Trauma and Stressor-related disorders Flashcards by brooke posey

What are individual traumas/stressors?

abuse
illness
victim of crime (robbery, etc.)

How well did you know this?

Not at all

Perfectly

What are group traumas/stressors?

War/terrrorist attack
natural disaster
community loss (death of prominent citizen)

How well did you know this?

Not at all

Perfectly

What are the characteristics of stress/trauma?

poor coping
difficulty managing stress
emotional difficulties
difficulty resuming activities of daily life
other symptoms: anxiety, insomnia, grief

How well did you know this?

Not at all

Perfectly

What are psychiatric problems related to trauma/stress?

adjustment disorder
depression
complicated grieving
acute stress disorder
posttraumatic stress disorder
dissociative disorder

How well did you know this?

Not at all

Perfectly

a disturbing pattern of behavior demonstrated by someone who has experienced, witnessed, or been confronted with a traumatic event such as a natural disaster, combat or an assault

PTSD

How well did you know this?

Not at all

Perfectly

What occurs when a person is experiencing PTSD?

Intense memories of the trauma
Dreams/nightmares
Flashbacks
Intense, recurrent, intrusive thoughts
Emotional numbing
Increased irritability
Hyperarousal

How well did you know this?

Not at all

Perfectly

What are the three major elements of PTSD?

Dreams or intrusive, recurrent thoughts of the trauma
Emotional numbing (feeling detached from others)
Hyperarousal (being on guard, irritable) symptoms that arise from high levels of anxiety, including insomnia, irritability, anger, outbursts, watchfulness, suspiciousness, and distrustfulness

How well did you know this?

Not at all

Perfectly

event that occurred <3 months

acute stress disorders

How well did you know this?

Not at all

Perfectly

event occurred >3 months ago

PTSD

How well did you know this?

Not at all

Perfectly

chronic in nature with periods of exacerbation during increased stress
can lead to other psychiatric disorders such as depression, anxiety, and substance abuse.

PTSD

How well did you know this?

Not at all

Perfectly

a group of symptoms, such as stress, feeling sad, or hopeless, and physical symptoms that occur following a stressful life event; the reaction is stronger than would be expected for the event that occurred

adjustment disorder

How well did you know this?

Not at all

Perfectly

occur before the age of 5 years in response to the trauma of child abuse or neglect, called grossly pathogenic care. The child shows disturbed, inappropriate social relatedness in most situations.

Reactive attachment disorder (RAD) and Disinhibited social engagement disorder (DSED)

How well did you know this?

Not at all

Perfectly

exhibits minimal social and emotional responses to others, lacks a positive affect, and may be sad, irritable, or afraid for no apparent reason

reactive attachment disorder

How well did you know this?

Not at all

Perfectly

exhibits unselective socialization, allowing or tolerating social interaction with caregivers and strangers alike. They lack the hesitation in approaching or talking to strangers evident in most children their age

Disinhibited social engagement disorder (DSED)

How well did you know this?

Not at all

Perfectly

Risk factors for PTSD

Directly involved in the traumatic event
Experiences of physical injury
Loss of loved one(s)
Lack of social supports
Pervious psychiatric history or personality factors

How well did you know this?

Not at all

Perfectly

Adolescents suffering from PTSD have increased risk for the following:

Suicide
Substance abuse
Poor social supports
Academic problems
Health concerns

How well did you know this?

Not at all

Perfectly

What are some PTSD treatment options?

Psychotherapy (individual or group)
Medications (antidepressants, anxiolytics, sleep aids)
Self-help groups
Exposure therapy
Relaxation techniques
Adaptive disclosure
Cognitive processing therapy
Mental health promotion

How well did you know this?

Not at all

Perfectly

A subconscious defense mechanism used to prevent recognition of a horrific or traumatic event
*** phenomena involves detachment from realit- rather than a loss of reality as in psychosis

dissociation

How well did you know this?

Not at all

Perfectly

*This allows the person to forget or remove himself or herself from the painful situation or memory of the situation

dissociation

How well did you know this?

Not at all

Perfectly

how is dissociation characterized?

Disruption in integration disorders use dissociation, a defense mechanism, pathologically and involuntarily

How well did you know this?

Not at all

Perfectly

What are the types of dissociative disorders?

Dissociative amnesia
Dissociative identity disorder (formerly multiple personality disorder):
Depersonalization/derealization disorder:

How well did you know this?

Not at all

Perfectly

The client cannot remember important personal information

Dissociative amnesia

How well did you know this?

