Trauma & Stressor-related Disorders Flashcards
Stressor
Any situation or event that requires an individual to make adjustments
Uncomplicated bereavement
Not a mental disorder
-Rx with a hypnotic and psychoeducation
Adjustment Disorder
Stressor triggers marked/disproportional emotional and/or behavioural Sx
-starts within 3mo of stressor (continues no longer than 6mo)
Adjustment disorder specifiers
- with depressed mood
- with anxiety
- with mixed anxiety and depressed mood
- with disturbance of conduct
- with mixed disturbance of emotions and conduct
Dissociation definition
Disruption of functions of the mind that are normally integrated
- consciousness
- memory
- identity
- emotion
- perception
- body representation
- motor control
- behavior
PTSD
Stressor/traumatic event threatening life or limb that triggers intrusive Sx regarding the trauma for >1mo
- persistent avoidance of reminders of trauma
- negative changes in cognition and mood
- marked changed in arousal and reactivity
- impaired functioning or significant distress
Intrusion symptoms
About the traumatic event
- recurrent, involuntary, intrusive memories
- nightmares about event
- dissociative reactions
- intense/prolonged psychological distress on exposure to reminders
- marked physiological reactions on exposure to reminders
PTSD specifiers
- with dissociative Sx (either or both depersonalisation and derealisation)
- with delayed expression (>6mo to meet full criteria)
PTSD negative alterations in cognition and mood
- dissociative amnesia about event
- detachment or estrangement
- persistent negative beliefs/expectations about self
- persistent distorted cognitions about cause/consequence of event
- persistent negative emotional state
- markedly reduced interest or participation
PTSD arousal and reactivity
- irritable
- reckless or self-destructive
- hypervigilance
- exaggerated startle response
- problems with concentration
- sleep disturbance
PTSD Mx
- Risk assessment
- In-pt or out-pt
- Psychoeducation (don’t avoid, stay away from substances)
- Biological Rx: SSRI
- Psychological: CBT, EMDR (eye movement desensitization and reprocessing)
- Whom to involve (supportive fam and friends)
- Whom to refer to (psychiatrist, psychologist, SW)
- Follow up - 1w, then 4wkly until at psychiatrist
Acute Stress Disorder
Stressor/traumatic event threatening life or limb that triggers a variety of Sx for more than 3d but <1mo
ASD Sx
- persistent avoidance of reminders of trauma
- negative changes in cognition and mood
- marked changes in arousal and reactivity
- dissociative Sx
- impaired functioning or significant distress
ASD Mx
- Risk assessment
- in-pt or out-pt
- Biological Rx: of little importance, sometimes briefly with hypnotics
- Psychosocial Rx: psychoeducation
- don’t avoid
- no alcohol/sedatives
- encourage tolerable confrontation (discussion with confidents, confrontation with scene etc) - Involve? Fam/friends
- Follow up regularly (watch for complications
- Refer if needed
