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CLP4143 Exam 3 Study Guide CHAPTER 7 ACUTE AND POSTTRAUMATIC STRESS DISORDERS DISSOCIATIVE DISORDERS AND SOMATIC SYMPTOM DISORDERS Dissociation Traumatic stress The disruption of the normally integrated mental processes involved in memory consciousness identity or perception THREATENED DEATH or serious injury or sexual violence to self or witnessing others experience trauma learning that loved ones have been traumatized or repeatedly being exposed to details of trauma Difference between ASD and PTSD Defined in the DSM 5 as an event that involves ACTUAL OR o Acute Stress Disorder Occurs within a month after exposure to traumatic stress o Posttraumatic Stress Disorder Lasts longer than one month sometimes has a delayed onset Symptoms of ASD and PTSD o Intrusive Re experiencing Repeated distressing images or thoughts Intrusive flashbacks Horrifying dreams Dissociative state o Negative Mood or Thoughts Range of negative feelings Persistent fear anger or guilt or feelings of detachment from others Numbing of responsiveness emotional anesthesia Inability to experience positive emotions o Dissociative Symptoms Dazed and act spaced out Depersonalization feeling like a robot Derealization Dissociative amnesia Diagnosis of ASD and PTSD o DSM 5 groups ASD and PTSD in a new diagnostic grouping Trauma and stressor related disorders This new category includes adjustment disorders o Dissociation is involved in many PTSD symptoms not just the explicit dissociative symptoms Historical perspective of ASD and PTSD o Vietnam War prompted combat being very common What Defines Trauma o DSM 5 definition much interest in PTSD due to delayed reactions to A direct exposure to actual or threatened death serious injury or sexual violation Sexual violation is a new part of the definition Being witness to actual or threatened death serious injury or sexual violation being in a car that is hanging off a bridge Disaster and Emergency Workers o Hardiness Sense of commitment Control Challenge in facing stress Prevalence of PTSD 6 8 of people living in the United States Frequency of Trauma PTSD and ASD o Prevalence of PTSD Unexpected death of loved one is most common cause 20 40 of children develop PTSD o Many traumas do not occur at random due to risky behaviors o People who are anxious or who have a family history of mental illness also experience more traumas o People with ASD are likely to develop PTSD Course and Outcome Causes of PTSD and ASD o Social factors o Psychological factors With less severe stressors social support after a trauma can play a crucial role in alleviating long term psychological damage The risk for PTSD depends on cognitive factors preparedness purpose and absence of blame EX if you are more likely to blame the situation that gave you trauma on yourself you re more likely to get PTSD positive changes resulting from trauma linked with depression and more positive well being but also with more intrusive and avoidant thoughts Posttraumatic growth Prevention and Treatment of ASD PTSD o Cognitive Behavior Therapy for PTSD is reexposure to trauma Prolonged exposure Imagery rehearsal therapy Cognitive restructuring o Antidepressant Medication Antidepressants and therapeutic reexposure are first line therapies for PTSD Effectiveness of SSRIs is likely at least partially due to the high comorbidity between PTSD and depression Dissociative Disorders o Symptoms characterized by persistent maladaptive disruption in the integration of memory consciousness or identity Psychologically produced amnesia Confused travel of long distances from home Existence of two or more personalities in one person o Controversial and disbelieved by many Social role o Symptoms of Dissociative Disorders Dissociative identity Disorder DID Two or more personalities coexist within a single individual Depersonalization Derealization People feel detached from themselves Symptom involves feelings of unreality detachment from the environment like living in a dream as if feelings Dissociative amnesia Partial or complete loss of recall for particular events or for a particular period of time emotional distress can be a cause o Dissociative identity disorder DID Existence of two or more personalities in a single individual Rarely diagnosed outside of the US EX only 1 case in 25 years in Britain CHAPTER 14 NEUROCOGNITIVE DISORDERS Neurocognitive disorders Most frequent disorders found among elderly psychiatric Dementia a GRADUAL worsening loss of memory and related cognitive functioning Delirium a confusional state that develops over a short period of time Amnestic disorders memory impairments that are more limited than those seen in Neurologists Physicians who deal with disease of the brain and nervous system medical patients dementia or delirium background Neuropsychologists Assess for cognitive impairments Delirium o Primary symptom A clouding of consciousness in association with a reduced ability to maintain and shift attention o Symptoms of delirium follow a rapid onset from a few hours to several days o Symptoms usually worse at night o Sleep wake cycle is often disturbed o Coma may occur if symptoms allowed to progress Neurocognitive Symptoms o Memory and learning Memory loss is diagnostic hallmark Retrograde amnesia Anterograde amnesia Most obvious problem during the beginning stages of dementia Inability to learn or remember new information Aphasia loss or impairment in language Apraxia difficulty performing purposeful movements in response to o Verbal communication verbal commands o Neuropsychological test Personality and emotion o Changes and disturbances frequently associated with dementia o Hallucinations and delusions are seen in at least 20 of dementia cases More common during the later stages of the disorder o Emotional consequences are varied some are apathetic some are unpredictable exaggerated Motor Behaviors o May become agitated pacing restlessly or wandering away from familiar places o Muscular rigidity o Dyskinesia tic tremors jerky movements of face limbs chorea o Approximately 25 of dementia patients also exhibit symptoms of major Dementia vs Depression depressive disorder o Lack of interest withdrawal from environment trouble concentrating Specific types of neurocognitive disorder o Many specific disorders are associated with dementia o Distinguished primarily on the basis of known neuropathology Prevalence of Dementia o Samples in North America and Europe prevalence of dementia in people between 65 and


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FSU CLP 4143 - Exam 3

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