Post Traumatic Stress Disorder and other stress-related disorders

what three categories are indicative of Reactive Attachment Disorder

1. emotionally withdrawn behavior toward adult caregivers 2. persistent social and emotional disturbance 3. child has experienced a pattern of extremes of insufficient care

what acronym can one remember to remember the symptoms of PTSD

"DREAMS": Detachment Reexperiencing the event Event had emotional effects Avoidance Month in duration (symptoms for >1 month) Sympathetic hyperactivity or Hypervigilance

what are the Treatment Barriers for Military (1)

1. Patients are more likely to speak to a medical professional in comparison to a mental health specialist 2. 33% of all soldiers are in need of mental health assessments, but only 12.5% receive that care 3. Behavioral Health provider shortage 4.After referral from physician only 44% of patients attend their first appointment, compared to 76% when the provider introduces the patient to the behavioral health specialist

what are the Treatment Barriers for Military (2)

5. PTSD has on-again-off-again symptoms that are exacerbated by a number of triggers and, therefore, should be assessed early after deployment (not standard of care) 6. Many medical professionals are not trained to assess for psychosocial difficulties 7. family therapy (both patinet and spouse) at regular times is more effective (hard to do)

PTSD must occur for at least _____ while ASD lasts up to ______ A. 1 month; 1 month B. 6 months; 1 month C. 1 month; 6 months D. 1 month; 1 year

A

PTSD is typified by what are the Treatment Types

AUTOMATIC, INVOLUNTARY SYMPTOMS, (e.g. flashbacks, intrusive thoughts, autonomic hyperarousal Individual Therapy Marital and/or Family Therapy Group Support Medication

Treatment by Type: Acute PTSD Severe Acute PTSD Chronic PTSD For PTSD in children, adolescents, and geriatrics

Acute PTSD - Stress debriefing and psychotherapy Severe Acute PTSD - Stress debriefing, medication, group and individual psychotherapy Chronic PTSD - Stress debriefing, medication, group and individual psychotherapy For PTSD in children, adolescents, and geriatrics the preferred treatment is psychotherapy

PTSD is more prevalent among males than females A. True B. False C. Same rate

B

Which is NOT true. Adults diagnosed with PTSD are more likely to also to be diagnosed with (comorbid): A. Depression B. Oppositional Defiant Disorder C. Anxiety D. Substance Use Disorder

B

Which option is NOT correct. Criterion A of PTSD (309.81) specifies that one may be exposed to : A. Direct experience of a traumatic event B. Witnessing the event occur C. Observing violence on television, media, etc. D. Learning that a traumatic event happened to a family member

C

how is CBT for PTSD done specifically for rape victims what is this therapy based on very effective 60-80%

Cognitive Restructuring involved teaching and reinforcing self-monitoring or thoughts and emotions, identifying automatic thoughts that accompany distressing emotions, learning about different types of cognitive distortions, and working to dispute the distress-enhancing cognitions, with a particular focus on abuse-related cognitions COGNITIVE MODELS- how the victim understands and appraises the stressful experience- are influential, and cognitive style also helps predict the occurrence of PTSD."

what is: Exposure Therapy Cognitive Therapy Stress inoculation training

Exposure Therapy Education about common reactions to trauma, breathing retraining, and repeated exposure to the past trauma in graduated doses. The goal is for the traumatic event to be remembered without anxiety or panic resulting. Cognitive Therapy Separating the intrusive thoughts from the associated anxiety that they produce. Stress inoculation training Variant of exposure training teaches client to relax. Helps the client relax when thinking about traumatic event exposure by providing client a script.

wha tis the treatment in Children

Medication: FDA approved Prozac for depression in children FDA approved Zoloft for OCD in children Therapy Cognitive-Behavioral therapy- exposure, anxiety management, Cognitive restructuring Family Therapy Play Therapy

what are the recommendations for the detection of PTSD

Mental health assessments should be completed EARLY AND OFTEN AFTER DEPLOYMENT military patients should BRING THEIR SPOUSES TO VISITS MENTAL HEALTH ASSESSMENTS OF SPOUSES of PTSD victims should be mandated Medical care for service personnel should always include interviews/assessments in the biological, psychological, and social (BPS) DOMAINS

