Chapter 6 - Trauma and Stressor Related Disorders

Acute stress disorder (ASD)

A condition characterized by flashbacks, hypervigilance, and avoidance symptoms that last up to 1 month after exposure to a traumatic stressor

Adjustment Disorder

A condition involving reactions to life stressors that are disproportionate to the severity or intensity of the event or situation

Asthma

A condition involving reactions to life stressors that are disproportionate to the severity or intensity of the event or situation

Atherosclerosis

A condition involving the progressive thickening and hardening of the walls of arteries due to an accumulation of fats and cholesterol along their inner lining

Aura

A visual or physical sensation (e.g., tingling of an extremity or flashes of light) that precedes a migraine headache

Biofeedback Training

A physiological and behavioral approach in which an individual receives information regarding particular autonomic functions and is rewarded for influencing those functions in a desired direction

Blood Pressure

The measurement of the force of blood against the walls of the arteries

Cluster Headaches

Excruciating stabbing or burning sensations located in the eye or cheek

Coronary Vascular Disease (CVD)

A disease process involving the narrowing of cardiac arteries, resulting in the restriction or partial blockage of the flow of blood and oxygen to the heart

Cortisol

A hormone released by the adrenal glands in response to stress

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Alternates brain structures if chronically elevated

Diastolic Pressure

The arterial force exerted when the heart is relaxed and the ventricles of the heart are filling with blood

Dissociation

A psychological coping mechanism characterized by a sense of disconnection from traumatic circumstances

Elevated Blood Pressure

A condition believed to be a precursor to hypertension, stroke, and heart disease, characterized by:

• Systolic BP: 120 to 129 mm Hg

• Diastolic Pressure: Less than 80 mm Hg

Epinephrine

A hormone released by the adrenal glands in response to physical or mental stress

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Also known as Adrenaline

Eye movement Desensitization and Reprocessing (EMDR)

A therapy for PTSD involving visualization of the traumatic experience combined with rapid, rhythmic eye movements

Fear Extinction

The elimination of conditioned fear responses associated with a trauma (often impaired in individuals with PTSD)

Hypertension

A chronic condition characterized by:

• Systolic BP: 130 mm Hg or higher

• Diastolic Pressure: 80 mm Hg or higher

Hypervigilance

A state of ongoing anxiety in which the person is constantly tense and alert for threats

Migraine Headaches

Moderate to severe head pain resulting from abnormal brain activity affecting the cranial blood vessels and nerves

Normal Blood Pressure

The normal amount of force exerted by blood against the artery walls. Characterized by:

• Systolic Pressure: Less than 120 mm Hg

• Diastolic Pressure: Less than 80 mm Hg

Posttraumatic Stress Disorder (PTSD)

A condition characterized by flashbacks, hypervigilance, avoidance, and other symptoms that last for more than 1 month and that occur as a result of exposure to extreme trauma

Prolonged Exposure Therapy (PET)

An approach incorporating sustained imaginary and real-life exposure to trauma-related cues

Prolonged Grief Disorder

Clinically significant grief symptoms over the loss of a loved one that last more than a year for adults and more than 6 months for children and adolescents

Psychophysiological Disorder

Any physical disorder that has a strong psychological basis or component

Relaxation Training

A therapeutic technique in which a person acquires the ability to relax the muscles of the body in almost any circumstance

Stress

The internal psychological or physiological response to a stressor

Stressors

A difficult life circumstance or event that places a physical or psychological demand on a person

Sympathetic Nervous System

The part of the nervous system that automatically performs functions such as increasing heart rate, constricting blood vessels, and raising blood pressure

Systolic Pressure

The force on blood vessels when the heart contracts

Tension Headaches

Head pain produced by prolonged contraction of the scalp and neck muscles, resulting in constriction of the blood vessels and steady pain

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT)

A therapeutic approach that helps clients identify and challenge dysfunctional cognitions about a traumatic event

In the DSM-5, Adjustment Disorder symptoms must begin within what time frame of exposure to the stressor?

Within 3 months of exposure to the stressor.

For a diagnosis of Adjustment Disorder, symptoms should last no longer than what after the termination of the stressor or its consequences?

6 months

How does Acute Stress Disorder (ASD) differ from Posttraumatic Stress Disorder (PTSD) in terms of symptom duration?

