Abnormal Psychology Ch7

flashbacks

Reexperienced memories of past events, particularly as occurs in posttraumatic stress disorder or following use of hallucinogenic drugs.

Arousal or Anxiety

an exaggerated startle response, excessive fear reactions to unexpected stimuli, such as loud noises

Reexperiencing Examples

1. visualizing trauma over and over again 2. repeatedly question what they might have done differently 3. horrifying dreams 4. flashbacks

traumatic stress

A catastrophic event that involves real or perceived threat to life or physical well-being.

Acute stress disorder (ASD)

A category of mental disorder in DSM-IV that is defined as a reaction occurring within four weeks of a traumatic event and is characterized by dissociative symptoms, reexperiencing, avoidance, and marked anxiety or arousal. Contrasts with posttraumatic stress disorder, which either lasts longer or has a delayed onset.

Posttraumatic stress disorder (PTSD)

A psychological disorder characterized by recurring symptoms of numbing, reexperiencing, and hyperarousal following exposure to a traumatic stressor.

DSM-IV-TR Diagnostic Criteria for Posttraumatic Stress Disorder (PTSD)

A. The person has been exposed to a traumatic event in which both of the following were present: 1. The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others. 2. The person's response involved intense fear, helplessness, or horror. B. The traumatic event is persistently reexperienced in one (or more) of the following ways: 1. Recurrent and intrusive distressing recollections of the event including images, thoughts, or perceptions 2. Recurrent distressing dreams of the event 3. Acting or feeling as if the traumatic event were recurring 4. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event 5. Physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following: 1. Efforts to avoid thoughts, feelings, or conversations associated with the trauma 2. Efforts to avoid activities, places, or people that arouse recollections of the trauma 3. Inability to recall an important aspect of the trauma 4. Markedly diminished interest or participation in significant activities 5. Feeling of detachment or estrangement from others 6. Restricted range of affect 7. Sense of a foreshortened future D. Persistent symptoms of increased arousal, as indicated by two (or more) of the following: 1. Difficulty falling or staying asleep 2. Irritability or outbursts of anger 3. Difficulty concentrating 4. Hypervigilance 5. Exaggerated startle response E. Duration of the disturbance is more than 1 month Specify if: Acute: If duration of symptoms is less than 3 months Chronic: If duration of symptoms is 3 months or more Specify if: With delayed onset: If onset of symptoms is at least 6 months after the stressor

DSM-IV-TR Diagnostic Criteria for Acute Stress Disorder (ASD)

A. The person has been exposed to a traumatic event in which both of the following were present: 1. The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others. 2. The person's response involved intense fear, helplessness, or horror. B. Either while experiencing or after experiencing the distressing event, the individual has three (or more) of the following dissociative symptoms: 1. A subjective sense of numbing, detachment, or absence of emotional responsiveness 2. A reduction in awareness of his or her surroundings (e.g.,"being in a daze") 3. Derealization 4. Depersonalization 5. Dissociative amnesia (i.e., the inability to recall an important aspect of the trauma) C. The traumatic event is persistently reexperienced in at least one of the following ways: recurrent images, thoughts, dreams, illusions, flashback episodes, or a sense of reliving the experience; or distress on exposure to reminders of the traumatic event. D. Marked avoidance of stimuli that arouse recollections of the trauma (e.g., thoughts, feelings, conversations, activities, places, people). E. Marked symptoms of anxiety or increased arousal (e.g., difficulty sleeping, irritability, poor concentration, hypervigilance, exaggerated startle response, motor restlessness). F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or impairs the individual's ability to pursue some necessary task, such as obtaining necessary assistance or mobilizing personal resources by telling family members about the traumatic experience. G. The disturbance lasts for a minimum of 2 days and a maximum of 4 weeks and occurs within 4 weeks of the traumatic event.

Social Factors

Research on social factors and the risk for PTSD focuses primarily on (1) the nature of the trauma and the individual's level of exposure to it and (2) the availability of social support following the trauma. Victims of trauma are more likely to develop PTSD when the trauma is more intense, life-threatening, and involves greater exposur

Biological Factors

Importantly, genetic contributions differed across symptoms. Genes contributed most strongly to arousal/anxiety symptoms and least strongly to reexperiencing. Conversely, level of combat exposure predicted reexperiencing and avoidance but not arousal/ anxiety

dissociation

The separation of mental processes such as memory or consciousness that normally are integrated. Normal dissociative experiences include fleeting feelings of unreality and déjà vu experiences—the feeling that an event has happened before. Extreme dissociative experiences characterize dissociative disorders.

Comorbidity

The simultaneous manifestation of more than one disorder.

Avoidance

Trauma victims may attempt to avoid thoughts or feelings related to the event, or, they may avoid people, places, or activities that remind them of the trauma

numbing of responsiveness

emotions are dampened or even nonexistent. This symptom may be referred to as "emotional anesthesia," a term that captures its essence. Emotional numbing can cause sufferers to withdraw from others, particularly from close relationships.

Acute Stress Disorder

explicitly includes dissociative symptoms and lasts no longer than four weeks