PTSD Risks by Event what are the Traumatic events most often associated with PTSD by gender 80% of PTSD sufferers have a comorbid disorder. What comorbidities are associated with PTSD by gender Rate of attempted suicide in patients who have PTSD is estimated at

Rape (49%) Severe beating or physical assault (31.9%) Other sexual assault (23.7%) Men rape, combat exposure, childhood neglect and childhood physical abuse Women rape, sexual molestation, physical attack, being threatened with a weapon and childhood physical abuse Women; Anxiety and depression, Men irritability, impulsiveness, substance abuse 20%

what medications are used for PTSD and what are the examples

SSRIs - Sertraline (Zoloft), Paroxetine (Paxil), Escitalorpram (Lexapro), Fluvoxamine (Luvox), Fluxetine (Prozac) Tricyclic Antidepressants- Clomiprimine (Anafranil), Doxepin (Sinequan) Nortriptyline (Aventyl), Amitriptyline (Elavil), Maprotiline (Ludiomil) Desipramine (Norpramin)

what is the Essential feature of PTSD how does the event have to be experienced Symptoms are now from four general groups

Significant reaction to serious traumatic event that involves actual or threatened death, serious injury or sexual violation Directly experiencing Witnessing in person Learning the event happened to a close family member or friend Repeated exposure to aversive details of event (e.g., first responders) -Intrusive symptom (e.g., intrusive memories, dreams, flashbacks) -Avoidance of reminders (e.g., avoiding people, places, activities) -Negative alterations in cognition and mood (e.g., self-blame, hopelessness, dissociative symptoms, negative emotional states) -Alterations of arousal and reactivity (e.g., hypervigilance, sleep problems, self-destructive behaviors)

Adjustment Disorders are redefined as The disturbance in adjustment disorders begins within how long of the stressor and last how long after it Adjustment Disorder subtypes

an array of stress-response syndromes occurring after exposure to a distressing event. 3 months of onset of a stressor and lasts no longer than 6 months after the stressor or its consequences have ceased with depressed mood with anxiety with disturbance of conduct

what is the The essential feature of Disinhibited Social Engagement Disorder

involves culturally inappropriate, overly familiar behavior with relative strangers. This behavior violates the social boundaries of the culture

how many patients with PTSD seek treatment and how many of those does it help PTSD is especially hard on what relationship of the patient As the effects of PTSD work their way into a marriage, many risks to individual and marital health increase, including

marriage Lack of support for the military member to cope with the disease Development of PTSD symptoms in the partner Increased marital conflict, which is related to worsening physical functioning for both individuals

PTSD Symptoms persist for at least a what people get Repeated exposure to aversive details of an event During a Traumatic Event what are norepinephrine and serotonin responsible for? what happens to PTSD patients does PTSD affect more men or women

month First responders to accidents/disasters, Social Workers/Therapists/Psychologists/Police Officers exposed to details of violent/unpleasant physical/sexual/emotional abuse of clients/patients/citizens Norepinephrine- Mobilizing fear, the flight response, sympathetic activation, consolidating memory Too much = hypervigalence, autonomic arousal, flashbacks, and intrusive memories Serotonin- self-defense, rage and attenuation of fear Too little = aggression, violence, impulsivity, depression, anxiety switch stuck on women

how does Parents' PTSD symptom severity correlate with their parenting skills what is secondary stress what is the mechanism of this occurrence what have been found to predict a mental health diagnosis for PARTNERS OF THE MILITARY PERSONNEL Partners of military members with PTSD have significantly higher clinical levels of

negatively correlates with parental functioning positively correlates with parenting stress degree of conflict with children severity of discipline partners develop symptoms that mirror PTSD without any primary trauma experience The TRAUMA TRANSMISSION MODEL specifies that partners use not only sympathy, but empathy for their partner's experience, resulting in a realistic experience of the trauma themselves. (1) Increased deployment length and (2) decreased predictability of deployments relational distress (71 %)