W6: Trauma & Stressor Related Disorders Flashcards
(31 cards)
What are some types of trauma and stressor related disorders
Post traumatic stress disorder PTSD
Acute stress disorder ASD
Complex post-traumatic stress disorder
What are some examples of trauma
Motor vehicle accidents sexual or nonsexual assault domestic violence natural disasters war terrorism
What aspects of traumatic events make it more likely to develop ASD or PTSD
The severity, duration and proximity of exposure to the trauma
Explain acute stress disorder
Post traumatic reactions in the first month after trauma
Has a similar symptom profile to PTSD apart from its greater emphasis on dissociation
What is a goal of diagnosing people with acute stress disorder
To assist in the identification of individuals who are at risk of developing PTSD this is based on the theoretical position that acute dissociation is a precursor to PTSD
What does the DSM say about acute stress disorder
Exposure to actual or threatened death, serious injury, or sexual violation, but either experience or witnessing the event, or learning of the event occurring to a close person
8 (3-31 days):
Intrusive memories that are recurrent or involuntary, Dreams of the event, dissociative reactions, intense or prolonged distress or physiological reactivity when exposed to cues, inability to perceive things as positive, altered sense or reality or self, inability to remember important aspects of the event, avoid internal reminders, avoid external reminders, sleep disturbance, hypervigilance, irritable or aggressive behaviour, exaggerated startle response, agitation or restlessness, concentration problems
What does the DSM say about PTSD (7)
Stressor
Intrusion symptoms
Avoidance
Negative alterations in cognitions and mood
Alterations in arousal and reactivity
Duration
Functional significance
Explain what the DSM says about the stressor in PTSD
The person was exposed to death, threatening death, actual or serious injury or sexual violence
This can be through direct exposure, witnessing it in person, indirectly through learning it happened to a close friend or relative or repeated or extreme in direct exposure via professional duties
Explain what the DSM says about intrusion symptoms in post-traumatic stress disorder
Need to of had one or more in the previous month
Recurrent involuntary and intrusive memories - in children these may be repetitive play
Traumatic nightmares
Dissociative reactions such as flashbacks which may occur on a continuing from brief episodes to a complete loss of consciousness - this is more than a memory they’re actually going back there in their mind
Intense or prolonged distress/physiological reactivity after exposure to a trauma reminder
Explain what the DSM says about avoidance in PTSD
It’s a persistent effort for avoidance of distressing trauma related stimuli after the event – only one is required
Trauma related thoughts or feelings through suppression maybe alcohol use
Trauma related external reminders such as people places conversations activities objects or situations
What does the DSM say about negative alterations in cognitions and mood in PTSD
They should have began or worse and after the trauma – and two are required
Inability to recall features of the traumatic event
Persistent negative beliefs of oneself and the world
Persistent distorted blame of self to others for causing the trauma or for the resulting consequences
Persistent negative trauma related emotions such as fear horror or guilt
Marked diminished interest in pre-traumatic activities
Feeling alienated from others
Constricted affect persistent inability to feel positive emotions
What does the DSM say about alterations in arousal and reactivity in PTSD
to have begin or worse and after the trauma and two are required
Irritable or aggressive behaviour
Self-destructive or reckless behaviour
Hypervigilant-high alert waiting for the next occurrence
Exaggerated startle response - high sympathetic nervous system activity
Problems with concentration
Sleep disturbance this is a result of hyper arousal or nightmares
What does the DSM say about the duration of PTSD
Persistence of symptoms for more than one month before one month it is considered acute stress disorder
What does the DSM say about the functional significance of PTSD
Significant symptoms related distress or functional impairment not due to medication, substance use or other illnesses
What is complex PTSD
Develops following exposure to an event or series of event of an extremely threatening or horrific nature most commonly prolonged or repetitive from which escape is difficult or impossible
All of the diagnostic requirements for PTSD are met but also:
Problems in affect regulation
Beliefs about oneself as diminished, defeated or worthless, accompanied by feelings of shame, guilt or failure related to the traumatic event
Difficulties in sustaining relationships and feeling close to others
What is the main difference between PTSD and complex PTSD
PTSD is one distinct event over a small time but complex PTSD is experiencing several events over the years that gradually accumulate the symptoms are often more severe
What is the most effective type of treatment for trauma based disorders
Trauma focused CBT
What are the goals of trauma focused CBT
Help with the individual to recognise and accept that they are not responsible for the trauma
To decrease the person sense of shame
Reduce symptoms related to or triggered by the trauma
Assist the person improving all areas of functioning that were affected by the trauma
To lessen any maladaptive behaviours connected to the trauma
To help Mend and strengthen relationships including communication and attachment
Trauma focused cognitive behavioural therapy has several main components. These components are represented by using an acronym -what is the acronym and what do the letters stand for?
PRACTICE
Psychoeducation - This can be powerful it gives some information about what they are experiencing
Relaxation methods - Directly addressing physiological arousal
Affective expression and regulation skills
Cognitive coping skills and processing - cognitive restructuring
Trauma narrative and processing
In Vivo exposure - exposure therapy
Conjoint therapy sessions - with significant others
Enhancing personal safety and future growth - setting goals for living fully and functioning
What does EMDR stand for
Eye movement desensitisation and reprocessing
What is the focus of EMDR?
It focuses directly on the memory and is intended to change the way the memory stored in the brain
Can anyone lead EMDR sessions
No it requires a very specific certification training otherwise you can do way more harm than good
EMDR uses a structured eight phase approach that includes:
1: history taking
2: preparing the client (psychoeducation)
3: assessing the target memory
4-7: processing the memory to adaptive resolution - holding memory in mind and hearing tones and tapping to move it into LTM(moving away from it being depressive)
8: evaluating treatment results
What does EMDR not include
Extended exposure to the distressing memory, detailed descriptions of the trauma, challenging of dysfunctional beliefs or homework assignments
