Unit 6 Trauma and Stress Related Disassociate Disorders Chapter 16 Flashcards
What type of incidents is an example of trauma?
- Witnessing murder
- witnessing death
- physical assault
- combat (veterans)
- sexual abuse
- accidents (plane, car)
- natural disasters
- child abuse
What is the #1 treatment for patients who have PTSD?
A. Operational conditioning therapy
B. Trauma focused cognitive behavioral therapy
C.Eye movement desensitization and reprocessing (EMDR)
D. Cognitive Behavioral Therapy
C.Eye movement desensitization and reprocessing (EMDR)
FROM BOOK
-eye movement desensitization and reprocessing (EMDR) therapy as first-line treatments for the treatment of traumatized children
This method involves moving your eyes a specific way while you process traumatic memories. EMDR’s goal is to help you heal from trauma or other distressing life experiences.
Name 2 Trauma associative disorder
- Posttraumatic stress disorder (PTSD)
- Acute stress disorder
- Adjustment disorder
Attachment Disorders - Reactive attachment disorder
-Disinhibited social engagement disorder
What type of traumas are associated with Dissociative disorders?
- Dissociative amnesia *Depersonalization/derealization disorder
- Dissociative identity disorder(2 personalities)
Which of the following behavior of a 6 year old child is associated with Reactive attachment disorder?
A. The child exhibits clingy behavior to parent.
B. The child exhibits emotional withdrawn behavior from parents.
C. The child seeks consolation from parents when crying
D. The child trust his parents
B. The child exhibits withdrawn behavior from parents.
Children with reactive attachment disorder have a consistent pattern of inhibited and emotionally with- drawn behavior. The child rarely seeks comfort or responds to comfort with adult caregivers when distressed.
Which of the following behavior of a 6 year old child is associated with Disinhibited social engagement disorder.?
A. The child exhibits no fear of strangers and is extremely friendly.
B. The child exhibits emotional withdrawn behavior from parents.
C. The child does not seek consolation from parents when crying.
D. The child does not trust his parents.
disinhibited social engagement disorder.
A. The child exhibits no fear of strangers and is extremely friendly.
Children with this disorder demonstrate no normal fear of strangers. They seem to be unfazed in response to separation from a primary caregiver. Younger children may allow unfamiliar people to pick them up, feed them, or play with them. These children tend to be overly friendly and are usually willing, or even eager, to go with someone they do not know.
What is the treatment plan for Attachment Disorders
*Treatment always involves both the child and the caregivers in individual and family therapy.
* A primary goal of care is to strengthen the relationship between the child and caregiver.
*A safe and stable living environment is also essential to improving attachment behaviors.
Risk factors for Attachment disorders
*Risk factors for attachment disorder include institutional living situations, as previously discussed.
*Frequently changing foster homes or experiencing shifts in primary caregivers also puts a child at risk.
*Impaired parenting due to severe psychiat- ric problems, criminal behavior, or substance use disorders also disrupts essential bonding experiences.
*Prolonged separation from caregivers or parents due to such events as extended hospitalization also puts children at risk for attachment disorders.
*Without treatment, attachment disorders may have lifelong consequences, including lack of trust or not feeling secure in friendships and partnerships.
What are types of Child abuse?
Experience traumatic events w/o the strength and coping mechanisms to
defend themselves
Those abused and neglected by caretakers/adults are at great risk for
developing physical and psychological problems.
Neglect – Ingestion of medication (overdose), not providing medical care,
unfit living environment
Physical abuse – physical injury
Sexual abuse – forcing a child to witness, act, fondle and/or sexual
intercourse
Those who have experienced abuse, are at risk for abusing others.
Who is the #1 Perputrator of Child Abuse?
A. Mother
B. Relative
C. Baby sitter
D. Grandparents
A. Mother
Post Traumatic Stress Disorder criteria according to the DSM-5
Exposure to actual or threatened death, serious injury, or sexual
violence in one or more of the following ways:
Directly experiencing, witnessing, learning of the event ,
The even must have been violent ,accidental, with threat of perceived
death
Repeated or extreme exposure
Intrusion symptoms associate with traumatic event
Persistent avoidance of stimuli associated with the trauma
Negative alterations in cognitions and mood associated with the
traumatic events
Alterations in arousal and reactivity(vets with fireworks [{{hyperactivity{{
How is Post Traumatic Stress Disorder manifested in children?
