Disorders of Trauma & Stress

Components of Stress

Different factors that contribute to stress

Stressors

Stimuli perceived as threatening that cause stress

Stress response

Reaction to stimuli perceived as threatening

Variable

Something that can change or vary

Overwhelming

Becoming too much to handle or cope with

Reactions

Responses to stress or stimuli

Anxiety

Feeling of unease or worry

Fear

Emotion caused by perceived threat

Anhedonia

Inability to experience pleasure

Aggression

Hostile or violent behavior

Dissociative

Disconnecting or separating from reality

Trauma & Stress-related Disorders

Disorders caused by exposure to trauma or stress

New category in DSM-5

Recently added category in the Diagnostic and Statistical Manual of Mental Disorders

Exposure to trauma/stressor is a diagnostic criterion

Requirement for diagnosis of trauma or stress-related disorders

Post-traumatic stress disorder (PTSD)

Disorder caused by experiencing or witnessing a traumatic event

Acute stress disorder

Short-term stress reaction to a traumatic event

Dissociative disorders

Disorders characterized by dissociation or detachment from reality

Dissociative Amnesia

Inability to recall important personal information due to trauma or stress

Dissociative Identity Disorder

Presence of multiple distinct identities or personalities

Depersonalization-derealization disorder

Feeling detached from oneself or the world

Stress Response: Cognitive

How the mind responds to stress

Appraisal

Evaluation or assessment of a stressor

Primary appraisal

Assessment of how threatening a situation is to important goals or survival

Secondary appraisal

Assessment of how well one can cope with a situation

Fear Response

Automatic response to a perceived threat

Speedy Low Road

Quick, unconscious processing of visual stimuli that triggers fear response

Visual stimuli

Information received through the eyes

Amygdala

Part of the brain responsible for processing emotions, including fear

Hypothalamus

Part of the brain that activates the body's stress response

Thinking High Road

Conscious processing of visual stimuli that triggers fear response

Prefrontal cortex

Part of the brain responsible for decision-making and rational thought

Cortical and subcortical

Involving both the outer layer and inner regions of the brain

Stress Response: Physiological

How the body responds to stress

Complex neural network

Intricate system of nerves that carries information throughout the body

Nervous System

System of nerves that controls actions and bodily processes

Central Nervous System (CNS)

Brain and spinal cord

Peripheral Nervous System (PNS)

Nerves that branch out from the spinal cord and brain to reach the extremities of the body

Somatic Division

Part of the peripheral nervous system responsible for voluntary muscle activation

Autonomic Nervous System Functions

Functions of the part of the nervous system that connects the central nervous system to other organs

Homeostatic conditions

Stable internal conditions maintained by the body

Coordinates the body's response to exercise, stress

Regulates the body's response to physical activity and stress

Endocrine System

System of glands that produce and release hormones

Adrenal glands

Glands that release stress hormones

Adrenaline (epinephrine)

Hormone released during stress that increases physiological arousal

Noradrenaline (norepinephrine)

Hormone released during stress that produces fear and physiological arousal

General Adaptation System

Body's response to stress, consisting of three phases

Alarm

Initial response to a stressor

Resistance

Body's attempt to cope with ongoing stress

Exhaustion

Body's inability to cope with prolonged stress

Acute and Posttraumatic Stress Disorders: Core Symptoms

Main symptoms of acute and posttraumatic stress disorders

Re-experiencing

Reliving traumatic events through thoughts, dreams, or flashbacks

Persistent avoidance

Avoiding people, places, or things associated with trauma

Reduced responsiveness

Decreased emotional or cognitive response to stimuli

Increased physiological arousal

Heightened physical response to stress, such as difficulty sleeping or irritability

Time differentiates PTSD and ASD

The duration of symptoms differentiates between post-traumatic stress disorder (PTSD) and acute stress disorder (ASD)

Acute

Short-term or immediate

PTSD

Post-traumatic stress disorder

Exposure to trauma required for diagnosis

Experiencing or witnessing a traumatic event is necessary for the diagnosis of trauma-related disorders

Direct or indirect exposure

Experiencing the trauma firsthand or learning about it happening to a loved one

Children and adults

Both children and adults can develop trauma-related disorders

Developmentally different symptom

Symptoms of trauma-related disorders may manifest differently in children compared to adults

Who's most likely to develop a stress disorder?

Certain groups of people are more likely to develop trauma-related disorders

Combat veterans

Military veterans who have experienced combat

Victims of physical or sexual assault, torture

Individuals who have experienced physical or sexual violence or torture

Victims of terrorism

Individuals who have been affected by acts of terrorism

Survivors of disasters (natural or man-made)

Individuals who have experienced natural or man-made disasters

Key factors

Important factors that contribute to the development of trauma-related disorders

Severity of trauma

The extent or intensity of the traumatic event

Duration of trauma

Length of time the traumatic event lasts

Proximity to the trauma

How close someone is to the traumatic event

Prevalence Estimates

Estimates of how common trauma-related disorders are

Lifetime prevalence estimates

Estimates of how many people will experience a trauma-related disorder in their lifetime

Victims of Hurricane Katrina

Individuals affected by the hurricane that hit the Gulf Coast of the United States in 2005

Risk factors for PTSD

Factors that increase the likelihood of developing post-traumatic stress disorder

Loss of a loved one

Experiencing the death of someone close

Being trapped/rescued

Feeling trapped or being rescued from a dangerous situation

No gender differences

There is no significant difference in the prevalence of trauma-related disorders between genders

Why do some people develop these disorders?

Factors that contribute to the development of trauma-related disorders

Damage to hippocampus

Injury or impairment to the part of the brain involved in memory and emotion

Intrusive memories

Unwanted and distressing memories of the traumatic event

Physiological arousal

Physical response to stress, such as increased heart rate or sweating

20% reduction in hippocampal volume in Vietnam vets with PTSD

Vietnam veterans with post-traumatic stress disorder have a 20% smaller hippocampus compared to those without PTSD

Hyperarousal of amygdala

Overactivation of the part of the brain responsible for processing emotions, particularly fear

Emotional memory

Memory associated with emotions, particularly fear

Fear

Emotion caused by perceived threat

Biopsychosocial Perspective

Approach that considers biological, psychological, and social factors in understanding mental health

Genetic Vulnerability

Increased risk of developing trauma-related disorders due to genetic factors

Prenatal exposure to higher cortisol levels

Being exposed to high levels of the stress hormone cortisol in the womb

Smaller hippocampal volume

Having a smaller hippocampus, which is associated with memory and emotion

Psychological vulnerability

Increased risk of developing trauma-related disorders due to psychological factors

Personality style

Characteristic way of thinking, feeling, and behaving

Higher trait anxiety

Tendency to experience anxiety in various situations

Perceived lack of control

Feeling of not having control over one's life or circumstances

Unpredictable/controllable events

Experiencing events that are unpredictable or beyond one's control

Poor coping strategies

Ineffective or maladaptive ways of dealing with stress or trauma

Social-cultural vulnerability

Increased risk of developing trauma-related disorders due to social and cultural factors

Living in poverty

Being in a state of extreme financial hardship

Social support family instability

Lack of stable and supportive relationships with family members

Multicultural factors

Factors related to different cultures and their impact on mental health

Increased prevalence of PTSD among Hispanic Americans

Higher rates of post-traumatic stress disorder among individuals of Hispanic American descent