PSY105 Test 3

trauma and stressor related disorders

new classification in DSM-5

shared origin, stressful life events

includes PTSD, acute stress disorder, adjustment disorders, and attachment disorders

main etiologic characteristics

trauma exposure and response

re-experiencing

main etiologic characteristic

avoidance

main etiologic characteristic

emotional numbing and interpersonal problems

main etiologic characteristic

markedly interferes with one's ability to function

main etiologic characteristic

PTSD diagnosis

reaction persists for one month or more

recurrent involuntary distressing memories of traumatic event

intrusion symptom

recurrent distressing dreams related to traumatic event

intrusion symptom

dissociative reactions (flashbacks)

intrusion symptom

intense or prolonged psychological distress to internal or external cues

intrusion symptom

marked physiological reaction to cues

intrusion symptom

traumatic event DSM-5

exposure to death, serious injury, or sexual violence

directly experiencing traumatic event, witnessing the event, learning about event happening to family, experiencing exposure to details

avoidance symptoms

avoidance of distressing memories/internal stuff or of external reminders

inability to remember an important aspect of traumatic event

negative cognitions and mood

persistent and exaggerated negative beliefs or expectations about oneself, others, or the world

negative cognitions

persistent, distorted cognitions about cause/consequences of traumatic event

negative cognitions

persistent negative emotional state

negative mood

markedly diminished interest or participation in significant activities

negative cognition

feelings of detachment or estrangement from others

negative cognition

persistent inability to experience positive emotions

negative cognition

irritable behavior and angry outbursts

arousal and reactivity symptoms

reckless or self-destructive behavior

arousal and reactivity symptoms

hypervilgilance

arousal and reactivity symptoms

exaggerated startle response

arousal and reactivity symptoms

problems with concentration

arousal and reactivity symptoms

sleep disturbance

arousal and reactivity symptoms

duration of disturbance

more than 1 month

most common traumas

combat and sexual assault

percent of people that experience PTSD

7%

acute

one to three months post trauma

chronic

diagnosed after three months

delayed onset

six months or more post trauma

acute stress disorder

PTSD immediately post-trauma

CBT

highly effective, graduated/massed exposure, develop narrative of traumatic event, challenge maladaptive beliefs, increase positive coping skills, increase social support

medication

SSRIs, medications against anxiety and panic

ACEs

Adverse Childhood Experiences

three types of ACEs

abuse, neglect, household dysfunction

PRACTICE P

psychoeducation & parenting skills

R

Relaxation techniques

A

Affective expression & modulation

C

cognitive coping

T

trauma narrative & processing

I

In vivo mastery of trauma reminders

C2

Conjoint parent-child session

E

Enhancing future safety & development

adjustment disorders

anxious or depressive reactions to life stress, milder than PTSD/acute stress disorder, occur in reaction to life stressor, clinically significant distress or impairment

excessive use

impaired control

use despite wanting to stop

impaired control

spending great deal of time using or recovering

impaired control

craving, especially when around triggers

impaired control

failure to fulfill obligations

social impairment

interpersonal problems caused by drug use

social impairment

giving up important social, recreational, or occupational activities

social impairment

use when intoxication endangers self or others

risky use

use despite substance-induced health problems

risky use

tolerance

needing more drug to feel effects

withdrawal

negative symptoms experienced when drug is removed after prolonged intake

increase DA in the reward pathway initially

addictive drugs

highly correlated with "high"

Dopamine in striatum

reduced in drug abusers

dopamine (D2) receptors

cell adhesion molecules

genes in GWAS addicts

receptors and ligands

genes in GWAS addicts

intracellular enzymes

genes in GWAS addicts

double risk of addiction

mood and anxiety disorders

low reward-setpoint

more vulnerable to addiction

increases risk of addiction

untreated ADHD

impulsivity

highly correlated with nicotine, alcohol, and cannabis addictions

impulsive at baseline

use stimulants, which make them more impulsive

pain-sensitive at baseline

use opiates

anxious at baseline

take more alcohol

cultural norms

environmental effects for development of addiction

socioeconomic status

environmental effects for development of addiction

sources of stress in the environment

environmental effects for development of addiction

stress-coping strategies and expectations

environmental effects for development of addiction

affects dopamine receptor expression

environment

pharmacological treatments for addiction

block drug associated reward or alleviate negative symptoms of withdrawal

behavioral therapies for addiction

train patients to recognize/deal with cravings, find reasons/motivations to avoid substance use

Therapeutic communities and self-help groups

TROSA/AA

structured safe environment with sober peers, limits on behavioral choice, graded return to freedom

neurodevelopmental disorder

ASD

mechanisms in place in prenatal development

ASD

presents with differences in brain anatomy and function

ASD

behavioral presentation early in life

ASD

presentation evolves over time

ASD

development impacts many areas of development and produces an atypical trajectory across most domains

ASD

Kanner (1943)

"autistic disturbances of affective contact"

'early infantile autism'

'Kanner's syndrome'

Asperger (1944)

Germany, WWII, merged with Lorna Wing "Asperger's Syndrome: A Clinical Account"

Behavioral phenotype of ASD

heterogeneous, neurodevelopmental disorder with lifelong course of illness

Percent of world population with ASD

1%

number of children with ASD in US

1 out of 44

four times more common in boys than in girls

ASD

prevalence has increased by 6-15% each year from 2002 to 2010

ASD

deficits in social-emotional reciprocity

DSM-5 ASD social communication

deficits in nonverbal communication behaviors used for social interaction

DSM-5 ASD social communication