Posttraumatic stress disorder (PTSD) in preschool children may manifest as a reduction in play—play that includes aspects of the traumatic event, social withdrawal, and negative emo- tions such as fear, guilt, anger, horror, sadness, shame, or con- fusion.
How is PTSD mainly manifested in children?
A. increase in play with friends
B. reduction in play with friends or family
C. Social inclination
D. excitability
B. reduction in play with friends or family
Posttraumatic stress disorder (PTSD) in preschool children may manifest as a reduction in play—play that includes aspects of the traumatic event, social withdrawal, and negative emotions such as fear, guilt, anger, horror, sadness, shame, or con-fusion.
Children may blame themselves for the traumatic event.
In addition, there may be a feeling of detachment or estrangement from others and diminished interest or participation in significant activities. Often, there is irritability, aggressive or self-destructive behavior, sleep disturbances(NIGHTMARES), problems concentrating, and hypervigilance.
What is they key idea of the Attachment Theory
Attachment Theory - the theory describes
the importance and the dynamics of the
infant : caregiver relationship and how this
early relationship can affect the individual
throughout their life. (positively and
negatively.
Influences Reactive Detachment Disorder and Disinhibited Social Engagement
Which of the following is a protective factor when it comes to stress?
A. a 12 year old child without friends.
B. A 9 year old son who has a close relationship with his mother.
C. a patient who has undergone a crisis with no family support
D. A child with mono phobia
B. A 9 year old son who has a close relationship with his mother.
External (environmental) factors can support or add more stress
Parental Modeling
Cultural expectations
Stabile/Nurturing Environment vs Chaotic/Non-nurturing
Adverse Childhood experiences
Resilience
S/S of PTSD FOR CHILDREN
Collecting Data - Interviewing, observing, screenings, interacting
History from multiple sources
Assessing for posttraumatic symptoms:
Nightmares
Night terrors
Hallucinations
Intrusive Traumatic thoughts and memories
Reexperiencing or flashbacks of trauma
Traumatic reenactments in play
Self-injurious behaviors
Dramatic Mood swings, rage, numbing, avoidance
Somatic Symptoms – headache, stomachache
What medication is used to treat nightmares with patients with PTSD?
A. Alprazolam
B. Buspirone
C. Prazosine
D. Amtriptiline
C. Prazosine
Interventions for Children with PTSD
Establish trust and safety through a therapeutic relationship
Use developmental language and teaching tools
Pharmacotherapy (SSRI)
Usually accompanies therapy – best results
Advanced Practice
Eye Movement Desensitization and Reprocessing (EMDR)
Cognitive Behavioral Therapy
Trauma Focused Cognitive Behavioral Therapy
How would you evaluate the treatment and interventions are effective in PTSD?
Treatment is effective when..
The child’s safety is maintained.
Anxiety has been reduced and stress is handled in a healthy way.
Emotions and behavior are appropriate.
The child achieves normal developmental milestones for age
The child can seek out adults for nurturing and help when needed.
PTSD IN Adults
Persistent, reexperiencing of a highly traumatic event that involves actual or
threatened death or serious injury to self or others – individual responds with
intense fear, helplessness or horror.
Might be brought on by indirect exposure – loved one has terminal cancer
First responders – repeated or extreme exposure to trauma
Examples of PTSD-inducing events include:
* Military combat, prisoner-of-war experience, or being taken
hostage
* Crime-related events, such as bombing, assault, mugging, or
rape
* Natural disasters, such as floods, tornadoes, and earthquakes
* Human disasters, such as automobile, airline, and train accidents
What is Flashbacks according to PTSD
. Re-experiencing the trauma through recurrent intrusive rec- ollections of the event or dreams about the event. Flashbacks are dissociative experiences during which the event is relived
along with vivid sensory input.
What is Avoidance according to PTSD
Avoidance of stimuli associated with the trauma, causing the
individual to avoid talking about the event or avoid activities, people, or places that arouse memories of the trauma. This avoidance is accompanied by feelings of detachment, emptiness, and numbing.
What is Hypervigilance according to PTSD
Persistent symptoms of increased arousal, as evidenced
by irritability, difficulty sleeping, difficulty concentrating,
hypervigilance, or exaggerated startle response.
** What is Alterations in mood according to PTSD**
Alterations in mood, such as chronic depression, negative appraisals, and lack of interest in previously pleasurable
activities (APA, 2013).
