week 5 (incomplete) Flashcards

1
Q

what are the 3 components of trauma?

A

Potentially traumatic event
- Who, what, when, where, & how?
- Expected or unexpected event?
- Direct or indirect experience?

Exposure to the event OR individual’s experience of the event
- Individual’s interpretation of an event & beliefs/assumptions about the world affects how they will process, react to, & cope with a traumatic event; depends on factors (SDoH)

*SDoH; biology & genetics, gender, culture, personal health practices, social support networks, social status, social & physical environments, child development, education & literacy, employment & working conditions, living environments/conditions

*These factors influence an individual’s chances of experiencing a trauma OR recovering from trauma faster

Symptoms of physical, mental, social, emotional, or spiritual distress seen after the traumatic event
- Nightmares, difficulty sleeping, social withdrawal, emotional dysregulation ( fits of anger/general emotional lability, & loss of faith/hope in the future-

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2
Q

what are the 3 types of trauma?

A

acute trauma
- one, isolated traumatic event that is short; narrowly focused in nature

Ex: medical emergency, motor vehicle accident, physical assault, rape, mass shooting, terrorist attack, natural disaster

chronic trauma
- multiple traumatic events (can be diverse/vary) but are repeated/frequently experienced over a long period of time

Ex: prolonged adult abuse (+witnessing abuse), domestic abuse (of various forms – physical/verbal), bullying, prolonged exposure to war/combat, repeated sexual abuse, homelessness, starvation/deprivation, chronic medical illness w/ invasive medical procedures

complex trauma
- chronic trauma that began/occurred often before 5 y/o, or during periods of attachment & relational growth; done by trust figures *this is a child’s exposure to multiple traumatic events

Ex: childhood physical, sexual, or emotional abuse (+incest & profound neglect) OR often historical/intergenerational trauma

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3
Q

trauma: natural vs. human action

A

Natural: flood, earthquake, hurricane *faster recovery time!

Human action: war, terrorist acts

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4
Q

trauma (human action): intentional vs. unintentional

A

Intentional
- ex: loss of friends/social support d/t an optional job transfer

Unintentional
- ex: loss of friends/social support d/t escape from a war zone *faster recovery time!

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5
Q

what are the 3 types of CHRONIC trauma?

A

Domestic violence *A.K.A. family violence/intimate partner violence
- Characterized by harmful behaviour between family members/partners (often occurs at home, even when not experienced daily)

*Domestic violence can affect everyone at home & those close to the family (ex: caregivers & fam friends); they may see/hear violent incidents OR witness the aftermath of a violent incident

Interpersonal trauma
- Involves actions done w/ the intent to hurt, harm, or take advantage of another
- May occur w/in the context of domestic violence, but may also occur amongst acquaintances
- Often refers to actions that betray trust (whether or not there’s physical violence involved)

Ex: bullying or repetitive lying/deceiving

System-oriented trauma
- When services that are meant to help people unintentionally cause trauma

*Sometimes, moving through an unfamiliar system can be overwhelming & trigger feelings of helplessness & isolation r/t a traumatic experience

*Ex: lack of privacy in health care settings, poorly explained invasive medical procedures, minimizing or ignoring reports of bullying within a school system, or use of seclusion/restraint in mental health settings

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6
Q

what are the 5 types of COMPLEX trauma?

A

Developmental trauma
- Common complex trauma; reactions to harmful events that occur during developing years (infancy, childhood, adolescence, & young adulthood)
- Experiencing psychological trauma in childhood is linked to developing risk factors for both social well-being & physical health

Trauma at the community level
- Traumatizing events surrounding whole communities (group of people bound together by common hx, identity, or culture) *traumatic events can affect an individual that identifies w/ a certain community

Historical trauma
- Refers to reactions to widespread & severe events that affect a large group over a lifespan or beyond (ex: intergenerational trauma)

Ex: colonialism (forcible removal of one’s autonomy & possible destruction of culture & language), genocide, slavery, & war

Intergenerational trauma*
- Aspect of historical trauma* (describes psychological/emotional effects that can be experienced by those who have a long-term connection to trauma survivors
- Memories of trauma & inadequate coping methods are passed from one generation to the next

Ex: negative social impacts amongst indigenous people in Canada r/t colonization

Cultural trauma
- A community’s reaction to events that challenge & may even seek to destroy its culture
- Culture is an important part of the way people define themselves & helps create a sense of belonging & meaning in the world

Ex: loss of culture can compromise the ability of a group of people to avail themselves of opportunities & fully participate in society

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7
Q

what is acute stress disorder (ASD)?

