Reaction to stress Flashcards
adjustment disorder presentation
mood and/or anxiety symps out of proportion to original sressor and/ or which can disturb soacial or occupational function. suicidal ideation is common
adjustment disorder treatment
no treatment but can be useful to address underlying psychosocial stressors
dissociation defineition
a phenomenon where an aspect of a patients consciousness or cognition becomes separated from te rest of their personailty and functions independently and outside of voluntary control
dissociative disorders presentation
disruption to memoery, identity thoughts, emotions, movements, sensation or control of behaviour
derealisation defintion
feeling that external reality is unreal
depersonalisation def.
feeling yourself to be unreal
conditions that can cause DPDR
anxiety/ substance misuse
traumatic stressor def.
an event where a person feels their own of a loved ones, physical or psychological i seriously threated. outside of normal hman experience/ would be perceived as traumatic to most people
acute stress reaction presentation
- immeditaely after traumatic stressor
- disorientation, narrowing of attention, diminished responsiveness, psychomotor agitation and oversctivity, amnesia of the episode
- symptoms diminish after 24-48hrs , resolved within 3 days
- normal!
PTSD presentation
persistent re experienceing, remebering or reliving the stressor by flashbacks, vivid meories, recurring dreams and/ or distress caused by triggers.
actual or preffered avoidance of circustances resembling the stressor.
increases psychological sensistivity and aroudsal - diff falling asleep, startled, hypervigilance
pathophys of PTSD
- genetic - heritable, GABA, serotonin and noradrenaline, amygdal hyeractivation
- social and psychoogical - trauma particularly in childhood
assessmnet of PTSD
- explore nature, meaning and severity of stressor and reaction
- seek evidence of re experiencing, avoidance, increased sensitivity / degree of functional impairment
- investigate hx of head injury or epilepsy
- screen for subtance misuse , mood disorders, psychosis and personailty disorders
management of mild to mod PTSD
within 4 weeks of trauma - wait
over 4 weeks - psychological therapy - trauma focussed CBT or EMDR
mod to severe PTSD management
- trauma foccused CBT or EMDR
- 1st line SSRI - sertraline/SNRI venlafaxine
2nd line - augmenetation with SGA - risperidone/ quetipaine - signif sleep disturbance / nightmares - consider hypnotic z drug NOT BENZOS or alpha 1 blocker (prazosin)
