Flashcards in Trauma and stress disorders Deck (77)
What are the four major reactions to trauma?
-Anxiety and fear
-Dysphoria and anhedonia
-Anger and aggression
What is reactive attachment disorder?
-Pattern of inhibited and emotionally withdrawn behavior toward adult caregivers, after a child has experience extreme of insufficient care
-Persistent social and emotional disturbance
What causes reactive attachment disorder? (3)
-Lack of emotional needs for comfort, stimulation, and affection
-Repeated changes in primary caregivers
-Living in settings with limited opportunities to form attachments with caregivers
True or false: developmental delays commonly occur with reactive attachment disorders
What indicates a better prognosis with reactive attachment disorder? (2)
With excellent caregiving environment following the neglect, and help received at an earlier age
What is disinhibited social engagement disorder? What are the 4 characteristics of their behavior?
-Child actively approaches and interacts with unfamiliar adults, and exhibits 2+ of:
-Lack of reticence in approaching
-Overly familiar verbal or physical behavior
-Diminished checking with adult caregiver
-Willingness to go off with unfamiliar adult w/o hesitation
What percent of severely neglected kids develop disinhibited social engagement?
Which is more common: disinhibited social engagement disorder or reactive attachment disorder? Which has a worse prognosis?
Disinhibited social engagement disorder x2
At what age will disinhibited social engagement disorder not develop (assuming adequate care prior to that point)?
If older than 2 years
Which is an externalizing and which an internalizing response to a lack of appropriate care: disinhibited social engagement disorder and reactive attachment disorder?
Internalizing = RAD
Externalizing = DSED
What is the treatment for RAD or DSED? (2)
-Family therapy if appropriate
-Psychosocial interventions to address unmet basic needs
What are the diagnostic criteria for PTSD, in terms of exposures (4)?
-Direct witness it
-Learning event occurred to a close person
-Repeated personal exposure to aversive details of traumatic events
What are the symptoms of PTSD? (5)
-Recurrent intrusive memories, dreams or dissociated flashbacks
-Psychological distress with internal or external cues
-Physiological rxns to internal or external cues
-Avoidance of memories
What are the five major categories of symptoms for PTSD?
1. exposure to actual or threatened death etc
2. Intrusive symptoms
3. Persistent avoidance
4. Negative alterations in cognitions
5. Alterations in arousal and reactivity
What are the negative alterations in cognition and mood associated with PTSD? (6)
-Unable to recall important aspects of trauma
-Exaggerated negative beliefs/expectations
-Distorted cognitions about cause or consequences
-Persistent negative emotional state
-Feelings of estrangement/detachment
-Inability to experience positive emotions
What is the duration for PTSD to meet the diagnostic criteria?
More than 1 month
What are the two major dissociative symptoms with PTSD?
-Depersonalization (you're not human)
-Derealization (nothing is real)
PTSD can occur at any age after what?
Symptoms of PTSD usually occur within what timeframe after the event?
3 months, but can be years
What are the risk factors for PTSD?
-Severity/duration of trauma
-Prior exposure to trauma
Is female or male sex a risk factor for the development of PTSD?
Is lower or higher intelligence a risk factor for PTSD? Higher or lower income?
What fraction of adults with PTSD will have remission within 12 months?
What is the treatment for PTSD in terms of trauma focused CBT? (3)
Trauma focused CBT:
-Confrontation of traumatic memories
-Reworking distorted cognitions
What is the pharmacotherapy for PTSD?
-Prazosin (reduces dreams)
What is the role of benzos in the treatment for PTSD?
Do not use
What is the foundation for psychotherapy for PTSD?
Exposing people to the trauma in a therapeutic manner
What is the MOA of prazosin? What is the use of treatment in PTSD?
Within what timeframe is starting of treatment and early social support particularly effective in treating PTSD?
Within 3 months