Trauma-Related Disorders, Exposure Therapies, and Epidemiology

Vocabulary flashcards covering trauma treatments (exposure therapies, TF-CBT, EMDR), diagnostic categories (PTSD, ASD, Adjustment Disorder, Prolonged Grief Disorder), and epidemiologic prevalence rates.

Fear Hierarchy

A structured series of feared situations arranged from least to most distressing, utilized in exposure therapy to help patients work up gradually.

Exposure Therapy

A behavioral treatment technique involving direct or indirect exposure to anxiety-provoking stimuli; common types include imaginal exposure, in vivo exposure, and flooding.

Imaginal Exposure

An exposure therapy technique that mentally recreates specific details of a traumatic event, requiring the patient to repeatedly discuss the event in increasing detail while providing thoughts and feelings at each step.

In Vivo Exposure

An exposure technique where an individual is reminded of a traumatic event using videos, images, or tangible objects while re-experiencing associated cognitions, emotions, and physiological symptoms, and encouraged to use positive coping strategies.

Flooding

An exposure therapy technique that disregards the fear hierarchy by presenting the most distressing memories or images at the beginning of treatment; highly effective but carries high distress and risk of patient dropout.

Cognitive Behavioral Therapy (CBT)

An effective form of psychological treatment designed to identify and challenge negative cognitions surrounding a traumatic event and replace them with positive/adaptive cognitions.

Trauma-Focused CBT (TF-CBT)

An adaptation of CBT combining cognitive behavioral techniques and trauma-sensitive principles, structured around the acronym PRACTICE.

PRACTICE Acronym

The components of TF-CBT: Psycho-education, Relaxation Training, Affect, Correcting negative or maladaptive thoughts, Trauma narrative, In vivo exposure, Co-Joint family session, and Enhancing Security.

Eye Movement Desensitization and Reprocessing (EMDR)

A therapy for trauma incorporating lateral eye movements induced by a therapist moving their index finger back and forth, integrating components of CBT and exposure therapy.

EMDR 8-Step Approach

The treatment protocol of EMDR consisting of 1. Patient History & Treatment Planning, 2. Preparation, 3. Assessment, 4. Desensitization Reprocessing, 5. Installation of Positive Cognitions, 6. Body Scan, 7. Closure, and 8. Reevaluation.

Desensitization Reprocessing (EMDR)

Step $4$ of EMDR where the patient holds a trauma image, cognition, and emotion in mind while tracking finger movement for $20\,\text{seconds}$ to blank out the memory and evaluate physiological symptoms.

Installation of Positive Cognitions (EMDR)

Step $5$ of EMDR where the patient holds a positive image or thought while tracking the therapist's finger movement for $10\,\text{seconds}$ after negative thoughts/images are reduced.

Bilateral Stimulation

Repeated in-session stimulation (typically eye movements, taps, or tones) used in EMDR for target memories until they are no longer distressing.

Stressor

Any event—witnessed firsthand, experienced personally, or experienced by a close family member—that increases physical or psychological demands on an individual.

Trauma

Significant events that pose a real or imagined threat to an individual, such as combat-related trauma, physical assault, sexual assault, and rape.

Posttraumatic Stress Disorder (PTSD)

A condition identified by physiological, psychological, and emotional symptoms following exposure to a situation with actual or threatened death, serious injury, or sexual violence.

PTSD Category 1: Recurrent Experiences

PTSD symptoms occurring via dissociative reactions such as flashbacks, intrusive distressing memories, or distressing dreams specific to the traumatic event or moments immediately following.

PTSD Category 2: Avoidance of Stimuli

PTSD symptoms where individuals avoid distressing thoughts, memories, feelings, locations, individuals, activities, or situations associated with the traumatic event.

PTSD Category 3: Negative Alterations in Cognition or Mood

PTSD symptoms including memory gaps regarding the event, self-blame, persistent negative beliefs about oneself/others, diminished interest in activities, social detachment, and inability to experience positive emotions.

PTSD Category 4: Alterations in Arousal and Reactivity

PTSD symptoms including quick temper, verbal/physical aggression, heightened startle response, sleep disturbances, reckless behavior, and concentration issues present for at least $1\,\text{month}$.

Acute Stress Disorder (ASD)

A disorder requiring $9$ symptoms across $5$ categories (intrusion, negative mood, dissociative, avoidance, arousal; $14$ total symptoms) present from $3\,\text{days}$ to $1\,\text{month}$ following a traumatic event.

Adjustment Disorder

A disorder characterized by significant emotional or behavioral symptoms in response to a stressor that impair social or occupational functioning, subtyped into six clinical classifications.

Prolonged Grief Disorder

A diagnostic entity in the DSM-5-TR characterized by intense yearning or preoccupation with thoughts of a deceased person who died at least $12\,\text{months}$ ago.

Epidemiology

The study of the distribution and determinants of health-related states or events in specified populations.

PTSD Prevalence Statistics

Affects $6.8\%$ of U.S. adults ($3.0\%$ to $8.1\%$ for U.S. adolescents), up to $30\%$ in combat veterans, with higher prevalence in females ($8\%$ to $11\%$) than males ($4.1\%$ to $5.4\%$).

Acute Stress Disorder Prevalence Statistics

Estimated that $7\%$ to $30\%$ of individuals experiencing a traumatic event develop ASD, with $50\%$ of ASD cases progressing to PTSD.

Adjustment Disorder Prevalence Statistics

Affects $5\%$ to $20\%$ of individuals in outpatient treatment, with higher rates observed in women, the LGBTQ+ community, and transgender individuals.

Prolonged Grief Disorder Prevalence Statistics

A diagnostic entity with a pooled estimated global prevalence of $9.8\%$ across studies.

Comorbidity

The simultaneous presence of two or more medical or psychological conditions, such as PTSD co-occurring with depressive, bipolar, anxiety, or substance abuse disorders.