in 1 mnth

Question 5

PTSD vs ASD

Answer 5

• Similarity: same triggers (violent events or repeatedly witnessing violent or traumatic events) same or similar manis
• Difference: only ASD resolves w/in 1 mnth

Question 6

Compassion Fatigue

Answer 6

• Secondary Traumatic Stress
• Example of nurses who are at high risl include those who work in following departments & disciplines:
  > hospice
  > pediatrics
  > emergency
  > oncology
  > forensics
  > psychiatric

Question 7

Dissociative Disorders

Answer 7

• Depersonalization/Derealization Disorder
• Dissociative Amnesia
• Dissociative Amnesia w/ Fatigue
• Dissociative Identity Disorder (DID)

Question 8

Dissociative Disorders Hallmark Characteristics

Answer 8

• Disturbances in a noramlly well-integrated continum of consciousness, memory, identity, & perception
• Dissociation: the unconscious defense mech to protect an individual against overwhelmng anxiety
• Intact reality testing; is not delusional & not hallucinating
• Includes amnesiac states

Question 9

Depersonalization/Derealization Disorder

Answer 9

• Recurrent periods of feeling unreal, detached, outside the body, dreamlike, numb, or w/ a distorted sense of time or visual perception
• Reality testing remains intact
• Symptoms are not r/t medical condition or substance use

Question 10

Dissociative Amnesia

Answer 10

Psychologically induced memory loss & inability to recall important personal info after severe stressor

Question 11

Dissociative Amnesia w/ Fatigue

Answer 11

Sudden, unexpected travel from a customary locale, and the inability to recall one’s identity after a traumatic event

Question 12

Dissociative Identify Disorder

Answer 12

Formerly known as multiple personality disorder, which is the presence of 2 or more personality states tht control behavior

Question 13

PTSD Prediposing Factors

Answer 13

• Age at event
• Female
• Personal or family hx of psychiatric illnesses
• Education lvl
• Previous military service

Question 14

Acute Stress Disorder Predisposing Factor

Answer 14

Same precipitating traumatic events tht can cause PTSD

Question 15

Dissociative Disorders Predisposing Factors

Answer 15

• Children exposed to long term abuse
• Natural disasters, combat, other traumas
• Biologic & genetic factors

Question 16

Outcomes for PTSD

Answer 16

• Remain safe
• Receive treatment for cooccurring conditions
• Attend support groups
• Expand their social support network
• Exhibit an incr in restful sleep
• Have fewer nightmares & flashbacks
• Express dcrd irritability
• Demonstrate effective anxiety reduction techniques

Question 17

Dissociative Disorder Outcomes

Answer 17

• Pt will verbalize clear sense of personal identity
• Pt will report dcr in stress (scale of 1-10)
• Pt will report comfort w/ role expectations
• Pt will plan coping strategies for stressful situations
• Pt will refrain from injuring self