Not at all

Perfectly

The client displays two or more distinct identities or personalities

Dissociative identity disorder (formerly multiple personality disorder)

How well did you know this?

Not at all

Perfectly

The client has a persistent or recurrent feeling of being detached from his or her mental processes or body

Depersonalization/derealization disorder

How well did you know this?

Not at all

Perfectly

Dissociative disorder leads to disturbance in the following

*Relationships *Ability to function (activities of daily living) *Ability to cope People with PTSD often experience dissociative symptoms

Treatment options for dissociative disorder

Individual therapy Group therapy Focus in therapy is on reassociation Medications (antidepressants, anxiolytics)

What are the goals of treatment for dissociative disorder?

1. Improve quality of life 2. Improve functional abilities 3. Decrease symptoms

* Can range from passive to angry, frightened, agitated, hostile * Experience nightmares, flashbacks, intrusive thoughts, hallucinations, self-destructive thoughts, fantasies * memory gaps; poor decision making

dissociative disorder

What are the outcome goals for dissociative disorder?

* Refer to patient as “survivor” rather than “victim” * Identification of flashback triggers * Encourage journaling of feelings * Utilize distractions and relaxation techniques

Maladaptive or Dysfunctional Personality Traits

``` Irresponsible, not accountable for own actions Risk-taking, thrill-seeking behaviors Mistrust Exhibitionism Dependency Eccentric perceptions Negative behavior toward others Anger and/or hostility Irritable/labile moods Lack of guilt, remorse or emotionally cold, and uncaring Impulsive, poor judgment ```

is characterized by a pervasive pattern of depressive cognitions and behaviors

depressive behavior

is characterized by a negative attitude and a pervasive pattern of passive resistance to demands for adequate social and occupational performance

passive-aggressive behavior

Temperament (harm avoidance, novelty seeking, reward dependence, persistence)

biologic theories

Character Self-directedness (responsible, goal oriented) Cooperativeness (integral part of society) Self-transcendence (integral part of the universe)

Psychodynamic theories

Treatment for personality disorders?

* psychopharmacology | * group, individual therapies

Cognitive-perceptual distortions;antipsychotics Affective symptoms and mood dysregulation; mood stabilizers and lithium Aggression and behavioral dysfunction; anticonvulsants and mood stabilizers Anxiety;

Psychopharmacology (symptom focused)

Examples of group, individual therapies?

Cognitive-behavioral therapies | Dialectical behavior therapy (borderline personality disorder)

Clinical picture: pervasive mistrust/suspiciousness; use of projection; conflict with authority Nursing interventions: formal, business-like approach; involvement in plan of care; idea validation before action

paranoid personality disorder

characterized by a pervasive pattern of detachment from social relationships and a restricted range of emotional expression in interpersonal settings

Schizoid personality disorder:

Clinical picture: social detachment and interpersonal deficits; restricted emotions; intellectual Affects 5% of the general population and more common in males than females Odd appearance, and will decline to engage with other people when given an opportunity

Schizoid personality disorder:

Nursing interventions: focus on self-care, social skills, and improved community functioning

Schizoid personality disorder:

characterized by a pervasive pattern of social and interpersonal deficits marked by acute discomfort with and reduced capacity for close relationships as well as by cognitive or perceptual distortions and behavioral eccentricities

Schizotypal personality disorder:

Clinical picture: social and interpersonal deficits, odd appearance, inability to respond to normal social cues, behavioral eccentricities

Schizotypal personality disorder:

Nursing interventions: Focus is for clients to develop self-care and social skills and improved functioning in the community Self-care, social skills, community functioning

Schizotypal personality disorder:

Odd appearance that causes others to notice them; clothes don’t fit, don’t match, and may be dirty; vague speech; anxiety around other people; remain in parents home well into adulthood

Schizotypal personality disorder:

Is characterized by a pervasive pattern of disregard for and violation of the rights of others, and by the central characteristics of deceit and manipulation

antisocial personality disorder

``` Assessment: Deceit/manipulation False emotions; no empathy Narrowed view of world Poor judgment; no insight Egocentric, but actually self-shallow and empty Relationships as serving own needs ```

antisocial personality disorder

is characterized by a pervasive pattern of unstable interpersonal relationships, self-image, and affect as well as marked impulsivity

borderline personality disorder

Unstable interpersonal relationships, self-image, and affect; marked impulsivity Wide range of behavior, appearance Dysphoric mood Polarized extreme thinking (splitting); dissociation Threats of self-harm Clients then to use transitional objects Social isolation

borderline personality disorder

Clinical picture: excessive emotionality and attention seeking; insincerity; center of attention; exaggeration of relationships

Histrionic personality disorder

Nursing interventions: feedback about social interactions; social skills training through role-playing; exploration of strengths, assets ******It may also help to discuss social situations to explore clients perception of others reactions and behavior. Teaching social skills and role-playing those skills in a safe, nonthreatening environment can help clients to gain confidence in their ability to interact socially.

