Abnormal Psych Chapter 5: Disorders of Trauma and Stress

The Stress Response

a physiological, psychological and/or behavioral response (non-specific psycho-physiological response) to the perception of onerous demand

The General Adaptation Syndrome

Hans Seyle

a universal, physiological set of reactions and processes created by demand and involving three stages

the alarm stage

the resistance stage

the exhaustion stage

peripheral nervous system

the somatic & autonomic systems

somatic

controls voluntary movements like muscle movement

autonomic

automatic movements, connects the central nervous system (brain and spinal cord) to all the other organs of the body (regulates the cardiovascular system; the endocrine system; and to a degree digestion and the regulation of body temperature)

The Sympathetic Nervous System

generally acts to arouse the body in preparation for the 'fight/flight' response

The Parasympathetic Nervous System

acts to relax and restore the body to normal levels of arousal

apparently mine is broken

The endocrine system

releases hormones directly into the bloodstream - eg epinephrine (adrenaline), norepinephrine (noradrenaline) and cortisol (the stress hormone)

The Hypothalamic-Pituitary-Adrenalcortical Axis (HPA)

-The Hypothalamus secretes the corticotrophin releasing factor (CRF) which stimulates the ANS which activates the adrenal gland - producing epinephrine, norepinephrine & cortisol

-In turn the hippocampus (close by in the limbic system) - acts to turn off the stress response - if the hippocampus is compromised chronic stress may lead to chronic secretion of cortisol

Acute Stress Disorder

fear and related symptoms are experienced soon after a traumatic event and last less than a month

Posttraumatic Stress Disorder (PTSD)

fear and related symptoms continue to be experienced long after a traumatic event

what are the major symptoms of PTSD?

1. flashbacks; re-experiencing the event

2. efforts to avoid thoughts, situations, conversations, associated with experience

3. reduced responsiveness--feeling of detachment, loss of interest, derealization

4. increased arousal; anxiety, guilt

PTSD - Statistics

because PSD and PTSD are a response to a traumatic event statistics vary with the likelihood of traumatic events and circumstances

combat experience

called 'shell shock' in WWI, and 'combat fatigue' in WWII

natural and accidental disasters

earthquakes, floods, tornadoes, car accidents

victimization

victims of assault or abuse - including domestic violence and rape

neurochemical changes

the traumatic experience triggers neurochemical changes - creating abnormal cortisol and norepinephrine activity

prolonged arousal from PTSD can damage hippocampus and amygdala

what does the pre-trauma personality about the likelihood of developing PTSD?

people who are normally anxious, have higher stress, more negative, or have limited sense of own control are more susceptible

what is the role of social support in PSD and PTSD?

people with a stronger social network/support are less likely to develop the disorder

graded imagined exposure to the original trauma

handling and expressing associated emotions

drug treatment

research on drug treatments is still in early stages - although SSRI's such as Paxil or Prozac, may prove useful

what is EMDR?

Eye Movement Desensitization & Reprocessing

what might cognitive behavior therapy address in the treatment of PTSD?

helps patients with their thinking process that has become damaged through the trauma

rap groups

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family therapy

when people with PTSD go to therapy with their families

psychological debriefing

when people with PTSD tell everything that has happened to a psychologist in order to try to avoid PTSD

what s dissociative amnesia?

inability to recall important info, usually of stressful nature about their lives w

dissociative amnesia - DSM

1. 2 or more distinct identities

2. control of behavior taken by at least 2 identities

3. inability to recall important personal info

what do we mean by sub personalities?

when people are aware of their different personalities

what do we mean by iatrogenic?

have own name, vital stats, abilities, preferences, physiological responses

how does the psychodynamic perspective explain DID

result of extreme repression, response to traumatic event or abuse from being younger

what is the behavioral view of DID?

result of operant conditioning

state-dependent learning

people who are susceptible have rigid state to state memory links

what is self-hypnosis?

form of escape from trauma

hypnotherapy

therapy that uses hypnosis to try to help with these disorders

how do we treat dissociative identity disorder?

hypnotic therapy, psychodynamic therapy, drug therapy

what is fusion

integrating sub personalities into 1 functional personality

Depersonalization/Derealization Disorder

A dissociative disorder marked by the presence of persistent and recurrent episodes of depersonalization, derealization or both