Test 3 Abnormal Psych Chapter 7 Acute and Post traumatic Stress Disorders Traumatic stress disorders dissociative disorders and somatoform disorders look different but share an important similarity Dissociation The disruption of the normally integrated mental processes involved in memory consciousness identity or perception Traumatic Stress De ned in the DSM 5 as an event that involves actual or threatened death or serious injury or sexual violence to self or witnessing others experience trauma learning that loved ones may have been traumatized or repeatedly being exposed to details of trauma Post traumatic Stress Disorder PTSD Lasts longer than one month sometimes has a delayed onset Acute Stress Disorder ASD Occurs within a month after exposure to traumatic stress Symptoms of ASD and PTSD Intrusive Re experiencing Repeated distressing images or thoughts Intrusive ashbacks Horrifying dreams Dissociative state Avoidance Increased Arousal or Reactivity Predicts a worse prognosis Hyper vigilance 1 Restlessness agitation and irritability Exaggerated startle response Negative Mood or Thoughts Persistent fear anger or guilt or feelings of detachment from others Range of negative feelings Inability to experience positive emotions Numbing of responsiveness emotional anesthesia Dissociative Symptoms Depersonalization feeling like a robot Derealization Dissociative amnesia Dazed and act spaced out Diagnosis of ASD and PTSD DSM 5 groups ASD and PTSD in a new diagnostic grouping Trauma and stressor related disorders This new category includes adjustment disorders Dissociation is involved in many PTSD symptoms not just the explicit dissociative symptoms Brief historical perspective combat being very common What de nes trauma Vietnam War prompted much interest in PTSD due to delayed reactions to An direct exposure to actual or threatened death serious injury or sexual violation Sexual violation is a new part of the de nition Being witness to actual threatened death serious injury or sexual violation being in a car that is hanging off a bridge 2 Disaster and Emergency Workers Not immune to trauma s aftereffects Emergency workers are less than half as likely to develop PTSD as victims Training preparation and sense of purpose appear to be protective Hardiness Sense of commitment Control Challenge in facing stress Frequency of Trauma PTSD and ASD Prevalence of PTSD 6 8 of people living in the United States 90 of people living in Detroit have experienced a trauma with 9 developing PTSD Unexpected death of a loved one is most common cause 20 40 of children develop PTSD Many traumas do not occur at random due to risky behaviors People who are anxious or who have a family history of mental illness also experience more traumas Course and Outcome People with ASD are likely to develop PTSD 3 symptoms best predict future PTSD Numbing Depersonalization A sense of reliving the experience Social Factors intense 3 Victims of trauma are more likely to develop PTSD when the trauma is more With less severe stressors social support after a trauma can play a crucial role in alleviating long term psychological damage Psychological Factors The risk of PTSD depends on cognitive factors Preparedness purpose and absence of blame Post traumatic growth positive changes resulting from trauma linked with depression and more positive well being but also with more intrusive and avoidant thought The role of dissociation is debated may not be adaptive may be related to more PTSD Prevention and Treatment of ASD PTSD Cognitive Behavior Therapy for PTSD The most effective treatment for PTSD is reexposure to trauma Prolonged exposure Imagery rehearsal therapy Cognitive restructuring Antidepressant Medication Antidepressants and therapeutic reexposure are rst line therapies for pTSD Dissociative Disorders Symptoms characterized by persistent maladaptive disruption in the integration of memory consciousness or identity Confused travel of long distances from home Psychologically produced amnesia Controversial and disbelieved Hypnosis Altered State or Social Role Debated as being a true state of dissociation Symptoms of Dissociative Disorders 4 Dissociative Identity Disorder DID Two or more personalities coexist within a single individual Depersonalization People feel detached from themselves Derealization Symptom involves feelings of unreality detachment from the environment Dissociative amnesia Partial or complete loss of recall for particular events or for a particular period of time emotional distress can be a cause Chapter 14 Neurocognitive Disorders Neurocognitive disorders Most frequent disorders found among elderly psychiatric patients Dementia Delirium A gradual worsening loss of memory and related cognitive functioning A confusional state that develops over a short period of time Primary symptom A clouding of consciousness in association with a reduced ability to maintain and shift attention Symptoms of delirium follow a rapid onset from a few hours to several days Symptoms usually worse at night Sleep wake cycle is often disturbed Coma may occur if symptoms allowed to progress Memory impairments that are more limited than those seen in dementia or Amnestic disorders delirium 5 Dementia and delirium are listed as cognitive disorders in DSM 5 Cognitive processes Physicians who deal with disease of the brain and nervous system Perception and attention Memory Reasoning and decision making Neurologist Neuropsychologists Asses for cognitive impairments Neurocognitive Symptoms Memory and Learning Memory loss is diagnostic hallmark Retrograde amnesia Anterograde amnesia Verbal communication Aphasia Loss or impairment in language Apraxia Symptoms Personality Emotion Inability to learn or remember new information Most obvious problem during the beginning stages of dementia Dif culty performing purposeful movements in response to verbal commands Hallucinations and delusions are seen in at least 20 of dementia cases More common during the later stages of the disorder Changes and disturbances frequently associated with dementia 6 Emotional consequences are varied Apathetic or emotionally at Exaggerated and unpredictable Motor Behaviors May become agitated pacing restlessly or wandering away from familiar places Muscular rigidity Dyskinesia Tic tremors and jerky movements of the face and limbs called chorea Dementia versus Depression Approximately 25 of dementia patients also exhibit symptoms of major depressive disorder Lack of
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