Trauma, Stress, and Related Disorders Overview

Stress

The body's response to perceived threats or demands.

Types of stressors

Acute (short-term), chronic (long-term), traumatic (life-threatening), daily hassles.

Stress response

The fight, flight, or freeze reaction.

Sympathetic nervous system

Activates the fight-or-flight response (e.g., increased heart rate and respiration).

HPA axis

Hypothalamus → Pituitary → Adrenal glands; releases cortisol to manage stress.

Effects of chronic stress

Impaired immunity, memory problems, anxiety, depression, cardiovascular issues.

Difference between PTSD and Acute Stress Disorder

PTSD symptoms last more than 1 month; ASD symptoms last less than 1 month.

Trauma (Criterion A)

Exposure to actual or threatened death, serious injury, or sexual violence.

Main PTSD symptoms (Criteria B-E)

B: Intrusion (flashbacks, nightmares), C: Avoidance (memories, reminders), D: Negative thoughts/mood (guilt, detachment), E: Arousal/reactivity (irritability, hypervigilance).

Dissociative symptoms in trauma

Depersonalization and derealization.

Who is more likely to experience PTSD

Women.

Risk factors for worse PTSD outcomes

Severe trauma, lack of support, prior mental health issues, ongoing stress.

Cognitive and behavioral causes of PTSD

Cognitive: Negative thoughts and faulty beliefs; Behavioral: Classical conditioning and reinforcement.

PTSD treatments

Prolonged Exposure, Cognitive Processing Therapy, SSRIs.

Difference between gender and sex

Gender = social identity; Sex = biological traits.

Gender expression

The way a person presents their gender (masculine, feminine, androgynous, fluid).

Minority stress model

Stress caused by stigma on personal, interpersonal, community, and policy levels.

Diagnostic criteria for gender dysphoria

Children: Strong desire to be another gender, cross-gender roles; Adults: Distress from gender incongruence.

Treatments for gender dysphoria

Trans-affirmative CBT, gender confirmation surgery.

Major controversy about gender dysphoria

Whether it pathologizes identity vs. ensures access to medical care.

Factors influencing sexual functioning/dysfunction

Biological, psychological, interpersonal, and cultural factors.

Paraphilic disorders

Distressing or harmful sexual interests, often involving non-consenting individuals.

Examples of paraphilic disorders

Exhibitionism, voyeurism, pedophilia, fetishism, frotteuristic disorder.

Treatment for paraphilic disorders

CBT to manage urges, reduce distress, and lower risk.

Positive symptoms of schizophrenia

Delusions, hallucinations, thought disturbances.

Types of delusions

Delusions of reference, persecution, and grandeur.

Types of thought disturbances

Thought broadcasting, insertion, withdrawal.

Most common type of hallucination

Auditory.

Symptoms of disorganized thinking/speech

Looseness of associations, word salad, neologisms, clanging.

Disorganized behavior

Inappropriate or bizarre behavior, catatonia.

Negative symptoms of schizophrenia

Blunted affect, avolition, alogia, anhedonia, apathy.

DSM-5 criteria for schizophrenia

At least 2 symptoms for 6+ months with impaired functioning.

Phases of schizophrenia

Prodromal, Active, Residual.

Prodromal Phase

Subtle changes (e.g., withdrawal, hygiene neglect, emotional flatness).

Active Phase

Pronounced positive and negative symptoms that impair function.

Residual Phase

Lingering negative symptoms and possible cognitive issues.

Prevalence of schizophrenia

Around 1%, slightly more common in men.

Causes of schizophrenia

Genetics, dopamine excess, brain abnormalities, viral exposure, diathesis-stress model.

Treatments for schizophrenia

Antipsychotics (typical/atypical), CBT, family therapy, psychosocial rehab.

Related disorders

Schizophreniform (1-6 months), Schizoaffective (schizophrenia + mood disorder).

Personality

Stable patterns of thinking, feeling, and behaving.

Difference between personality traits and disorders

Traits are flexible; disorders are rigid, maladaptive, and impairing.

Difference between OCPD and OCD

OCPD = ego-syntonic (feels normal); OCD = ego-dystonic (distressing).

Three clusters of personality disorders

Cluster A (odd/eccentric): Paranoid, Schizoid, Schizotypal; Cluster B (dramatic): Antisocial, Borderline, Histrionic, Narcissistic; Cluster C (anxious): Avoidant, Dependent, Obsessive-Compulsive.

Cluster A disorder closest to schizophrenia

Schizotypal—odd beliefs, magical thinking.

Challenges in diagnosing personality disorders

Overlapping symptoms and difficulty distinguishing normal vs. abnormal traits.