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PSYC 316 Book Chapter 5 Notes

by: Sara Karikomi

PSYC 316 Book Chapter 5 Notes PSYC 316

Marketplace > Northern Illinois University > Psychlogy > PSYC 316 > PSYC 316 Book Chapter 5 Notes
Sara Karikomi
Simon Jencius

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About this Document

Book notes from Chapter 5, extended definitions for further understanding.
Simon Jencius
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Popular in Intro-Psycpathology

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This 11 page Bundle was uploaded by Sara Karikomi on Tuesday September 29, 2015. The Bundle belongs to PSYC 316 at Northern Illinois University taught by Simon Jencius in Fall 2015. Since its upload, it has received 60 views. For similar materials see Intro-Psycpathology in Psychlogy at Northern Illinois University.


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Date Created: 09/29/15
Chapter 5 Disorders of Trauma and Stress Stressor event that causes us to change Stress Response reaction to the changes due to the stressor 1 Stress and Arousal The Fightor Flight Response 1 Hypothalamus brain area that kickstarts arousal and fear This area activates the Autonomic Nervous System 2 Autonomic Nervous System ANS complex network of nerve bers that connect the brain and spinal cord Central Nervous System to the body s organs Fibers help control organs Involuntary activities blood pressure heartbeat breathing etc 3 Endocrine System network of Glands in the body that release Hormones into the bloodstream and thus to other organs a The ANS and Endocrine Svstem often interact and produce arousal and fear reactions Svmpathetic Nervous Svstem and anothalamicPituitary Adrenal Pathway 4 Sympathetic Nervous System group of autonomic nervous system bers activated by the hypothalamus that speed up our heartbeat and essentially prepare us for action in the face of fear or anxiety a Think of this system as sympathetic to our experiences thus providing us with the necessary functions to act on them b Directly stimulates heart rate c Indirectly stimulating the Adrenal Glands to produce Epinephrine adrenaline and Norepinephrine noradrenaline The Fightor Flight Response 5 Parasympathetic Nervous System helps the body return to normal processes This system is activated when the perceived danger passes a Think of this system as paralyzing or something that resembles paralyzing in such a way that it slows down the sympathetic nervous system s excitement 6 HypothalamicPituitaryAdrenal HPA Pathway the second path arousal and fear reactions are produced a anothalamus signals the Pituitary Gland when one faces a stressor Pituitary Gland secretes adrenocorticotropic hormone ACTH the major stress hormone that stimulates the Adrenal Cortex triggering the release of Corticosteroids including Cortisol more stress hormones Hypothalamus gt Pituitary Gland gt ACTH gt Adrenal Cortex gt Corticosteroids Cortisol II Acute and Posttraumatic Stress Disorders Shortly after the perceived danger passes the stress reactions subside in most individuals For others the effects may persist long after These individuals may be suffering from Acute Stress Disorder or Posttraumatic Stress Disorder Differences Anxiety Disorders Chapter 4 are triggered by situations that not everyone perceives as threatening The development of ASD and PTSD is brought on by events that everyone would consider threatening or traumatic Acute Stress Disorder symptoms begin immediately or soon after the traumatic event and last for less than a month Posttraumatic Stress Disorder symptoms may begin immediately after the event or may begin months or years following the event Unlike ASD the symptoms persist beyond a month Symptoms of ASD and PTSD are nearly identical Reexperiencing the Traumatic Event recurring thoughts memories nightmares connected to the traumatic event Some experience Flashbacks reliving the traumatic event so vividly that the individual believes it is happening again Avoidance Avoiding activities thoughts feelings or conversations that remind the individual of the traumatic event Reduced Responsiveness a feeling of detachment from others loss of interest in activities that were once enjoyable Some experience symptoms of Dissociation psychological separation feeling dazed having memory problems or a sense of Derealization experiences seem unreal Increased Arousal Negative Emotions and Guilt hyperalertness easily startled attention problems sleep disturbances displaying anxiety anger depression and survivors guilt A What Triggers Acute and Posttraumatic Stress Disorders ASD or PTSD can develop at any age and may cause individuals to experience a depressive anxiety or substance abuse disorder Some may become suicidal According to Surveys 35 of people in the US experience ASD or PTSD in any given year 79 suffer from ASD or PTSD at some point in their lifetime 23 of these individuals seek treatment but few do so at first Women are twice as likely as men to develop ASD or PTSD Approximately 20 of women exposed to serious trauma develop ASD or PTSD compared to the 8 of men with similar experiences Individuals with low incomes are twice as likely to develop ASD or PTSD than those with higher