A

*directly associated w /trauma

This is a normal response to high stress situations (ex: facing death, serious injury or sexual violation)

Occurs d/t 1 specific event rather than the experience of long-term or chronic exposure to trauma

S/S: emotionally “numb”, having distressing memories of the event, flashbacks, problems w/ sleep & concentration, angry outbursts, & exaggerated startle response
- s/s appear 2 days to 4 weeks after the event & resolve by 4 weeks

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8
Q

what is post-traumatic stress disorder (PTSD)?

A

*directly associated w /trauma

Most commonly diagnosed trauma-related disorder

S/S fall into 4 classes *s/s last longer than 4 months
- Re-experiencing (intrusive memories, flashbacks, nightmares)
- Avoidance of internal & external reminders of the event
- Cognitive & emotional dysregulation
- Hypervigilance & reactivity

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9
Q

explain the fight, flight, or freeze response.

A

In a traumatic situation, multiple organs & systems engage to create a response to the threat in the environment & prepare us to survive the threat.

“Fight, flight, or freeze response” helps us pay attention (freeze), & either fight off the threat or flee to safety; note: ‘freeze’ response may also signal an overwhelmed system which reduces the ability to pay attention.

S/S: increased HR, tachycardia, tension in muscles, & sweating

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10
Q

explain the prolonged stress & stress response.

A

Repeated & chronic stress causes wear/tear on body & mind

Chronic prolonged stress is linked to many problematic health outcomes
- ex: cardiovascular, metabolic, immune, & nervous system problems; also causes brain changes that may contribute to anxiety, depression, & addiction

Prolonged stress response to repeated traumatic events that occur in childhood can have more serious effects; early exposure to trauma is harmful to a developing brain & body

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11
Q

what are adverse childhood experiences (ACES)?

A

Harmful experiences that happen during developing years; can be acute, chronic, or complex
- These events usually begin in the childhood home & involve parents & other trusted caregivers
- Study showed that experiencing trauma in childhood is directly r/t risk factors for health & social well-being; ACEs harm neurological, endocrine & immune systems, increasing a one’s risk of physical, mental, & substance use disorders.

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12
Q

list the types of ACES.

A

Acute
- ex: a single exposure to an episode of domestic violence

Chronic
- ex: lack of adequate nutrition throughout pre-school years

Complex
- ex: being raised by parents w/ substance use issues

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13
Q

what should you consider when applying trauma-informed care (TIC)?

A

Personal level: self-awareness & understanding of indirect trauma
- Strategies: reflect on self & biases/assumption about trauma survivors & recovery

*Reflect on strengths, triggers, & background

Practice level: trauma awareness & use of language
- Strategies: relationships are vital in helping trauma survivors learn new coping skills, interactions w/ survivors & staff must be respectful, supportive, collaborative, & strengths-focused, be mindful of language use

Organizational level: staff training, education, & supervision

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14
Q

true or false: a person doesn’t need to disclose their trauma hx to receive TIC

A

true; disclosure NOT required

*ask only for the necessary details
*review & clarify limits to confidentiality
*ask about strengths, interests, goals, coping, etc.
*keep conversations safe, contained, & present-focused
*provide rationales for questions & normalize the process where possible
*watch for common signs of trauma & stop when necessary to assist w/ grounding & regulation

***TIC can help people recognize the connection b/w their past experiences & current situations
- Can provide relief from suffering, give hope, & help survivors in developing stories about their past

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15
Q

what are the 6 broad components/principles of TIC?

