Clinical Approach to Trauma

Question 1

consistent pattern of inhibited emotionally withdrawn behavior toward an adult caregiver

doesn’t seek comfort when in distress and doesn’t respond well to comfort when distresses

little emotional responsiveness to others

little positive affect like smiling

episodes of irritability/sadness/fearfulness for no reason

Answer 1

reactive attachment disorder

(a child who doesn’t like to be consoled, frowns, is sad, and cant respond to other peoples emotions and actions esp. to an adult.)- flat affect

(birth -3 y/o) - neglect vs violence (PTSD)

Question 2

how do you develop reactive attachment disorder (3)

Answer 2

from experiences patterns of extreme insufficient care

1. social neglect/deprivation of basic needs
2. changes in primary providers (foster care)
3. in places where formation of selective attachments is limited (high child to caregiver ratio)

Question 3

person exposed to PERCEIVED traumatic event in which both are present: experienced/witness actual or threatened death/injury/integrity of self or others

Answer 3

PTSD

Question 4

people with PTSD can _ the traumatic event

can _ stimuli associated with trauma

have symptoms of _ arousal such as difficulty sleeping, irritability, difficulty concentrating.

Answer 4

re-experience

avoid

increased/hyper

Question 5

what are some symptoms of negative cognitions associated with PTSD

Answer 5

distorted blame of self or others

isolation

diminished interest in activities

inability to remember key aspects of the event

Question 6

what are the neurological abnormalities in PTSD

Answer 6

increase HPA axis (CRF and cortisol) leading to increase HR, BP, and disrupted sleep)

Increased amygdala stimulation (fear/anxiety)

decreased PFC and hippocampus (memories)

increased neurotransmitters (norepinephrine, dopamine, opioids)

Question 7

what are the neurological abnormalities in PTSD

Answer 7

increase HPA axis (CRF and cortisol) leading to increase HR, BP, and disrupted sleep)

Increased amygdala stimulation (fear/anxiety)

decreased PFC and hippocampus (memories)

increased neurotransmitters (norepinephrine, dopamine, opioids, cortisol)

Question 8

treatment for PTSD

Answer 8

SSRI (sertraline)

cognitive processing therapy (support group, eye movement desensitization and reprocessing)- bright lights

avoid addictive RX like Benzos

Question 9

in PTSD you want to avoid what medications

Answer 9

benzodiazepines ( addictive)

Question 10

what cognitive processing therapies can we use in PTSD

Answer 10

support groups

eye movement desensitization and reprocessing

Question 11

PTSD is common in the _

Answer 11

military

Question 12

examples of trauma (PTSD)

Answer 12

domestic violence, dating violence, sexual abuse, natural disaster (hurricane), car accident, burns, dog attacks, life threatening illness (cancer/traumatic birth)

Question 13

potentially traumatic events that occur during childhood that are linked to chronic health problems, mental illnesses, and can have a negative impact on education, job opportunities, and earning potential

can be prevented!

Answer 13

Adverse childhood Experiences

Question 14

what are adverse childhood experiences

Answer 14

potentially traumatic events that occur during childhood that are linked to chronic health problems, mental illnesses, and can have a negative impact on education, job opportunities, and earning potential

can be prevented!- alot them

very common!

Question 15

what are some examples of adverse childhood experiences

Answer 15

experiencing violence/abuse

witnessing violence

having a family member attempt or die by suicide

substance abuse in the house

mental health issues in the health

parent divorce

Question 16

how can we prevent adverse childhood experiences

Answer 16

strengthen economic supports to family, promote social norms, ensure strong start for children , teach skills, connect youth to caring adults and activities, intervene to lessen immediate and long term harms

Question 17

PTSD symptoms are how long

Answer 17

greater than 1 month

Question 18

similar symptoms to PTSD that lasts from 3 days to 1 month after trauma exposure

Answer 18

Acute stress disorder

Question 19

how do we treat Acute distress disorder

Answer 19

usually supportive

or PRN medications

Question 20

development of emotional/behavioral symptoms in response to an identifiable stressor occurring within 3 months of stressor

results in

significant distress out of proportion to severity of stressor

impairment of functioning

Answer 20

adjustment disorder

-does not require treatment

Question 21

adjustment disorders usually do not persist beyond 6 months- not normal in _

Answer 21

grief

Question 22

what is dissociative amnesia

Answer 22

inability to recall important personal information

-information regarding traumatic event

Question 23

dissociative fugue

Answer 23

sudden unexpected travel away from home

inability to recall ones past/personal identity

Question 24

dissociative idencity disorder

Answer 24

aka multiple personality disorder

-usually in survivors of sexual abuse

Question 25

depersonalization disorder

Answer 25

watching your life out of body (as a bystander)

Question 26

Presence of two or more distinct identities or personality states

disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning
* signs and symptoms may be observed by others or reported by the individual

Answer 26

multiple personality disorder

Question 27

multiple personality disorder is more common in?

Answer 27

women

Question 28

multiple personality disorder is associated with

Answer 28

sexual abuse