Week 13; psychiatrische problemen in adolescentie

Question 1

What are chronic trauma’s?

Answer 1

Sexual abuse, domestic violence, neglect and maltreatment.

Question 2

What are the 5 DSM-5 criteria for PTSD?

Answer 2

A. Exposure to threatened or actual death, serious injury or violence. Can be directly experienced, seen happening with others, get to know that a loved one experienced it or experiencing extreme exposure to aversive details of the traumatic event.
B. Intrusion symptoms: dreams, intrasive memories, dissociative reactions.
C. Avoidance: talking about it or everything that is associated with it.
D. Negative alterations in cognitions: negative thoughts about self, others or the world. Self-blame, destorted coginitions about the cause.
E. Alterations in arousal and reactivity: Irritable, reckless, self-destructive, exaggarated startle response.

Question 3

What is different in the DSM-5 criteria for PTSD in children <6yr?

Answer 3

A. Almost the same, more emphasis on caregiver/parents.
B. Almost the same: more reenactive play.
C. =C+D. Almost same: constriction of play, socially withdrawn, less expression of positive emotions.
D. =E. Is the same.

Question 4

What are the manifestations of trauma in Toddler/daycare, primary school age and adolescents?

Answer 4

Toddler/ daycare: confusion, because of difficulty to explain themselves. Fears like seperation anxiety. Reenactive play, constrictive play. Destructive or agressive behavior.
Primary school age: concentration problems. Severe worries about own and others safety. Reenactive play or in drawings or vocabulary. Agressive or fearful thoughts.
Adolescents: More problems at school. Shame of feeling vulnerable. Extreme behaviour changes. Thrill seeking. Alcohol and drug abuse.

Question 5

What is complex trauma?

Answer 5

Multiple and or severe and persasive traumatic events. Mostly of an invasive interpersonal nature. A wide ranging, long term impact.
Is not in DSM-5, no good tools for screening.

Question 6

What is the prevalence of:

• Traumatic events <18 years
• Child abuse and neglect
• Child PTSS
• interpersonal trauma

Answer 6

• 25-65%
• 1/30
• 10-35%
• 25%

Question 7

What are the phases of PTSD intervention in children?

Answer 7

1. Safety
2. Stabilization and motivation
3. Treating trauma
4. Sharing and bonding.

Question 8

Interventions that can be done are:

Answer 8

PCIT: parents learn what to say to their child, be responsive.
MST-CAN: multidiciplinary team that visits 3x a week
EMDR: Activation of neural network; have to think hard about the trauma. At the same time the psychologist will make movements before the eye, which the child has to follow. Because the brains are overstimulated, the emotions that are attached to the experience will decrease.

Question 9

What are effects of processing the trauma?

Answer 9

1. Disensitation: Trauma narrative loses its emotional charge, images become less horrible.
2. Narrative: it gives children a narrative, with beginning and an end.
3. Widening perspective: MAkes them curious what the answers are, open for different views.
4. Negative cognitions are replaced by positive ones.
5. Growth