Childhood & Short-Term Trauma Responses and DSM-5-TR Diagnoses

Flashcards covering key definitions and characteristics of Reactive Attachment Disorder (RAD), Disinhibited Social Engagement Disorder (DSED), Acute Stress Disorder (ASD), and Prolonged Grief Disorder (PGD) as discussed in the DSM-5-TR lecture notes.

DSM-5-TR

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision, which describes criteria for mental health conditions including 6 Trauma and Stressor-Related Disorders.

Trauma & Stressor-Related Disorders (DSM-5-TR)

A category of disorders in the DSM-5-TR, all of which require exposure to a traumatic or stressful event as an etiological factor.

Ecopsychosocial approach to grief

A framework proposed by Gurley-Green, et al. that integrates ecological, psychological, and social factors to understand grief, offering an alternative perspective to purely biomedical models.

Reactive Attachment Disorder (RAD)

A disorder characterized by a consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, arising from extremes of insufficient care (e.g., neglect, instability), evident before age 5 with a core feature of markedly disturbed, developmentally inappropriate attachment behavior.

Core Feature of RAD

Markedly disturbed, developmentally inappropriate attachment behavior, specifically a failure to seek or respond to comfort from caregivers when distressed.

Causes of RAD

Extreme emotional neglect or instability in caregiving, such as institutional rearing, multiple foster care placements, or severe parental neglect and emotional non-responsiveness.

Treatment for RAD

Focuses on providing a safe, nurturing, caring, and stable environment, caregiver training and support, child-parent psychotherapy, and play therapy.

Disinhibited Social Engagement Disorder (DSED)

A disorder characterized by actively approaching and interacting with unfamiliar adults with reduced or absent reticence, overly familiar behavior, and diminished 'checking back' with caregivers, arising from severe neglect and instability, with behaviors often persisting beyond early childhood.

Core Feature of DSED

Indiscriminately social and a lack of appropriate boundaries with unfamiliar adults, not limited to impulsivity.

Causes of DSED

Severe social neglect or deprivation, repeated changes of primary caregivers that limit stable attachments, or rearing in unusual settings with severely limited attachment opportunities.

Treatment for DSED

Involves creating a safe, nurturing, caring, stable environment, psychotherapy with a focus on safety and boundary setting, and social skills training.

Acute Stress Disorder (ASD)

A short-term reaction to a traumatic event characterized by severe anxiety and stress responses (intrusion, negative mood, dissociation, avoidance, arousal symptoms) that begin immediately after the event and last a minimum of 3 days and a maximum of 1 month.

Core Features of ASD

Severe anxiety and stress response happening immediately after a traumatic experience, involving symptoms from intrusion, negative mood, dissociation, avoidance, and arousal categories.

Duration of ASD

Symptoms must last a minimum of 3 days and a maximum of 1 month after trauma exposure.

Treatment for ASD

Emphasis on support, normalization of symptoms, psychoeducation, monitoring, ensuring safety and basic needs, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), and exposure-based interventions.

Prolonged Grief Disorder (PGD)

A recently added DSM-5-TR diagnosis characterized by an intense, persistent grief response to the death of a close person, experienced for at least 12 months in adults (6 months in children/adolescents), that far exceeds expected social/cultural norms of grieving and causes significant distress or impairment.

Core Features of PGD

Intense, persistent yearning or preoccupation with thoughts/memories of the deceased, combined with at least three other specific symptoms such as identity disruption, disbelief, avoidance of reminders, or intense emotional pain related to the death.

Adult Diagnostic Criteria for PGD

Death of a close person at least 12 months ago, intense yearning/preoccupation on most days for at least one month, and at least three other specified symptoms of grief (e.g., identity disruption, emotional numbness, loneliness) for at least one month.

Child/Adolescent Diagnostic Criteria for PGD

Death of a close person at least 6 months ago, intense yearning/preoccupation on most days for at least one month, and at least three other specified symptoms of grief for at least one month.

Treatment for PGD

Includes Complicated Grief Therapy (CGT), Cognitive Behavioral Therapy (CBT), group therapy, pharmacotherapy for comorbid depression/anxiety, and sleep aids on a case-by-case basis.