incomes Any event can trigger ASD or PTSD but some events combat disasters abuse and victimization are more likely to increase one s chances to develop the disorders Combat during combat many soldiers develop severe arousal anxiety depression and related symptoms a World War I such occurrences were called shell shock b World War II amp the Korean War it was called combat fatigue c Vietnam War clinicians started to learn that soldiers can experience psychological symptoms after combat d Veterans of the wars in Afghanistan and Iraq have displayed a similar pattern Nearly 20 of those deployed to the wars have reported PTSD symptoms Disasters ASD and PTSD may develop due to the experience of natural disasters and accidents a According to research unusually high rates of PTSD have been reported among the survivors of Hurricane Katrina and the BP Gulf Coast oil spill b Such natural disasters and accidents occur almost ten times as often as combat related traumas Victimization individuals who have experienced abuse or victimization experience longlasting stress symptoms According to research more than 13 of all physical or sexual assault victims develop PTSD 12 of all individuals directly exposed to terrorism or torture may develop PTSD a Sexual Assault 1 Rape forced sexual act committed against a non consenting person intercourse with an underage person a Around 1 out of 6 women is a victim of rape b Victims experience great distress throughout the week after their assault Effects may persist for up to 18 months or more after their assault experiencing anxiety suspiciousness depression low self esteem selfblame ashbacks sleep disturbances and even sexual dysfunction Terrorism Victims of terrorism or those living under the threat of terrorism may experience symptoms of PTSD Torture 1 2 3 4 brutal degrading and disorienting strategies in order to reduce victims to a state of utter helplessness Okawa amp Hauss 2007 Physical Torture beatings waterboarding electrocution Psychological Torture death threats verbal abuse degradation Sexual Torture rape genital mutilation sexual humiliation Torture Through Deprivation preventing sleep sensory stimulation social contact necessary nutrition medical or hygiene rights 3050 of torture victims develop PTSD Why Do People Develop Acute And Posttraumatic Stress Disorders 4 a 5 a b B 1 a b 2 3 a b Bio loqical and Genetic Factors trauma triggers physical changes in the brain and body that may lead to severe stress reactions ASD or PTSD Abnormal Hormone Activity cortisol and norepinephrine in combat soldiers rape victims concentration camp survivors etc Abnormal Hippocampus and Amygdala Activity Personality some studies suggest that individuals With certain personalities attitudes and coping styles are more likely than others to develop ASD and PTSD Those Who vieW life s negative events as beyond their control are more likely to dev elop more severe stress symptoms than those Who feel that they have more control Childhood Experiences certain traumatic childhood experiences have been found to leave some individuals more vulnerable to the development of ASD and PTSD Childhoods marked by poverty Individuals Whose family members suffered from psychological disorders assault abuse or catastrophe or individuals younger than 10 When their parents separated or divorced 4 Social Support individuals with weak social and family support systems are more likely to develop ASD or PTSD following trauma a Victims of rape who feel loved valued and accepted by their friends and family recover more successfully b Those treated with dignity and respect by the criminal justice system are also found to recover more successfully c Poor social support systems can contribute to the development of ASD and PTSD in combat veterans 5 Multicultural Factors some clinical researchers believe that the rate of PTSD may differ among ethnic groups particularly Hispanic Americans 1 Study Results Some combat veterans of Vietnam Iraq and Afghanistan present higher rates of APTSD among Hispanic American veterans than white American or African American veterans 2 Survey Results Hispanic American police offers report more severe job related stress symptoms than nonHispanic of cers New York City residents revealed that following the September 11th attacks 14 of Hispanic American residents developed PTSD 9 of African Americans 7 of white Americans 3 Data after some hurricanes Hispanic American victims have shown signi cantly higher rates of PTSD than victims of other ethnic groups b Why are Hispanic Americans more vulnerable to PTSD than other groups 1 Cultural Belief System many Hispanic Americans view traumatic events to be inevitable and unchangeable Such a coping response may heighten their risk for developing PTSD Traumatic events permanently or temporarily deprive them of the important relationships and support systems they hold at a high value 6 Severitv of Trauma the severity or traumatic events help determine whether an individual will develop ASD or PTSD a Study Results 23 of the 253 studied Vietnam War Prisoners quali ed for a clinical diagnosis even 5 years after their release b Mutilation and severe physical injury or witnessing the injury or death of another individual seem to increase the risk of