Histrionic personality disorder

Clinical picture: grandiosity; need for admiration; lack of empathy; arrogant or haughty attitude; superior view; fragile, vulnerable self-esteem; ambitious

Narcissistic personality disorder

Nursing interventions: self-awareness skills to avoid anger and frustration; matter-of-fact approach; limit setting

Narcissistic personality disorder

50-75%of people with this are men; lack ability to empathize or sympathize with other; belittle or discredit the feelings of others

Narcissistic personality disorder

Clinical picture: social discomfort; low self-esteem; hypersensitivity to negative evaluation These clients are reluctant to do anything they perceived as risky, which for them is almost everything

Avoidant personality disorder

Nursing interventions: self-affirmations; positive self-talk; support and reassurance; reframing/decatastrophizing; social skills training

Avoidant personality disorder

Clinical picture: need to be taken care of; submissive; clinging Have tremendous difficulty making decisions Clients perceive themselves as unable to function outside of a relationship with someone who can tell them what to do

Dependent personality disorder

Nursing interventions: Clients may need assistance in daily functioning Expression of feelings; autonomy/self-reliance; cognitive restructuring; problem solving

Dependent personality disorder

Clinical picture: The demeanor of these clients is formal and serious and they answer questions with precision and much detail perfectionism; formal, serious; orderliness a priority; problems with decision making, judgments; low self-esteem; harsh self-evaluations

Obsessive personality disorder

Nursing interventions: Helping clients to accept or to tolerate less-than-perfect work or decisions made on time may alleviate some difficulties at work or home different perspective view; cognitive restructuring; risk taking

Obsessive personality disorder

Clinical picture: It occurs more often in people with relatives who have major depressive disorders pervasive depressive cognitions and behaviors (less severe than major depression); pessimistic, negative thinking; low self-esteem

Depressive personality behavior

Nursing interventions: safety; involvement in activities; factual feedback Often seek treatment for their distress

Depressive personality behavior

Clinical picture: They may appear cooperative, even ingratiating or sullen and withdrawn, depending on the circumstances Their mood may fluctuate rapidly and erratically Negative attitude, passive resistance to demands for adequate social and occupational performance; blaming of others

Passive-aggressive personality behavior

Nursing interventions: | Identification and expression of feelings

Passive-aggressive personality behavior

Elders with personality disorders are at increased risk for?

depression, suicide, and dementia

How are personality disorders organized?

Cluster A,B,C

What are the cluster A personality disorders?

Paranoid personality disorder Schizoid personality disorder Schizotypal personality disorder

What are the cluster B personality disorders?

Antisocial personality disorder Borderline personality disorder Histrionic personality disorder Narcissistic personality disorder

What are the cluster C personality disorders?

Avoidant personality disorder Dependent personality disorder Obsessive personality disorder

medication for affective aggression

Lithium Anticonvulsants Low-dose antipsychotics

medication for predatory (hostility/cruelty)

Antipsychotics | Lithium

medication for emotional lability

Lithium Carbamazepine (Tegretol) Antipsychotics

medication for emotional detachment

SSRIs | Atypical antipsychotics

showing little or a slow-to-respond facial expression; few observable facial expressions

blunt affect

displaying a full range of emotional expressions

broad affect

showing no facial expression

flat affect

false sensory perceptions or perceptual experiences that do not really exis

hallucinations

displaying a facial expression that is incongruent with mood or situation; often silly or giddy regardless of circumstance

Inappropriate affect

rapidly changing or fluctuating, such as someone’s mood or emotions

labile

disorganized thinking that jumps from one idea to another with little or no evident relation between the thoughts

loose assoications

invented words that have meaning only for the client

neologisms

displaying one type of emotional expression, usually serious or somber

restricted affect

wandering off the topic and never providing the information requested

tangential thinking

What are the cluster A personality disorders?

paranoid, schizoid, Schizotypal

What are the cluster B personality disorders?

antisocial, borderline, histrionic, narcissistic

What are the cluster C personality disorders?

avoidant, dependent, obsessive

Trauma and Stressor-related disorders Flashcards

(86 cards)