Abnormal Psychology 1 Exam 3 Book Notes Topics VI and VII Topic VI Acute and Posttraumatic Stress Disorders Dissociative Disorders and Somatoform Disorders Chapter 7 Traumatic stress disorders somatoform disorders and dissociative disorders all share one similarity dissociation Dissociation the disruption of the normally integrated mental processed involved in memory consciousness identity or perception Traumatic stress disorders are grouped with anxiety disorders in the DSM Traumatic Stress an event that involves actual or threatened death or serious injury to self or others and creates intense feelings of fear helplessness or horror Acute Stress Disorder ASD occurs within 4 weeks after the exposure to traumatic stress and is characterized by dissociative symptoms re experiencing of the event avoidance of reminders of the trauma and marked anxiety or arousal Posttraumatic Stress Disorder PTSD is defined by symptoms of re experiencing avoidance and arousal But in PTSD the symptoms either are longer lasting or have a delayed onset The defining symptoms of both ASD and PTSD are re experiencing avoidance and persistent arousal or anxiety Dissociative symptoms also are common in the immediate aftermath of a trauma and must be present to make a diagnosis of ASD but not PTSD Re experiencing Survivors often re experience trauma in various ways experience repeated distressing images or thoughts of the incident Visualize the trauma over and over or repeatedly question what they might have done differently Relive the trauma in horrifying dreams Flashbacks repeated or intrusive sudden memories during in which the trauma is replayed in images or thoughts often at full emotional intensity In rare cases it occurs as a dissociative state where the person feels and acts as if the trauma were Abnormal Psychology 2 reoccurring in the moment dissociative states are usually of short duration but in unusual cases they can last for days Avoidance Marked or persistent avoidance of stimuli associated with the trauma is another symptom of ASD and PTSD 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 In PTSD the avoidance my manifest itself into a general numbing or responsiveness emotions are dampened or even nonexistent can cause sufferers to withdraw from others particularly from close relationships emotional anesthesia Arousal or Anxiety Includes hypervigilance in searching for dangers restlessness agitation and irritability Exaggerated startle response excessive fear reactions to unexpected stimuli The symptoms of arousal and anxiety are why traumatic stress disorders are grouped with the anxiety disorders in DSM Dissociative Symptoms Feeling dazed act spaced out depersonalization derealization or dissociative amnesia and a numbing or detachment from others Depersonalization feeling cut off from themselves or their environment Derealization marked sense or unreality about yourself and the world around you Dissociative Amnesia the inability to recall important aspects of traumatic stress ASD The diagnostic criteria for ASD and PTSD are essentially the same except ASD explicitly includes dissociative symptoms and lasts no longer than 4 weeks PTSD must continue longer and have a delayed onset Disaster and Emergency Workers are protected by their training preparation and sense of purpose More generally hardiness a sense of commitment control and challenge in facing stress predicts lower risk for PTSD Comorbidity many people with PTSD also suffer from another mental disorder Comorbidity is high for Depression other anxiety disorders Abnormal Psychology 3 substance abuse PTDS is also associated with Disturbing nightmares Physical symptoms headaches and gastrointestinal problems Grief Relationship difficulties Increased suicide risk Anger at oneself and others is another prominent issue Prevalence of PTSD 8 of living people 10 women 5 men Men combat exposure Women rape Children 20 to 40 develop PTSD Minority groups more likely to experience PTSD because of their living conditions Most common trauma which causes PTSD is sudden unexpected death of a loved one the prevalence is only about 1 in 7 but because of the high rate of unexpected death of loved ones the risk is high Rape and assault are among the very worst traumas and have a high risk for PTSD Risk course and outcome experience trauma Men young people people with conduct disorders and extroverts are all more likely to Neurotic people are more likely to develop PTSD after exposure to trauma People who experienced trauma earlier in life and developed PTSD are also more likely to develop PTSD after experiencing a second trauma People who suffer from ASD are more likely to develop PTSD Subclinical ASD symptoms not severe or pervasive enough to meet the criteria for diagnosis nevertheless increases risk for PTSD may be chronic Causes for PTSD and ASD Social factors for PTSD and ASD focus 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 In PTSD the sympathetic nervous system is aroused and the fear response is sensitized Abnormal Psychology 4 Alterations in the functioning and perhaps the structure of the amygdala and hippocampus are consistent with the experience of heightened fear reactivity and intrusive memories Two factor theory associated with it 1 classical conditioning creates a fears when the terror of trauma is paired with the cues 2 operant conditioning maintains avoidance by reducing fear negative reinforcement And avoidance also prevents the extinction of anxiety through extinction The risk for PTSD depends on cognitive factors such as preparedness and control purpose and blame Dissociation is an unconscious defense that helps victims cope with trauma Over time victims need to find a balance between gradually facing their painful emotions while not being overwhelmed by the them Emotional processing involves three stages 1 Victims must engage emotionally with their traumatic memories 2 victims need to find a way to articulate and organize their chaotic experience 3 victims must come to believe that despite the trauma the world is not a terrible place Meaning making the last step of emotional processing Eventually finding some value or reason for having endured trauma Posttraumatic growth positive changes resulting from trauma is linked with
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