Trauma- and Stressor- Related Disorders
Trauma- and Stressor- Related Disorders PSYCH 3830
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This 6 page Class Notes was uploaded by Margaret Bloder on Monday February 22, 2016. The Class Notes belongs to PSYCH 3830 at Clemson University taught by Pam Alley in Winter 2016. Since its upload, it has received 26 views. For similar materials see Abnormal Psychology in Psychlogy at Clemson University.
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Date Created: 02/22/16
Trauma- and Stressor Related Disorders I. Stress 2 Kinds: Eustress: positive stress (ex: planning a wedding, having a baby) Distress: negative stress (ex: losing someone close to you) Stressors: the demand placed on an individual Stress: person’s response A. Factors affecting the experience of stress 1. Nature of the stressors Relevance: important aspect of your life (ex: losing a job, divorce more relevant than “it’s raining outside so I can’t play golf”) Length: the longer the problem is around, the more stressful it is Number of stressors: the more stressors, more stress Predictability: events that are unpredictable are typically more stressful 2. Characteristics of the person A. Personality: Optimistic vs. Pessimistic B. Type A vs. Type B Personality Type A: impatient, competitive, hostile Type B: relaxed, easygoing, unhurried According to Friedman and Rosenman, Type A individuals are more likely to suffer heart attacks in their 30s and 40s than Type B individuals who almost never have heart attacks before their 70s Recent Research shows that only hostility, which involves the distrust of the motives and intentions of other people, seems related to heart disease C. Coping strategies: examples include research and preparing D. Stress tolerance (tolerance level): our ability to withstand stress without becoming impaired B. Effects of Stress 1. Fight or Flight Response Emotional and physical response to a stressor that involves either attacking or avoiding the presenting threat In the short term, this response is highly adaptive If chronically aroused, this response can cause physical and emotional damage 2. Stress can impair the functioning of our immune system (more at risk for getting sick); stress can also develop symptoms of anxiety and depression C. Stress Management Aerobic Exercise: sustained exercise that increases physical and emotional well being Biofeedback: system for electronically measuring and feeding back one’s physiological state (ex: measure heart rate, muscle movement, etc.) Relaxation Training: involves teaching individuals how to tense and relax muscle groups Social Support Groups: friends and family that help one cope with stress (this technique is usually overlooked, but very effective) Write expressively, make an effort to slow down and enjoy life II. Adjustment Disorder A. What is it? The person develops emotional or behavioral symptoms in response to an identifiable stressor occurring within three months of the onset of the stressor Once the stressor (or its consequences) has terminated, the person does not experience symptoms for more than an additional six months Least stigmatizing and mildest diagnosis you can give someone Commonly accompanies a medical disorder In adults, women get the diagnosis more B. Differential Diagnosis Other conditions that may be a focus of clinical attention: uncomplicated bereavement (losing someone close to you) Trauma- and Stressor- related disorders: adjustment disorder Depressive disorders: major depressive disorder *One form of treatment would be cognitive therapy III. Posttraumatic Stress Disorder (PTSD) A. Diagnostic Criteria The person has experienced, witnessed, or been confronted with an event that involves actual or threatened death, serious injury, or sexual violence to themselves or others. (Extreme or traumatic event) The person persistently re-experiences the traumatic event. (Dreams, flashbacks, intrusive thoughts) The person persistently avoids stimuli associated with the trauma. (Avoids talking about it, avoid people and places associated with it) The person experiences negative changes in their thought processes and mood. The person experiences persistent symptoms of increased arousal. (Difficulty sleeping, concentrating, unrealistically angry) The person experiences the disturbance for more than one month. The person experiences clinically significant distress or impairment in functioning. B. Demographics and etiological factors Diagnosed more commonly in females than in males Duration of symptoms lasts longer in females Co-occurs with anxiety and depressive disorders; they tend to go together Any age can develop PTSD (criteria is a bit different for children) Symptoms usually begin within 3 months, but that’s not part of the diagnostic criteria (sometimes delayed) Recovery typically occurs in 3 months (at least ½ of the cases) Less likely to develop PTSD if you have a higher education, in a higher socioeconomic group, good support system, good coping skills C. Differential Diagnosis Adjustment Disorder -May be triggered by a stressor of any severity -May involve a wide variety of symptoms PTSD -Must be triggered by an extreme stressor -Must involve a specific constellation of symptoms Both -Always involves the presence of a stressor IV. Rape A. What is it? Rape (also sometimes referred to as sexual assault) is the occurrence of sexual intercourse by force or threat of force without the consent of the person against whom it is perpetrated. Intercourse can be penile-vaginal, oral-genital, anal, or penetration of the vagina or anus by objects such as broom handles. Statutory rape is a legally defined form of rape that involves sexual intercourse with a person who is under the legal age of consent. For intercourse to be defined as statutory rape, overt force or threat of force is not required. B. Statistics, demographics, and trends It is estimated that between 15% and 25% of U.S. women have been or will be raped at some point in their lives It is estimated that 3% of all men in the U.S. have been or will be rape at some point in their lives (most typically happens to a male child or prison inmate) Women between the ages of 18-21 years are the victims of more than 20% of all rapes Research suggests that 82% of women know their rapists Rape is the main reason females experience PTSD Decline of rape in the West and NE, increase in the South and Midwest C. Two kinds of Rape 1. Acquaintance Rape: rape between 2 people that know each other (82%) A. Date Rape: most common form of acquaintance rape Factors: Alcohol and drugs occur in more than ½ of all rape Communication: men overestimate their date’s interest in taking it further, women underestimate Token resistance: men have a tendency to perceive no as maybe and a desire to be convinced Most common locations: person’s apt or home, dorm room/residence hall, a parked car B. Marital Rape: husband forces wife against her will In 1857, the U.S. accepted the hale doctrine, which exempted husbands from getting arrested for raping wife, but it was removed in the late 1980s Most women don’t record it, so there’s not much data Women are afraid of repercussions from spouse 2. Stranger Rape: rape between two strangers (18%) Not a lot of specific information on the difference between acquaintance and stranger rape D. Rape Myths about women Victims provoke rape by their appearance or behavior Women want sex but later falsely cry rape Women mean yes when they say no The sexual contact did not do her any harm Most rapes are committed by strangers in dark alleys *The use of these myths by defense attorneys and their acceptance by jurors in rape cases provides evidence that they are oftentimes accepted by society E. Psychological impact of rape Symptoms do not seem to differ regardless of acquaintance or stranger rape Short term effects: difficulty sleeping, eating, lots of crying, withdrawing from other people, fearful, angry, guilt, confusion (changes in behavior and emotional experience) Long term effects: poor physical health, impact ability to perform sexually, impair relationship with family, partner, other people About 95% of women will meet symptom criteria for PTSD for 2 weeks, but for many, symptoms will go away within a month V. Treatment of Stress Related Disorders A. Treatment of Adjustment Disorders Common treatment is cognitive therapy B. Treatment of PTSD 1. Short term crisis intervention Very brief Focuses on immediate emotional problem Very pragmatic Very active therapist “Here and now” 2. Post disaster debriefing sessions Event experienced by a lot of people (ex: school shooting) Bring therapists/counselors into the community People says it helps them typically (even though there’s not much support) 3. Telephone hotlines Often times volunteers and paraprofessionals People report they have been helpful 4. Medication Used only for intense PTSD symptoms Question about whether medication really helps (research not consistent) Anti-depressants seem effective for depressive symptoms C. Treatment for Rape Counseling Hotlines Victim Advocacy Services: rape crisis center; trained volunteers that accompany a women wherever she needs to go (hospital, police, court)…most volunteers are women who have been previously raped