Exam 2 (4/21) Flashcards
Posttraumatic stress disorder (PTSD): causes, symptoms, assessment, interventions
cause: Has to be a causative trauma or event that occurs prior to the development of PTSD (3 months). Associated with event exposure, rather than personal characteristics.
sx: Feelings of guilt and shame Low self-esteem Reexperiencing events/ flashbacks Hyperarousal Insomnia
assessment:
interventions:
Dissociative disorders like Dissociative Identity Disorder (DID)
Formally multiple personality disorder. Display 2 or more distinct identities or personality states that recurrently take control of their behavior. Accompanied by inability to recall important personal information.
Depersonalization disorder
Persistent or recurrent feeling of being detached from their mental processes or body (depersonalization) or sensation of being in a dream-like state in which the environment seems foggy or unreal (derealization).
Dissociative amnesia and fugue states
Cannot remember important personal information. Includes fugue experience where individual suddenly moves to new geographic location with no memory of past identity or events.
Suddenly leaves home or work with no explanation, travels to another city and is unable to remember past identity. May assume new identity.
Techniques for helping patients manage stress and emotions
Discuss self-harm thoughts
Use grounding techniques
Validate client’s feelings
Use supportive touch
Teach deep breathing and relaxation techniques
Use distraction techniques
Help make a list of activities to engage the client when they are having intense feelings
Refer to client as “survivor” vs. “victim”
Establish social support system
Levels of anxiety and helpful interventions for severe and panic levels
Mild: a sensation that something is different and warrants special attention. Sensory stimulation increases and helps the person focus attention to learn, solve problems, think, act, feel, and protect him or herself; motivation
- no interventions
Moderate: the disturbing feeling that something is definitely wrong; the person becomes nervous or agitated. the person can still process information, solve problems, and learn new things with assistance from others. He or she has difficulty concentrating independently but can be redirected to the topic.
- attention can wander
Severe: primitive survival skills take over, defensive responses ensue, and cognitive skills decrease significantly. A person with severe anxiety has trouble thinking and reasoning. Muscles tighten, and vital signs increase. The person paces; is restless, irritable, and angry; or uses other similar emotional–psychomotor means to release tension
Panic: Characterized by intense periods of fear or discomfort that are unexpected and that are accompanied by certain symptoms SOB Tachycardia Paplitations Sweating Choking Nausea depersonalization Fear of dying or losing control
Interventions for panic attacks
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Agoraphobia
Fear of being outside (from the Greek “fear of the marketplace”)
Leaves people homebound
Attached to “safe person”
Avoidant
Smaller world
Depression often accompanies; needs suicide assessment
Simple phobias
Persistent and disproportionate fear of a specific stimuli
Social phobias
Persistent irrational fear of one or more situations in which the individual might be exposed to the scrutiny of others
Cognitive and behavioral approaches used in treatment
Not for the faint of heart, takes courage
Collaborative, supportive, educational
Cognitive
Ask client to keep log. Need baseline information before intervention.
Look for avoidance as well as symptoms.
Behavioral
Exposure and response prevention
Identify areas that are avoided
Rate the tasks from easy to hard, simple to complex
Collaborate with patient to begin exposures
Team approach
Client will have a high anxiety response when they do not do the ritual.
Will be reduced with each exposure.
Continual and frequent exposure, as you work with the patient up the hierarchy.
Systematic desensitization.
Primary and secondary gain
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Medications used in treatment for anxiety
SSRI’s- long term
Benzos- short term
propranolol in some cases
Signs and symptoms: Obsessions, compulsions, ritualistic behaviors
obsessions: (recurrent, persistent, uncontrollable, intrusive, unwanted thoughts, images, or impulses that cause marked anxiety and interfere with interpersonal, social, and/or occupational functioning).
Common preoccupations:
Contamination, pathologic doubt, aggressive, sexual, need for symmetry
Compulsions (ritualistic, repetitive acts or behaviors) Checking Washing Counting Need to ask Symmetry Hoarding These help to neutralize anxiety (for a while)
Effective treatments for OCD: behavioral approaches, medications
SSRI’s