stress reactions C How Do Clinicians Treat Acute and Posttraumatic Stress Disorders 1 Treatment for Combat Veterans As it has been with most of the disorders discussed in class the most common treatments are Drug Therapy Behavioral Exposure Techniques Insight Therapy Family Therapy and Group Therapy 1 Flooding b Eye Movement Desensitization and Reprocessing DMDR a form of exposure therapy in which clients move their eyes from side to side in a rhythmic manner while ooding their minds with images of the typically avoided situations or objects Many believe that it is the exposure rather than the rapid eye movement that is in uential in the treatment of the disorder c Rap Groups group therapy veterans meet to share experiences and feelings develop insights and offer mutual support 2 Psychological Debriefing A form of crisis intervention otherwise known as Critical Incident Stress Debriefing victims discuss their feelings and reactions to their traumatic experiences a Clinicians and counselors guide group members to describe their traumatic event and list the emotions they experienced then tell the victims that their reactions are normal responses to their trauma They also offer stress management advice and occasionally provide resources for further counseling 3 Does Psychological Debriefing Work some studies question its effectiveness a After an investigation in the 1990s some individuals displayed PTSD symptoms when interviewed nine months after their experience during the Gulf War when they were required to identify bodies of the deceased b In another study on hospitalized burn victims half were debriefed shortly after their accident while the control group received no debrie ng After 3 months the results showed that all studied victims had similar rates of PTSD After 13 months however the debriefed victims showed higher 26 rates of PTSD than the victims who were not debriefed 9 c While some clinicians believe that highrisk individuals may benefit from debrie ng others should not receive such interventions Some early intervention programs may encourage victims to dwell on their trauma III Dissociative Disorders Dissociative Disorders are group of disorder in which some parts of an individual s identity or memory seem dissociated from other parts of their identity or memory Memory recollection of past events and learning Dissociative Amnesia sufferers are unable to recall information typically of a stressful nature Dissociative amnesia may be Localized Amnesia Most common type of amnesia the individual loses memory of the events that took place within a limited period of time also called an Amnestic Episode Onset typically begins at the time of a disturbing event Selective Amnesia Second most common type of amnesia the individual remembers only bits and pieces of the events that occurred during a period of time Generalized Amnesia Individual loses memory of things that occurred long before the event Continuous Amnesia Individual is unable to recall new and present experiences what happened before and during the event In addition to localized selective generalized and continuous an individual may experience Dissociative Fugue the individual forgets their identity details of their life and travel to a different place In some cases the individual will not stray far from home but others may travel far form a new identity form new relationships and lead an entirely different life Dissociative Identity Disorder Multiple Personality Disorder an individual develops two or more distinct personalities SubpersonalitiesAltemate Personalities that possess their own memories thoughts and behaviorsThe development of the disorder is typically brought on by a stressful event a PrimaryHost the dominant sub personality that appears most often b Switching transitioning from one personality to another How do the Subpersonalities Interact a The subpersonalities typically have three kinds of relationships 1 Mutually Amnestic Relationships the subpersonalities are unaware that the others exist 2 Mutually Cognizant Patterns the subpersonalities are aware of the others 3 OneWay Relationships the most common relationship pattern some subpersonalities are aware of others but others are not The aware subpersonalities are CoConscious Subpersonalities 3 D l 3 a b a b How Do Subpersonalities Differ Identifying Features Subpersonalities may be of a different age gender or race than the diagnosed individual Abilities and Preferences Some subpersonalities may have different talents or abilities one may have knowledge of foreign languages musical skills and even different handwriting The subpersonalities may also have different preferences in food music art and friends Physiological Responses Subpersonalities can have different levels of blood pressure allergies etc Subpersonalities may have different Evoked Potentials brainresponse patterns How Common is Dissociative Identitv Disorder DID was once believed to be rare that manyall cases were unintentionally created Iatrogenic by practitioners Many cases of DID came after an individual had already been in treatment for a less serious issue thus reinforcing the argument of Iatrogenic cases DID diagnosis is on the rise many clinicians are learning more about the disorder believing