A
  • Safety: is everything being done to ensure the client’s physical & emotional safety?
  • Trustworthiness & transparency: are expectations & interactions for everyone clear & consistent? (boundaries, respect, nonjudgmental approach)
  • Peer Support: those w/ lived experiences can be critical resources for support
  • Collaboration & mutuality: members of the organization can contribute equally
  • Empowerment, voice & choice: developing plans of actions that require patient-centered approaches & empower clients
  • Cultural, historical & gender issues: culturally sensitive, free of biases & stereotypes
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16
Q

true or false: in acute care mental health settings, use of restraints (& seclusion as a form of restraint) are encouraged

A

false; recognizing the use of restraints may be re-traumatizing/triggering, based on own past experiences

*when all other attempts to calm a situation fail, the use of seclusion &/or restraints may be needed to ensure the pt. is safe, & everyone else on the unit

17
Q

what is the six core strategies approach?

A

an approach to care that emphasizes importance of working WITH the individual to find a solution, rather than creating power struggles to enforce rules.

18
Q

what does it mean to call for a “show of support?”

A

calling for more staff to help manage a situation involving an individual who’s demonstrating aggressive behaviour.

18
Q

what is seclusion? when can it be implemented?

A

Voluntary/involuntary confinement of a pt. alone in a room, locked from outside for care & treatment; requires physician order

Used in Mental Health settings but only as a LAST RESORT
- Decision to use seclusion must be made in consultation w/ other members of the healthcare team & physician’s order is required

Indications:
- ONLY IN EMERGENCIES when danger is imminent *whether voluntary or involuntary status
- To help pt. re-establish behavior control
- Seclusion or restraint should only be used when behavior of the pt. shows a greater risk than risks associated w/ using seclusion
- Should be used ONLY when ALL OTHER LESS RESTRICTIVE MEASURES have been ineffective & should be used for the least amount of time possible!

19
Q

after a restraint has been used, what is the most important thing to do?

A

Debrief!
- For the person affected
- For the staff
- For other pts. or visitors if appropriate

Gives a chance to reflect, learn & modify the care plan to prevent recurrence *important for recovery

20
Q

what are the goals of debriefing?

A

To assess physical & emotional wellbeing of all staff & individuals involved in a crisis event

To re-establish therapeutic rapport w/ the person who experienced a crisis event

To reduce the adverse & potentially traumatizing impact on involved staff/patients & bystanders

To reduce likelihood of future crisis events by finding changes that can be made by individual/staff/both

21
Q

what is anxiety?

A

a subjectively distressing experience triggered by perceived threat, which has both a potential psychological & physiological etiology & expression

22
Q

what’s the difference b/w anxiety & fear?

A

Anxiety: is a vague sense of dread r/t unknown danger; affects one at a deeper level – it attacks the main core of our personality & destructs self-esteem & personal worth

Fear: a reaction to a real or perceived specific danger

23
Q

what is “normal anxiety”?

A

a healthy reaction needed for survival

  • It provides us energy to do daily tasks & strive towards goals;
  • Motivates us to make & survive change; &
  • Prompts constructive behaviours

Ex: studying for exam, being on time an interview, preparing for a presentation

24
Q

when can anxiety be positive, a motivating factor, bring attention to detail, etc?

A

Anxiety as a warning sign
- To bring attention to a current situation or changes that may need to be made in one’s life.

Anxiety as a motivator
- Could provide encouragement to take action.

*Ex: to address a situation, study for an exam, etc.
- Anxiety as a built-in warning system Could alert you, or help one react as to keep self safe.

Anxiety as a positive trait in one’s character
- People who’ve experienced lots of anxiety may be more empathetic, understanding & supportive of others.

Anxiety as a leadership trait
- People who have experienced anxiety may make good leaders: problem-solvers, decision-makers, or contemplating consequences of decisions.

25
Q

what are the levels of anxiety?

A

none -> mild -> moderate -> severe -> panic