Ch6 Disorders of Trauma ad Stress

stressor

event that creates a demand on a person

-not always bad

-if viewed as threatening then it causes a fear response

stress response

how the person reacts to the stressor

acute stress disorder

symptoms last less than a month

-arousal, anxiety, guilt, reexperiencing the traumatic event

-avoidance

-reduced responsiveness and dissociation

ptsd

symptoms last more than a month

-arousal, anxiety, guilt, reexperiencing the traumatic event

-avoidance

-reduced responsiveness and dissociation

hypothalamus

arousal and fear

autonomic nervous system

connects the central nervous system to other organs of the body

endocrine activities

network of gland located throughout the body—-release hormones

sympathetic nervous system

activation system

responding to fear induced stimuli

inhibits digestive activities

parasympathetic system

helps return heartbeat and other body processes to normal

in a normal person, more active than sympathetic system

what organ activated the pituitary gland?

hypothalamus

pituitary gland

secreted hormones throuhgout the body

what hormones act on other body organs to trigger arousal?

corticosteroids

traumatic event

event in which person is exposed to actual or threatened death

hypervigilence

excessive alertness

avoidance

when someone does not want to be around something

combat

29% of vietnam vets had acute or PTSD

medical illnesses

rates higher when people affected by epidemic

victimization

SA, rape, terrorism, shootings, torture, physical, psychological, neglected

what triggers acute and posttraumatic stress disorders?

combat, disorders, disasters and accidents, medical illnesses, victimization

biological factors

brain body stress routes

brain stress circuit

inherited predisposition

childhood experiences that increase risk for later PTSD

chronic neglect or abuse

poverty

parental conflict

catastrophe

family members with psychological disorders

why do people develop acute and posttraumatic stress disorders?

biological factors, childhood experiences, cognitive factors and coping styles, social support systems, severity and nature of traumas

intolerance of uncertainty

not knowing what is going to happen

negative worldview

everything is bad and it will never get better

complex PTSD

somebody experiences all symptoms including numerous dissociative experiences profound issues in emotional regulation

symptoms at a higher level

developmental psychology perspective

-inherited or acquired biological predisposition

-overreactive stress routes

-timing of stressors and traumas

prolonged grief disorder

continues display of sever wide-ranging symptoms of grief almost every day that occurs year or more after death of a loved one

-can look like intense yearning for the individual

-disbelief about the loss

-extreme emotional loss

what are goals of treating stress disorders?

end lingering stress reactions

gain perspective on painful experiences

return to construction living

prolonged exposure

client reexperiences verbally or by writing the trauma

dissociative disorders

triggered by traumatic events

-at least 1 part of the persons memory is dissociated/ separated from themselves

dissociative amnesia

person cannot reacall important life—reated information

leads to significant distress or impairment

symptoms are not caused by a substance or medical condition

what are the 4 types of dissociative amnesia?

localized, selective, generalized, continuous

localized amnesia

most common; events that ocurred around stressed event

selective amnesia

loss of memory for some of event but not allgenr

generalized amnesia

starts with event and then goes backward in time

continuous amnesia

can go back so far that people forget identity, friends, family

dissociative fugue

extreme version of amnesia

forget personal identities, details of past, and flee to entirely different location

dissociative identity disorder

person experiences a disruption to his or her identity, as reflected by at least two seperate personality states or expereinces of posession

memory gaps 

disrtress and impairment

subpersonalities

subpersonalities

each has unique sets of memories, behaviors, thoughts, and emotions,

primary—dmoniates

5-10 average number

-most cases diagnosed in late adolescence or early adulthood

how do subpersonalities interact?

mutually amnseic—personalities dont know eachother

mutually cognizant—personalities aware of eachother

one-way amnesic—co-conscious personalities

how do subpersonalities differ?

identifying features

abilities and preferences

physiological responses

how common is DID?

number of diagnoses has increased

thousands of US and canada alone

atrogenic

clinicians unintentionally producing DID in their patients

How do theorists explain dissociative amnesia and DID?

combine cognitive, behavioral, and biological principles

-have captures the interest of clinical scientists

psychodynamic view: DID and amnesia

caused by repression

brutal childhood histories

single episode of repression

dissociative amnesia and dissociative fuguel

lifetime repression

DID

state-dependent learning

individual may only be able to recall specific event when they are back in that state

-each subpersonality is considered a different state

self-hypnosis

ocurrs after event so individual can regulate and forget event

a wish to become a different person

psychodynamic therapist: dissociative amnesia

focus on unconscious

hypnotic therapy: dissociative amnesia

hypnosis to guide patients to recall forgotten events

dissociative amnesia: drug therapy

intravenous injections of barbituates are sometimes used to help patients regain lost memories

how do therapists help individuals with DID?

-recognize fully the nature of sidorder

-recover gaps in memory

-integrate subpersonalities into one fucntional personality

fusion

integrate subpersonality into one functional personality; must be maintained with follow up therapy

depersonalization

feelin separation from own bod

seeing self from inside out

having mechanical, dreamlike dizzy feelings

awareness that perceptions are distorted

derealization

feeling external world is unreal and strange

changing object shape or size

may see other people as robots

depersonalization-derealization disorder

-triggered by extreme fatigue, physical pain, intense stress, substance abuse recovery,

-persistent or recurrent

-cause considerable distress

-may impair job performance and social relationships