in its existence and feeling more comfortable in diagnosing it How Do Theorists Explain Dissociative Amnesia and Dissociative Identitv Disorder 3 b C a b The Psvchodvnamic View the beliefs of these theorists include that dissociative disorders stem from Repression unconsciously pushing away memories of a traumatic eXperience dissociative amnesia is a Single Episode of repression DID is the result of a lifetime of immense repression The Behavioral View the beliefs of these theorists include that dissociation is learned through Operant Conditioning When confronted with trauma the individual eXperiences relief when they are not thinking about the trauma Not thinking about the trauma is reinforced Unfortunately this model does not eXplain how temporary and normal escapes from traumatic memories turn into a compleX disorder or why some develop the disorder and others do not StateDependent Learning a The link between a situation and state of mind an individual are more likely to remember an event when they are exposed to the same conditions under which they experienced the event b Arousal Levels a particular level of arousal will be associated with certain thoughts skills and memories c StatetoState Memories a particular state of arousal leads to the recollection when they experience the arousal state they endured at the time of the event 4 SelfHypnosis a When under hypnosis subjects may become very suggestible b While hypnosis may help individuals to recall forgotten memories it can also cause Hypnotic Amnesia forgetting facts events one s own identity etc c Links between Hypnotic Amnesia and Dissociative Disorders 1 people forget information from a period of time and remember it later 2 individuals are unaware of why they have lost memories 3 individuals may be unaware that they have forgotten anything at all d Such links cause theorists to believe that dissociative disorders may stem from SelfHypnosis hypnotizing oneself to forget traumatic events e SelfHypnosis may also serve as an eXplanation for DID E How Are Dissociative Amnesia and Dissociative Identity Disorder Treated 1 How Do Therapists Help Peonle With Dissociative Amnesia leading treatments include Psychodynamic Therapy Hypnotic Therapy and Drug Therapy Support for these interventions come from mainly case studies not controlled investigations a Psychodynamic Therapy patients search their unconscious to uncover lost memories Such techniques work best for individuals suffering from dissociative amnesia b Hypnotic Therapy patients are hypnotized and guided to recall the missing memories Such techniques are often combined with others c Drug Therapy Barbiturates also known as truth serums Amytal or Pentothal have been used to treat patients with dissociative amnesia and help recall lost memories These drugs calm and free the inhibitions but may not always work They are also combined with other therapy techniques 2 How Do Therapists Help Individuals With Dissociative Identity Disorder individuals With DID do not typically recover Without treatment Techniques include a Recognizing the Disorder 1 Therapists attempt to form a bond With the primary and subpersonalities and educate the individual to understand the disorder a Sometimes through hypnosis the therapist Will introduce the subpersonalities to each other b Group and Family Therapy techniques have also been helpful b Recovering Memories 1 Therapists may use the approaches applied in treating dissociative amnesia psychodynamic therapy hypnotherapy and drug treatment 2 While these methods work for DID patients some subpersonalities may deny What other personalities remember 3 One sub personality may serve a protective role to prevent the individual from suffering through reliving their trauma c Integrating the Subpersonalities 1 Subpersonalities are merged into one integrated identity 2 FLion fmal merging of subpersonalities in a DID patient 3 After integration further therapy learning social and coping skills is necessary to help the individual maintain the single personality F DepersonalizationDerealization Disorder Depersonalization feeling as if one s body one s self is detached or unreal Derealization feeling as if one s experiences are unreal 3 Doubling outofbody sensations feeling as if one s mind or other parts of their body is physically separate from the rest Some experiences distorted sensory experiences and behaviors sense of touch smell sense of time or space 4 Experiencing depersonalization or derealization DOES NOT indicate DepersonalizationDerealization Disorder a 13 of all people report feelings of outofbody experiences b 13 of those Who have experienced lifethreatening situations report experiences of depersonalization and derealization c Many individuals experience feelings of depersonalization after meditating d Many individuals experience feelings of derealization When traveling to new places e DepersonalizationDerealization Disorder symptoms are persistent recurrent cause distress impair relationships and job performance 5 This disorder is more common in adolescents and young adults and rarely in people over 40 Symptoms last long may improve and disappear for a While but return or worsen during stressful times IV


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