ASD symptoms persist from 3 days to 1 month, while PTSD symptoms must be present for at least 1 month.

What type of stressor is required for a diagnosis of Acute Stress Disorder or PTSD?

Direct or indirect exposure to a traumatic stressor involving actual or threatened death, serious injury, or sexual violence.

PTSD is twice as prevalent in which gender?

Women

What is the term for the relatively stable functioning and few symptoms that can result from trauma?

Resilience

Which trauma outcome trajectory involves initial distress with a reduction in symptoms over time?

Recovery

What are the five main symptom clusters required for a diagnosis of PTSD or ASD?

Intrusion, avoidance, negative alterations, in mood or cognition, arousal/changes in reactivity, and dissociation

What is the minimum number of symptoms required for an Acute Stress Disorder (ASD) diagnosis?

At least nine symptoms from any of the symptom clusters.

The system involved in stress and trauma reactions, which releases hormones like epinephrine and cortisol, is known as the _____.

Hypothalamic-pituitary-adrenal (HPA) axis

Which part of the brain activates following threat detection and is the major interface between environmental events and physiological fear responses?

The Amygdala

Serotonin transporter gene (5-HTTLPR).

Individuals with two short alleles of the _____ gene appear to have increased stress sensitivity and are more prone to anxiety reactions following severe trauma.

According to the multipath model, what is a key factor in the social dimension that can diminish PTSD symptoms?

Social support

What class of antidepressants is moderately effective in treating PTSD by altering serotonin levels?

Selective Serotonin Reuptake Inhibitors (SSRIs)

What experimental drug, when combined with exposure-based therapy, has shown effectiveness in reducing severe PTSD symptoms by suppressing emotional memory circuits?

Methylendioxymethamphetamine (MDMA)

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Ecstasy

What type of therapy for PTSD involves sustained imaginary and real-life exposure to trauma-related cues to facilitate fear extinction?

Prolonged Exposure Therapy (PET)

Eye Movement Desensitization and Reprocessing (EMDR)

A therapy for PTSD where clients visualize their trauma while engaged in bilateral stimulation, aiming to decrease physiological reactivity.

Atherosclerosis

The narrowing of cardiac arteries due to the buildup of plaque, which is a key process in coronary heart disease

Broken Heart Syndrome

What is the common name for the reversible cardiac condition where severe stress results in a sudden reduction in heart function?

Systolic Pressure: At or above 130 mm Hg

Diastolic Pressure: At or above 80 mm Hg

What systolic and diastolic blood pressure readings are considered the threshold for hypertension?

Migraine

Which type of headache is often accompanied by nausea and aura alongside moderate to severe pain?

Tension Headache

What type of headache is characterized by moderate to severe pain resulting from abnormal brain activity, often accompanied by nausea and an aura?

Cluster Headache

What type of headache involves excruciating, rapid-onset stabbing or burning sensations located in or around one eye?

Asthma

What chronic inflammatory disease of the lungs can be aggravated by stress, causing mucus secretion, spasms, and swelling of the airways?

impair

While brief exposure to stressors enhances immune functioning, long-lasting stress can _____ immune response.

Hostility

In the psychological dimension of psychophysiological disorders, what personality trait is particularly associated with coronary heart disease (CVD)?

Biofeedback Training

Therapeutic technique involves learning to voluntarily control physiological processes like heart rate or blood pressure by receiving feedback on them

Mindfulness-Based Stress Reduction

What cognitive-behavioral approach helps clients foster nonjudgmental awareness of sensations and feelings to reduce stress?

Depersonalization

The feeling of being detached from one's body or thoughts, sometimes experienced in trauma

Derealization

A persistent sense of unreality or detachment from one's surroundings, sometimes seen in trauma-related disorders

Dissociation

Psychological coping mechanism characterized by a sense of disconnection from traumatic circumstances

Epinephrine (Adrenaline)

Hormone released by the adrenal glands in response to stress as part of the 'fight or flight' response

Norepinephrine (Noadrenaline)

Hormone that is released during severe stress and is implicated in 'broken heart syndrome'

An Adjustment Disorder can be caused by a stressor of any type or severity, whereas PTSD requires a specific traumatic stressor involving threat to life, serious injury, or sexual violence.

