trauma and related disorders
trauma and related disorders PSYCH 470
Penn State Harrisburg
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This 4 page Class Notes was uploaded by heatherzim84 on Wednesday March 16, 2016. The Class Notes belongs to PSYCH 470 at Penn State Harrisburg taught by Senel Poyrazli, Ph. D. in Spring 2016. Since its upload, it has received 14 views. For similar materials see Abnormal Psychology in Psychlogy at Penn State Harrisburg.
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Date Created: 03/16/16
Posttraumatic Stress (PTSD) and Acute Stress (ASD) Disorders PTSD *War, car accidents, child abuse/neglect, sexual abuse/rape, workrelated acts (police killing someone, journalism photographers, first responders, etc.), natural disasters, terrorist attacks/human made disasters, etc. *Secondary trauma *Numbing loss of interest in other people, disaffection or hostility towards other people, or incapacity to feel positive emotions Create wall around them and don’t let anyone in Social isolation Alcohol/Drug abuse Detrimental behavior coping mechanisms *Passive suicides Symptoms: 1. Person exposed to threatened or actual death, serious injury, sexual violation, in one or more of the following ways: a. Firsthand experience of the event b. Witnessing another’s event c. Hearing that a violent/accidental death or threat of death happened to someone close to you d. Repeated or extreme exposure to negative/harmful details of a traumatic event 2. At least 1 of the following intrusion symptoms: a. Repeated, involuntary, and intrusive distressing memories of the trauma, or in children, repeated play reenacting the traumatic events or details from them b. Repeated distressing dreams about traumatic event c. Dissociative reactions (e.g. flashbacks) where person feels or acts as if the trauma(s) were happening in the present moment d. Intense or lengthy distress or physiological reaction in response to any reminders of the traumatic event 3. At least 1 of the following avoidance systems: a. Avoids any internal triggers of traumatic memories b. Avoids any external triggers of traumatic memories 4. At least 3 (or 2 for children) of the following negative or harmful changes in thinking or mood that changed after traumatic event(s): a. Can’t remember major details of event b. Repeated or embellished negative thoughts about self, other people, or the rest of the world c. Repeated or unnecessary self blame or blame of another for the event d. Universal destructive or negative emotional condition e. Major loss of interest or involvement in daily activities f. Detaching or isolating self from others g. Repeatedly incapable of feeling positive emotion 5. At least 3 (or 2 for children) of the following changes in excitement or responsiveness that happened after traumatic event(s): a. Mean, harmful, antagonistic behaviors b. Careless, rash, or selfharming behaviors c. Hyperattentiveness, constantly being “on guard” d. Embellished reactions of being startled when unnecessary e. Difficulty concentrating f. Disrupted sleep 6. The person’s symptoms started, changed, or got worse after traumatic event(s) and persisted for longer than one month Characteristics: Outlandish reactions to a major, negative stressor such as enhanced anxiety or anxiousness, going out of the way to elude situations or circumstances surrounding traumatic event, or reactivity of amplified provocation or excitement Disorder began to cultivate after the veterans returned home from Vietnam Reactions to SERIOUS traumatic event(s) including but not limited to real or risk of death, major injury or damage, or some form of sexual abuse to one’s self or another very close to you Rape is the most common traumatic event for women with this disorder, approximately 1/3 of women that were victims of rape exhibited signs of PTSD 4 key classes of symptoms – 1. Disturbing reencounters of details or trauma including but not limited to persistent memories, nightmares, extreme negative reactivity to any detail reminding one of traumatic event 2. Excessive evasion of any physical details that may remind one of traumatic event or thinking about event (this may seem to negate symptoms of reencountering experience of trauma but evading the thoughts or details is usually not successful and may lead to re experiencing traumatic event(s) 3. Tremendous variations in temperament, attitude, or intellect following traumatic event(s) including but not limited to the victim’s failure to recollect major details of trauma, repeated negative patterns of thinking, selfblame or excessive blame to another for occurrence of traumatic event(s), extensive pessimism or depressing emotion, inability to take part in daily activities or major loss of concern or attentiveness in important pursuits, isolation or distance from other people, or incapacity to feel constructive, confident, or optimistic reactions or feelings 4. Amplified excitement or combative, volatile reflexes to stimuli surrounding or in reminder of trauma including but not limited to illtemper, petulance, hostile, antagonistic, or destructive behaviors, wild and careless or self devastating behaviors, interrupted sleep patterns, inability to concentrate, hyperattentiveness, or an extravagant or embellished, unnecessary response to stimuli in a frightened or alarmed manner Symptoms are usually chronic or longlasting Ideas surrounding suicide or selfdamaging behaviors are fairly common Most people with PTSD have symptoms of anxiety or conduct disorders, major depression, or substance abuse Disorder can be influenced by culture – more/less, regular experience with trauma or different symptoms or reactions to traumatic event(s) Treatment: Antidepressants, some SSRI’s Relapse is fairly common in those who stop taking their medication Exposure treatment – focus on memories to help victim confront trauma and reassure them that they can conquer feelings of anxiety about the trauma by using imagined exposure or virtual reality (VR) technology Cognitive strategies can be used instead of the harsher exposure treatments – interventions to help victim cope with event, prevent/treat selfblame, reducing guilt Acute Stress Disorder (ASD) Symptoms: 1. Subjected to real or risk of death, major injury, or sexual abuse in 1 or more of the following conditions: a. Personal experience b. Firsthand witness c. Discovering a vicious or inadvertent death or risk of that kind of death happened to someone close to you d. Persistent or severe incident related to negative or harmful reminders of details of trauma 2. At least 8 of the following: a. Uncontrolled, automatic, persistent, and disturbing recollections of trauma b. Persistent, alarming, mentally/emotionally harmful dreams surrounding details of trauma c. Detached responses including flashbacks where one believes the traumatic event is happening again at that present moment d. Extreme or chronic mental or physical anguish in response to exposure to details of trauma e. Personal acts of numbing, isolation, or lack of interest in other people f. Distorted sense of actuality or authenticity of life or one’s environment g. Incapable of recollecting at least 1 major detail of trauma h. Dodging both internal and external prompts or memories of trauma i. Disruption of sleep pattern j. Hyperattentiveness k. Angry, cranky, mean behavior l. Extreme alarmed or frightened reactivity to stimuli m. Excessive worry, nervousness, edgy, or impatient behavior The preceding symptoms must have started or gotten worse after the traumatic event(s) and persisted at least 3 days to 1 month Characteristics: Symptoms are similar to PTSD but occur in a smaller window of time Two major concerns about disorder: o May cause shame or negative perception about one having these symptoms for only a short period of time (even though it is common) o Some people who are diagnosed with PTSD may not exhibit symptoms of ASD within the first month after traumatic event(s) ASD aids prediction of a higher risk of one to acquire PTSD within 2 years after trauma Treatment: Antidepressants, some SSRI’s Relapse is fairly common in those who stop taking their medication Shortterm cognitive/behavioral treatments including exposure and early intervention that can last for years; exposure is more effective than cognitive treatments to prevent PTSD *************BOTH DISORDERS: Coping skills – most show resilience (especially those of high intelligence or those with a strong social support system) but coping skills can help predict risk of PTSD after a traumatic event including but not limited to avoidance of thinking about trauma, dissociation, or memory concealment Treatment – medication and psychological Kring, A. M., Johnson, S. L., Davison, G. C., & Neale, J. M. (2012). Abnormal psychology (12 ed.). Hoboken, NJ: John Wiley & Sons, Inc.