Unit 5 part 2 Flashcards
according to the video on C-PTSD, what is the difference between PTSD & C-PTSD
with PTSD there’s typically one traumatic incident that the person is dealing with, while C-PTSD, is a diagnosis that occurs when a person experiences repeated episodes of trauma (over the years) - their symptoms can be more severe than someone with PTSD because their trauma is repeated or prolonged
- not a seperate category in the DSM5, but it is in the International classification of disease
according to the video on C-PTSD, what is one of the most difficult things about complex PTSD
- trauma is usually of an interpersonal nature
- repeated behaviour makes the person lose their sense of safety and trust in others
according to the video on C-PTSD, how do ACES relate to C-PTSD
- cause serious physical health problems such as diabetes, fibromyalgia, mental health issues
- instead of early childhood trauma causing PTSD/CPTSD, a person’s trauma can manifest as physical health issues later in life
according to the video on C-PTSD, C-PTSD is often misdiagnosed as
borderline personality disorder
because some of the behaviours ppl present with are similar to BPD
Disorders in children & adolescents who have experienced trauma
- reactive attachment disorder
- disinhibited social engagement disorder
- acute stress disorder
- PTSD
- developmental trauma disorder
- oppositional defiant disorder
- ADHD
what is reactive attachment disorder
- Reactive attachment disorder is only an early childhood diagnosis
- Problem in attachment relationship that can be diagnosed
what is Disinhibited social engagement disorder
- opposite to reactive attachment disorder
- grossly abnormal social behaviour
– latch onto adults without any regard of whether they’re a stranger or not - within first 5 years of life but cant be diagnosed before the age of 1
what is acute stress disorder
- Immediately after identifiable event, child functioning affected (like ptsd)
- nightmares, distress, concentrating issues (sypmtoms not long enough to be PTSD diagnosed time not long enough for criteria)
- short term diagnosis
PTSD in children
- looks different in children
- has separate criteria from adults when child is under 6
what is Developmental trauma disorder
- not in DSM not official diagnosis but off the record is accepted
- Equivalent of complex PTSD in kids
- Used to describe impact on children chronic attachment
- People who want this as official diagnosis, see children misdiagnosed with the following two disorders:
- *Oppositional defiant disorder
- ADHD
what is Oppositional defiant disorder
- Behaviour fluctuates based on developmental stages
- Erroneous (wrong) diagnosis when trauma is not accounted for
- Defiant behaviour – not follow rules, cant sit still, difficulty processing information
- Usually a reaction to something- not something that just happens out of the blue/something you’re born with
- overlap between this and trauma responses and ADHD
Disorders in adults who have experienced past trauma
- Adjustment disorder
- Acute stress disorder
- Major depression (Usually comorbid with PTSD; Neurovegetative disorder etc – physiological symptoms)
- Substance related disorders (High comordbity with PTSD)
- Anxiety disorders
- Borderline personality disorder (High correlation between this diagnosis and past trauma – usually complex trauma)
- Eating disorders
- Psychotic disorders (less common)
- CPTSD = complex PTSD
adjustment disorder
Doesn’t have to occur in response to a traumatic event, maybe loss of a job or relationship
acute stress disorder in adults
Disorders that are short-term in nature – some identifiable trauma or stressor or single incident trauma, having a difficult time coping but don’t meet criteria for PTSD
when was the diagnosis of PTSD approved in DSM
DSM-III: 1980
- Prior: mental illness was biological disorder that caused by internal factors, not outside stressors
- originally categorized as an anxiety disorder
- Experiences used to have be pretty extreme to be diagnosied with PTSD (war, torture, rape etc)
- PTSD could not be diagnosed if stressful experiences were “normal” e.g., divorce etc
DSM-V PTSD diagnosis
- Most significant ** Trauma and stressor-related disorders became its new diagnosis
o No longer lumped in with anxiety disorders - Increase in number of symptoms: negative alterations in cognition and mood
o PTSD now don’t have to have a separate diagnosis related to mood - diagnosis* Indirect exposure to trauma included – e.g., learning about violent or accidental death or perpetrated death that happened to a loved one
o Indirect exposure for RPNs/first responders wtc. Exposure thru work could be attributed to PTSD and diagnosed
- diagnosis* Indirect exposure to trauma included – e.g., learning about violent or accidental death or perpetrated death that happened to a loved one
Diagnostic Criteria for PTSD
CRITERION A (one required):
- the person was exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence in the following ways: direct exposure, witnessing trauma, learning a relative or close friend was exposed to trauma, indirect exposure to details usually in course of profession
CRITERION B (one required):
- the traumatic event is persistently re-experienced in the following ways: intrusive thoughts, nightmares, flashbacks, emotional distress to reminders or physical reactivity to reminders
CRITERION C (one required)
- avoidance of trauma related stimuli following trauma in the following ways: trauma related thoughts to feelings or trauma related reminders
CRITERION D (two required)
- negative thoughts or feelings that began or worsened after the trauma in the following ways: inability to recall key features of trauma, overly negative thoughts and assumptions about oneself to the world, exaggerated blame of self or others for causing trauma, difficulty experiencing positive affect, negative affect, decreased interest in activities, feeling isolated
CRITERION E (two required)
- trauma related arousal and reactivity that began or worsened after the trauma, in the following ways: irritability or aggression, risky or destructive behaviour, hyper vigilance, weighted startle reaction, difficulty concentrating, difficulty sleeping
CRITERION F (required): symptoms last more than 1 month
CRITERION G (required): symptoms create distress or functional impairment
CRITERION H (required): symptoms are not due to medication, substance use or other illness
Dissociative specification - PTSD
in addition to meeting criteria for diagnosis an individual experiences high levels of either of the following in reaction to trauma related stimuli:
- depersonalization (experience of being an outsider observer)
- derealization (experience of unreality or distortion)
delayed specification - PTSD
- full diagnostic criteria ( I think for dissociative specification?) are not met until at least six months after trauma although onset of symptoms may occur immediately
what does DESNOS stand for
disorders of extreme stress not otherwise specified
criticisms of C-PTSD DIAGNOSIS
- lack of clear definition: significant variability in descriptions of the types of traumatic events that contribute and symptoms of the disorder
- lack of discriminative validity: overlap between symptoms of CPTSD, PTSD, BPD and major depressive disorder
- lack of validated measurement/assessment tools
CPTSD diagnosis in the ICD-11
- has a uniform definition, specific symptoms
- standardized tools have been developed including the international trauma questionnaire (ITQ) & International trauma Interview (ITI) that seek to identify and differentiate PTSD and CPTSD in clinical practice
- “promising” psychometric properties in terms of diagnostic precision, easy to use, efficient
- clinical differences between PTSD & CPTSD have been supported in various studies
(karatzias et al)
what is the difference between CPTSD & PTSD
- compared to PTSD, ppl with CPTSD have higher degree of functional disturbance and tend to have experienced multiple and persistent traumas
- increased risk of self-injury and repeated victimization among ppl with CPTSD
what are similarities between CPTSD & PTSD
- symptoms of CPTSD include several defining criteria of PTSD (reexperiencing, avoidance, numbing and hyperarousal) + disturbances in self-organization (DSO) that are grouped into 3 categories:
- affect dysregulation
- negative self-concept
- disturbances in relationships
