Trauma and Stress Related Disorders

Question 1

Characteristics of Stress/Trauma

Answer 1

May experience anxiety, insomnia, difficulty coping, grief, etc.

Some individuals have problems coping, managing stress and emotions, or resuming daily activities.

Question 2

Acute Stress Disorder

Answer 2

Reexperiencing, avoidance, hyperarousal

Question 3

When does acute stress disorder occur?

Answer 3

Occurs 3 days to 4 weeks after trauma

Question 4

What is a precursor to PTSD

Answer 4

Acute Stress Disorder

Question 5

If acute stress lasts more than 4 weeks, what disorder are we looking at?

Answer 5

PTSD

Question 6

According to the DSM-V, the diagnostic criteria for PTSD the duration of
Posttraumatic Stress Disorder – PTSD is?

Answer 6

According to the DSM-V, the diagnostic criteria for PTSD “The duration of the disturbance is more than 1 month”

Question 7

PTSD

Answer 7

Disturbing pattern of behavior demonstrated by someone who has experienced, witnessed, or been confronted with traumatic event

Question 8

How can the traumatic event for someone with ptsd be described?

Answer 8

Event poses actual or threatened death or serious injury

Question 9

What are the responses to PTSD?

Answer 9

Intense fear
Helplessness
Terror

Question 10

Subcategories of symptoms of PTSD

Answer 10

Being on guard/hyperarousal

Reexperiencing the trauma

Avoidance

Negative congition/thoughts

Disturbance is more than 1 month

Question 11

What does rexperiencing the trauma include?

Answer 11

Dreams
Flashbacks (acting or feeling like trauma reoccurring)
Intrusive, recurrent thoughts

Question 12

Etiology of PTSD

Answer 12

A causative trauma

Lack of social support, previous psychiatric history/personality factors can increase risk

Question 13

What group of people are most likely to develop PTSD?

Answer 13

Adolescents are more likely to develop PTSD than are children or adults.

Question 14

The Adolescent is at a increased risk for the following:

Answer 14

Suicide
Substance abuse
Poor interpersonal relationships
Poor physical health
Academic problems

Question 15

Cultural Considerations of PTSD

Answer 15

Posttraumatic stress disorder (PTSD) is a universal phenomenon.

Question 16

What would lead to a lesser frequency of being diagnosed with PTSD?

Answer 16

Stronger sense of self and cultural identity = less frequently diagnosed with PTSD, better long-term outcomes

Question 17

PTSD Treatment Options

Answer 17

Counseling and therapy (individual or group)

Medications (especially targeting specific issues)

CBT/CPT (Cognitive
Processing Therapy)

Exposure therapy

Relaxation techniques

Question 18

What is the gold standard treatment for PTSD?

Answer 18

Cognitive Therapy

Question 19

Dissociative Symptoms

Answer 19

The presence of two or more distinct personality states.

Question 20

Why do Dissociative Symptoms occur?

Answer 20

Subconscious defense mechanism used to prevent recognition of a horrific or traumatic event

Question 21

When can dissociative symptoms occur?

Answer 21

Can occur during and after event

Question 22

What is an essential feature of dissociative symptoms?

Answer 22

Essential feature: disruption in usually integrated functions of consciousness, memory, identity, environmental perception

Question 23

How does the onset of dissociative symptoms occur?

Answer 23

Onset can be sudden or gradual.

Question 24

Dissociative symptoms interfere with:

Answer 24

Relationships
Ability to function (activities of daily living)
Ability to cope

Question 25

What kind of clients are seen with dissociative symptoms?

Answer 25

Clients with PTSD

Question 26

Four main types of dissociative symptoms

Answer 26

1. Dissociative amnesia 2. Dissociative identity disorder 3. Depersonalization/Derealization disorder 4. Dissociative Fugue

Question 27

1. Dissociative amnesia

Answer 27

(condition in which a person cannot remember important information about his or her life)

Question 28

2. Dissociative identity disorder

Answer 28

(formerly multiple personality disorder)

Question 29

3. Depersonalization/Derealization disorder

Answer 29

(periods of feeling disconnected or detached from one's body and thoughts or you have a sense that things around you aren't real, or both

Question 30

4. Dissociative Fugue

Answer 30

the person with memory loss travels or wanders.

Question 31

Dissociative Treatment Options

Answer 31

Individual therapy Group therapy Medications (for anxiety or depression or both)

Question 32

What is the focus of group therapy in dissociative treatment

Answer 32

Group therapy Focus in therapy is on reassociation

Question 33

Trauma and Stressor-Related Assessment: What is NOT necessary

Answer 33

Not necessary or desirable for client to detail specific events of abuse or trauma*

Question 34

What is the general appearance/motor of someone with trauma/stress?

Answer 34

Client often appears hyperalert. Client may have discomfort with physical closeness. Client may appear anxious or agitated.

Question 35

What is the mood/affect of someone with Trauma/stress?

Answer 35

Can range from passive to angry, frightened, agitated, hostile

Question 36

What is the thought process/content of someone with Trauma/stress?

Answer 36

Experience nightmares, flashbacks, intrusive thoughts, hallucinations, self-destructive thoughts, fantasies

Question 37

What is the sensorium and intellectual process of someone with stress/trauma

Answer 37

Oriented to reality except during flashback Memory gaps Intrusive thoughts/ideas of self-harm

Question 38

What is the judgement and insight of someone with stress/trauma?

Answer 38

May report little idea of relationship between trauma and symptoms Others may be quite knowledgeable. Decision-making ability may be impaired.

Question 39

What is the self concept of someone with trauma/stress?

Answer 39

Low self-esteem See self as worthless

Question 40

How are the roles and relationships of someone with stress/trauma?

Answer 40

Problems with authority Close relationships difficult or impossible

Question 41

Physiological concerns of someone with stress/trauma?

Answer 41

Difficulty sleeping Change in appetite Alcohol and drug use

Question 42

Trauma and Stressor-Related Outcomes

Answer 42

Physical safety Distinguish ideas of self-harm versus taking action Demonstrate healthy, effective stress management Nondestructive expression of emotions Social support system

Question 43

Trauma and Stressor-Related Outcomes and Interventions

Answer 43

Grounding techniques Encourage journaling of feelings Utilize distractions and relaxation techniques Refer to client as “survivor” rather than “victim”

Question 44

Grounding Techniques

Answer 44

Helpful with dissociation or flashback. Remind the person that he or she is present, is an adult, and is safe. Increase contact with reality. Diminish the dissociative experience by focusing on current experiences. Focus the client in the present.

Question 45

Medication prescribed for nightmares associated with PTSD?

Answer 45

Prazosin

Question 46

Side effects of Prazosin?

Answer 46

Dizziness, headache, blurred vision

Question 47

Life threatening side effects of Prozosin?

Answer 47

Syncope with sudden loss of consciousness with rapid dose increases or the introduction of antihypertensive

Question 48

FRA approved medications for PTSD?

Answer 48

Paroxetine Sertraline

Question 49

Self Awareness Issues

Answer 49

Deal with own personal feelings about traumatic events, abuse, and natural disasters. Convey empathy. Remain nonjudgmental.