5. TSRDs & Somatic Disorders Flashcards
Where does trauma stem from? (3)
- poor upbringing
- early childhood trauma
- stress (can’t get PTSD from watching the news Noori)
Reactive Attachment Disorder (RAD)
Consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, where rarely or minimally:
- Seeking comfort when distressed
- Responding to comfort
What is the developmental age RAD presents?
> 9 months
At what age is RAD prevalent
prevalent BEFORE age 5
Disinhibited Social Engagement Disorder (DSED)
Behavior pattern where child actively approaches and interacts with unfamiliar adults and has at least 2 of:
- Reduced or absent reticence in approaching and interacting
- Overly familiar verbal or physical behavior (not age-appropriate or culturally consistent
- Diminished or absent checking back w/ adult
- Willingness to go off w/ unknown adult without hesitation
Adjustment disorders
Development of emotional or behavioral symptoms to an identifiable stressor(s) occurring within 3 months of onset
Symptoms of adjustment disorders are clinically significant when ____________ (5)
- Marked by disproportionate distress to severity of stressor (taking into account external and cultural factors)
- Significant impairment in social, occupational, or other important areas of functioning
- Disturbance doesn’t meet criteria for other mental disorder or re-occurrence of old
- Not normal bereavement
- Does not persist more than 6 months post-symptom resolution
Acute Stress Disorder (ASD)
Exposure to actual or threatened death, serious injury, or sexual violation in one or more of:
- Direct experience
- Direct witness
- Learning event happened to close family or friend (violent or accidental)
- Repeated or extreme exposure to aversive details (not via media, TV, pics, or movies unless work related)
Criteria for ASD
Presence of 9 or more of criteria from 5 major categories which begin or worsen after trauma exposure (14 total)
- Intrusion symptoms (4)
- Negative mood (1)
- Dissociative symptoms (2)
- Avoidance symptoms (2)
- Arousal symptoms (5)
What is the duration for ASD?
3 days to 1 month after exposure (after 1 month passes, it is PTSD critical)
T/F: PTSD is age dependent
True! Adults, adolescents, children over 6; children under 6 rare
PTSD
Exposure to actual or threatened death, serious injury, or sexual violence in 1 or more of:
- Direct exposure
- In-person witness
- Learning close family or friend affected
- Experiencing repeated or extreme exposure
What are some key differences between PTSD vs. ASD?
PTSD:
- Diagnosed after 1 month
- Does not include a dissociative symptom cluster
- Can develop from untreated ASD
- Has long-term effects and is more difficult to treat
ASD:
- Diagnosed within 3-30 days of a traumatic event
- Includes a dissociative symptom cluster
- Can lead to PTSD if left untreated
- Easier to treat
For PTSD, how long is the duration of disturbance from previous criteria?
More than 1 month
T/F: PTSD is not highly comorbid
FALSE! It is highly comorbid.
What are some dissociative symptoms associated with PTSD?
- Depersonalization (“out-of-body” recurring experiences
2. Derealization (“dreamlike”, “distant”, “distorted”)
What is delayed expression?
Add-on to PTSD
Full diagnostic criteria = 6 months after event
Onset and expression of some symptoms immediate
What is the evolution of PTSD?
WW1, Vietnam, Classrooms
PTSD prevalence in adolescents
- 2010 National Comorbidity Survey - Adolescent
- F > M (8%/2.3%)
- Total = 5%
- Severe impairment = 1.5%
PTSD in Africa
- S. Africa Study showed 3.2% prevalence
- Other regions vary (20-80%)
Other specified TSRDs
- Persistent complex bereavement disorder
- Adjustment-like disorders presenting 3 months after initial stressor
- Adjustment-like disorders 6 months+ without stressor duration
When is something characterized as unspecified?
In emergency settings where proper diagnosis cannot be given immediately
Somatic Symptom Disorder
- New classification
- Specifiers: severity, persistent, predominant pain
Illness Anxiety Disorder
- New hypochondriasis
- Care seeking vs. avoidant
- Worry having or acquiring serious illness
