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what is a stressor?
an event that’s witnessed or experienced firsthand that increases physical or psychological demands on the individual
shell shock
the combat-related trauma experienced by soldiers from World War 1
what is PTSD?
the development of psychological physiological and emotional symptoms, following the exposure of a traumatic event
what symptoms must an individual experience for at least a months to be diagnoses with PTSD?
recurrent experiences: trauma-related flashbacks, nightmares, etc.
avoidance: when an individual tries to get away from that which can “trigger the memory of the traumatic event”
negative alterations in cognitions or mood: when an individual struggles to remember an aspect or part of the traumatic event
alterations in arousal and reactivity: individuals may be quick-tempered and aggressive because of a heightened startle response
what is the prevalence of PTSD in the U.S?
about 8.7%
what levels of comorbidity rates does PTSD have?
it has high levels of comorbidity; 80% of individuals with PTSD are likely to report depressive, bipolar, anxiety, or substances abuse related symptoms
what is ASD?
PTSD-like symptoms that occur from 3 days to 1 month after a traumatic event
what symptoms must be experienced to get a diagnosis of ASD?
an individual must experience symptoms for 3 days to a month after a traumatic event:
intrusion symptoms: involuntary and intrusive distressing memories of the trauma or recurrent distressing dreams
negative mood
dissociative symptoms
avoidance symptoms
arousal symptoms: difficulty falling asleep,
what is an adjustment disorder?
symptoms occur within 3 months of an identifiable stressor and cause significant distress and impairment; less intense than PTSD and ASD
what does the hypothalamic-pituitary-adrenal(HPA) axis control?
is involved in fear producing responses
what is the amygdala and what does it do?
integrative system that causes the physiological responses to stress/ trauma; communicated with the HPA axis and then the HPA axis releases epinephrine and cortisol
epinephrine
increases blood pressure, heart rate, alertness, and muscle tension
cortisol
helps return the body to homeostasis after a stressful event
what can expose individuals to trauma and stress related disorders?
pre-existing conditions may predisposed an individual to develop this kind of disorder, because those individuals may ruminate/analyze the stressful or traumatic event, and because those individuals may already have negative cognitive styles and processes
what racial/ethnic group experiences the most traumatic symptoms for stress and trauma related disorders?
Hispanics
what are treatment options for trauma or stress-related disorders?
psychological debriefing
exposure therapy
cognitive behavioral therapy(CBT)
eye movement desensitization and reprocessing (EMDR)
psychopharmacological treatment
what is psychological debriefing?
considered a type of crisis intervention that requires individuals who have recently experienced a traumatic event to discuss or process. Their thoughts and feelings related to the traumatic event typically within 72 hours
what is the process for psychological debriefing?
identify facts
evaluate through to and emotions before, during, and after event
normalize the reaction
discuss how to hope and create a support system
what are the pros and cons of psychological debriefing
pros: may allow for faster recovery time
cons: doesn’t reduce the amount or severity of symptoms; may cause patients to ruminate in the event and cause the disorder to become worse
what is the purpose of exposure therapy?
the help distinguish fears
what are the three types of exposure therapy?
imaginable, in vivo, flooding
what is imaginable exposure therapy?
the individual is asked to re-create, or imagine, specific details of the traumatic event; gradual process
what is in vivo exposure therapy?
the individual is reminded of the traumatic event through the use of videos, images, or other tangible objects related to the traumatic event that induces a heightened arousal response; gradual process
what is flooding exposure therapy?
disregards the gradual nature of the fear of hierarchy; may be more effective, but is the most distressing type of exposure therapy
what is the acronym used to describe the goal of CBT?
PRACTICE:
Psychoeducation about the traumatic event
Relaxation training
Affect
Correcting maladaptive thoughts
Trauma narrative
In vivo
Co-joint family session
Enhancing security
what are the 8 steps of EMDR?
patient history and treatment planning
Preparation and education
Assessment and identification of triggers
Desensitization while holding a trigger in mind, and moving eyes
Installation of cognitions while holding a positive thing in mind and moving eyes
Body scan while moving eyes
Closure with coping strategies
Reevaluation
why is EMDR controversial?
because it originated from the personal observation of Francine Shapiro, who concluded that lateral eye movements, facilitate cognitive processing of traumatic thought
what types of medicine are used to treat trauma and stressor related disorders?
selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs)
what do SSRIs do?
increase the amount of serotonin available to neurotransmitters
what are TCAs and MAOIs in relation to stress and trauma related disorders?
most effective in those individuals with occurring major depressive disorder, and those individuals who do not respond to SSRIs