What is the primary difference between a stressor that causes an Adjustment Disorder and one that causes PTSD?

Rape (45.9%)

Which specific trauma shows the highest risk percentage for developing PTSD in women?

Rape (65%)

Which specific trauma shows the highest risk percentage for developing PTSD in men?

out of proportion

The diagnostic criteria for Adjustment Disorder state that the emotional distress and behavioral symptoms must be _____ to the severity of the stressor.

Homeostasis

In the biological etiology of physical disorders, what is the term for physiological balance that the body's systems are designed to maintain?

Acceptance and Commitment Therapy (ACT)

Therapy that focuses on helping clients accept life difficulties and commit to behaviors consistent with their personal values

Race-Based Discrimination and Racism

What type of stressful experiences can produce psychological trauma and account for ethnic differences in PTSD prevalence according to the Sociocultural Dimension?

Reactive Attachment Disorder and Disinhibited Social Engagement Disorder 

Which two childhood disorders, covered in Chapter 16, are included in the DSM-5 trauma- and stressor-related disorder category?

Between 8 to 11%

What is the lifetime prevalence of PTSD for women in the United States?

4 to 5%

What is the lifetime prevalence of PTSD for men in the United States?

By witnessing a traumatic event, learning of one involving loved ones, or through repeated contact with aversive details of a traumatic event.

In what way can indirect exposure to trauma lead to a diagnosis of PTSD?

Intergenerational Trauma

The concept that collective historic trauma (e.g., from slavery or colonization) is passed down through generations

Diastolic Pressure

The arterial force exerted when the heart is relaxed and the ventricles are filling with blood

Systolic Pressure

The force on blood vessels when the heart contracts

Coronary heart disease (CHD) or Coronary vascular disease (CVD)

What is the leading cause of death in the United States, which can be influenced by psychosocial factors like stress and depression?

Dysregulation of physiological processes and the development of a physical disorder.

In the context of psychophysiological disorders, what can chronic activation of the sympathetic nervous system and continual release of stress hormones lead to?

Control and the perception of control over the environment and its stressors.

What psychological factor can mitigate the negative effects of stress by providing a sense of mastery?

African American adults have one of the highest rates of hypertension.

What is a key difference in prevalence rates of hypertension among ethnic groups in the U.S.?

Medication-overuse Headache

A secondary headache disorder that results from rebound effects associated with excessive use of headache medication.

To teach a person to acquire the ability to relax the muscles of the body in almost any circumstance.

What is the primary goal of relaxation training in the treatment of stress-related disorders?

Having the client repeatedly imagine and describe the traumatic event as if it were happening now, including thoughts and emotions.

What is a core technique in prolonged exposure (PE) therapy?

Few initial symptoms followed by increasing symptoms over time.

Delayed Symptoms Trajectory following Trauma

Natural Disaster (57.5%)

Among undergraduates, what is the most commonly reported lifetime exposure to a traumatic event according to Table 6.2?

Intrusion Symptoms

Symptom cluster of PTSD that includes distressing recollections, nightmares, or flashbacks of the trauma

Avoidance

Symptom cluster of PTSD includes avoidance of thoughts, feelings, or physical reminders associated with the trauma

Negative alterations in mood or cognition

Symptom cluster of PTSD includes difficulty remembering details of the event and persistent negative views about oneself or the world

Arousal and changes in reactivity.

Symptom cluster of PTSD includes irritability, hypervigilance, and an exaggerated startle response

Through epigenetic mechanisms that produce lasting changes in stress-responsive neurobiological systems

How might early environmental influences like childhood trauma increase vulnerability to psychophysiological disorders?

They can moderate the link, as hostile individuals in high-quality relationships display reduced physiological reactivity to stress.

What effect can good social relationships have on the link between hostility and poor health?

Posttraumatic Growth 

The finding that moderate amounts of prior adverse events can lead to better mental health and resilience compared to minimal or high levels of adversity

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The “silver lining” effect described in the “Focus on Resilience” section

intentional

PTSD symptoms are more likely to develop when the trauma is _____ rather than nonintentional.

ASD requires nine symptoms from any cluster, while PTSD requires at least one or two symptoms from each of the four main clusters.

What is the primary difference in diagnostic criteria between ASD and PTSD regarding symptom clusters?