Flashcards in L6: Trauma and Stressor Related Disorders, PTSD Deck (15):
Which five Trauma and Stressor Related Disorders are listed in the DSM-5?
- Adjustment Disorders
- Acute Stress Disorder
- Reactive Attachment Disorder
- Disinhibited Social Engagement Disorder
What are the 5 criteria required for a diagnosis of PTSD in the DSM-5
A. Exposure to actual or threatened death, serious injury or sexual violence in one or more of the following ways (see following slide)
B. Intrusion Symptoms (1 or more needed) - memories, dreams, flashbacks of the event.
C. Persistent avoidance of stimuli (1+) - memories, etc., or external reminders of the event.
D. Negative changes in cognition, mood (2+) - fear, negative beliefs about self, others, the world.
E. Changes in arousal, reactivity (2+)
F. Duration of symptoms is 1 month or more.
G. Clinically significant distress or impairment.
What are the four ways in which the actual or threatened death, sexual violence or serious injury can be experienced?
- Directly experiencing the traumatic event/s.
- Witnessing, in person, the event as it occurred to others.
- Learning that the traumatic event occurred to a close family member or close friend. In the case of the actual or threatened death of a family or friend, the actual or threatened death must have been violent or accidental.
- Experiencing repeated or extreme exposure to aversive details of the traumatic events, e.g. first responders collecting human remains, police repeatedly exposed to details of child abuse.
What are the five kinds of intrusion symptoms (1+ needed)?
- Recurrent, involuntary, intrusive, distressing memories.
- Recurrent, distressing dreams related to the event/s.
- Disocciative reactions (e.g. flashbacks), the individual feels or acts as though the traumatic event was reccuring.
- Intense or prolonged psychological distress at exposure to internal or external cues that are reminders of the traumatic event/s.
- Marked physiological reactions to internal or external cues that are reminders of the traumatic event/s.
Describe the two avoidance symptoms (1+ needed).
- Avoidance of, or efforts to avoid, distressing memories, thoughts, or feelings, about or closely related with the traumatic events.
- Avoidance of or efforts to avoid external reminders (people, places, objects, activities, conversations, situations) that arouse distressing thoughts, feelings, or memories about or closely related with the traumatic events.
Describe the 7 possible negative alternations in cognition or mood (2+ needed).
- Inability to remember an important aspect of the event(s) (due to dissociative amnesia, not to other factors such as injury, alcohol).
- Persistent and exaggerated negative beliefs about oneself, others, or the world (e.g., “I am bad,” “No one can be trusted”).
- Persistent, distorted cognitions about the causes/consequences of the event(s) that lead the individual to blame him/herself or others.
- Persistent negative emotions (e.g., fear, horror, anger, guilt, shame).
- Markedly diminished interest or participation in significant activities.
- Feelings of detachment or estrangement from others.
- Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).
What are the 6 alterations in arousal and reactivity (2+ needed)?
- Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.
- Reckless or self-destructive behavior.
- Exaggerated startle response.
- Problems with concentration.
- Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).
Describe the features of Acute Stress Disorder and how it relates to PTSD.
- Occurs within 3 days to 4 weeks of traumatic event
- Posttraumatic reaction lasting up to 4 weeks
◦i.e., symptoms resolve within 4 weeks.
◦if they don’t: change diagnosis to PTSD
- More emphasis on dissociative symptoms
What percentage of people experience a traumatic event in their lives (as defined in PTSD criteria)?
What is the 12 month prevalence of PTSD?
What percentage of men and women develop PTSD following trauma exposure?
- 10-20% of women, 6-8% of men
In what percentage of people does distress in response to a traumatic event drop substantially within 3 months?
What are 5 pre-trauma risk factors for PTSD?
- childhood trauma
- prior psychiatric history
- family instability
- substance abuse
- social/economic disadvantage
What are 5 trauma risk factors for PTSD?
- Degree of life threat (injury/death) or
- Severity of exposure to traumatic elements
- Location of trauma (safe place vs. elsewhere)
- individual's role in the trauma (helper/victim)
- meaning assigned to event (uncontrollability)