Trauma and dissociation Flashcards
(16 cards)
What’s the difference in timelines between:
Childhood attachment disorders
Prolonged grief disorder
Acute stress disorder
Adjustment disorders
Post-traumatic stress disorder (PTSD)
Childhood attachment disorders
Disturbed and developmentally inappropriate behaviours in children before age 5
Prolonged grief disorder
Extreme difficulties with adjusting to loss for 1 year or longer
Acute stress disorder
Severe symptoms in the first month after the trauma
Adjustment disorders
Sx within 3 months of identifiable stressor (less severe than acute stress or PTSD)
Post-traumatic stress disorder (PTSD)
Severe symptoms persist after at least 1 month (Barlow et al.; Cengage, 2024)
PTSD
What is it?
What’s it caused by?
What are the symptoms A-G name, at least two per categories? How many symptoms per criteria?
Minimum amount of time?
- Long-lasting severe emotional reactions persist leading to post-traumatic stress disorder
- Exposure to actual or threatened death, serious injury, or sexual
violence in one or more of a variety of ways (e.g., direct, witness) - Intrusion symptoms (1+)
- memories, dreams, flashback (disassociative reactions) intense psychological distress related to cues, physiological distress
Persistent Avoidance (1+)
1. avoid associated memories
2. Avoid associated reminders
Negative mood or cognition, (2+)
Irritable anger or aggressive, reckless, exaggerated startle, hypervigilance, concentration or sleep issue,
- 1+ months needs to be impaired or distressed
PTSD STATS
How much of general pop?
Who most likely?
Men vs women?
8%
32% rape victims more often women
Men: witness
Women experience
Cause of PTSD
Exposure to a traumatic event (combat, rape)
Biological, psychological, social vulnerabilities
Intensity and severity of trauma
No or little social support system
Damaged hippocampus
Key factor: INTENSITY/SEVERITY of
traumatic experience.
Risk factors for ptsd
Pre-event factors: low SES, education, existing psych disorders, adverse
childhood experiences
Exposure to trauma: Proximity to event, bigger threat to life
Differences in personal resiliency, coping skills, early adversities, ongoing
stress
No or little social support system (family instability)
Biological vulnerabilities:
Genetic susceptibility to anxiety
Smaller hippocampus
History of brain injury
Contributing Factors:
Classical and operant conditioning
Cognitive theories – sensory vs. verbal memorie
PTSD treatment
Pharmacological
SSRIs (Prozac, Paxil) to relieve anxiety
Psychological:
Imaginal exposure
Prolonged exposure therapy (write and read your narrative)
Cognitive therapy, constructivist-narrative approach, coping skills, relaxation
training
Eye-movement desensitization and reprocessing (EMDR)
What is prolonged grief disorder?
Extreme difficulties with adjusting to loss for 1 year or longer
Adjustment disorders
Anxious/depressive reactions to life stress (generally less severe than acute stress or PTSD)
Biological and psychological vulnerabilities to stress
Attachment disorder
Who?
What?
How?
1. Reactive attachment disorder
- Disinhibited social engagement disorder:
Disturbed and developmentally inappropriate behaviours in children before age 5
Child is unwilling/unable to form normal attachment relationships with caregiving adults
Caused by inadequate/abusive child-rearing practices
Reactive attachment disorder: Child very seldom seeks out a caregiver for
protection and support and seldom responds to caregivers
Disinhibited social engagement disorder: Child shows no inhibitions whatsoever to approaching adults (e.g., inappropriate intimate behaviour, willingness to accompany strangers without checking back with caregiver)
Dissociative Disorders
What is it?
Severe disruptions of identity, memory, and consciousness out of one’s control
Dissociation: Lack of integration/unity of psychological functioning and the self
Depersonalization-Derealization Disorder
Severe feelings of detachment
Outside observer of own body or mind
Dissociative Amnesia
Inability to recall significant personal
information, often following a traumatic event
Generalized vs. localized/selective
Dissociative Fugue: Unexpected trip
Dissociative trance
Dissociative Identity Disorder overview
Amnesia, fragmented identity, certain aspects of identity are dissociated
Several identities (alters) co-exist simultaneously (M = 15) Minimum of 2 distinct personalities
Aspects of person’s identity are partially independent
Host identity asks for treatment, alters are the other identities
Switch: instantaneous transition from one personality
Physical transformations may occur: posture, facial expressions, patterns of
facial wrinkling, physical disabilities, handedness (37%)
A controversial diagnosis.
DID DSMR
. Disruption of identity characterized by 2+ distinct personality
states, with marked discontinuity in sense of self and agency,
and alterations in affect, behaviour, consciousness, memory,
perception, cognition, and/or sensory-motor fx.
Sx can be observed by others or reported by
individual.
B. Recurrent gaps in memory for everyday events, personal
information, and/or traumatic events.
C. Cause significant distress or impairment in functioning.
D. Not part of a broadly accepted religious/cultural practice.
E. Not attributable to a substance or medical condition.
dID cause
- abuse childhood
suggestibility - Memories real or false can be due to trauma
Treatment of did
Pharmacological
Generally not useful
Hypnosis
Popular, but may result in false memories and personalities
Psychotherapy
Long-term psychotherapy
Reintegrate separate personalities
22% success rate
Treatment of associated trauma similar to PTSD
