9. Specific Disorders - Trauma and Stressor-Related Disorders Flashcards Preview

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According to the DSM-5, what are the trauma and stressor related disorders?

1. Reactive Attachment Disorder
2. Disinhibited Social Engagement Disorder
3. Posttraumatic Stress Disorder (Includes PTSD for children 6 Years and Younger)
4. Acute Stress Disorder
5. Adjustment Disorders
6. Other Specified Trauma and Stressor Related Disorder
7. Unspecified Trauma and Stressor Related Disorder


What is the essential diagnostic feature of PTSD?

The development of characteristic symptoms following exposure to one or more traumatic events.

Note - Emotional reactions to the traumatic event (e.g., fear, helplessness, horror) are no longer part of criterion A.


What are the diagnostic criteria for PTSD in adults?

*List is not exhaustive, please see p. 271 for review

A. Exposure to actual or threatened death, serious injury, or sexual injury in one or more way (see page 271 to review).
Note, doesn't include exposure through media unless
its work related.

B. Symptoms associated with the traumatic event (again see 271, but the gist is distressing memories, distressing dreams, dissociative reactions, distress via cues/reminders, marked physiological reactions)

C. Avoidance of stimuli associated with traumatic events

D. Negative alterations in cognitions and mood associated with the traumatic events worsening after the events occurred

E. Marked alterations in arousal and reactivity associated with the traumatic events

F. Duration of B, C, D, and E of more than 1 month

G. Clinically significant stress or impairment in social, occupational, or other important areas of functioning

H. Not due to the physiological effects of a substance or another medical condition


What is depersonalization?

Feeling detached from or like an outside observer of one's mental processes or body.


What is derealization?

Feeling like one's external surroundings are unreal, dreamlike, distant, or distorted.


Summarize the prevalence of PTSD in the U.S.

Projective lifetime risk for PTSD at 75 is 8.7%

12-month prevalence among all adults is about 3.5%

High among veterans, medical first responders, police, firefighters, etc.

Higher among U.S. Latinos, African Americans, and American Indians. Lower among Asian Americans.


How are risk and prognostic factors typically divided for PTSD?

Pretraumatic, peritraumatic, and posttraumatic factors.


Is PTSD more prevalent in males or females?

Across the lifespan, females. They also experience symptoms for a longer duration than do males.


What is important to know about differential diagnosis of PTSD?

Adjustment Disorders - Use when the response to a stressor that meets PTSD criterion A does not meet other PTSD criteria or criteria for another mental disorder. Also diagnosed when the symptom pattern of PTSD does not meet criterion A.

Acute stress disorder - Restricted to 3 day to 1 month following exposure to the traumatic event


What is know about the co-morbidity of PTSD?

Individuals with PTSD are 80% more likely than those without PTSD to have symptoms that meet criteria for another disorder.

Comorbid substance use disorder and conduct disorder are more common among males.

In children, co-morbidity with oppositional defiant disorder and separation anxiety disorder dominates.

In veterans recently deployed to wars in Afghanistan occurrence of PTSD and mild TBI is 48%

Overlap between PTSD and major neurocognitive disorder.


What is the diagnostic criteria for adjustment disorder (286)?

A. The development of emotional or behavior symptoms in response to identifiable stressors occurring within 3 months of the onset of the stressors.

B. Symptoms or behaviors are clinically significant, based on either clinically significant impairment or out of proportion distress.

C. Doesn't meet criteria for another mental disorder

D. Not normal bereavement

E. Once the stressor and its consequences have terminated, the symptoms don't persist for and additional 6 months