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Trauma and Stress Disorders

Trauma and Stress Disorders Overview

  • Meaning of Stress:
  • Biologically: Internal biological and psychological response to demands.
  • Psychologically: Emotional stress results from inadequate coping strategies.
  • Stressor: An event that creates demands, generates fear, and is perceived as threatening.
  • Stress Response: Reactions from an individual to stress.

Identifying Stress

  • Arousal and Stress:
  • Two important systems involved in stress response:
    • Autonomic Nervous System: Controls involuntary bodily functions.
    • Endocrine System: Releases hormones affecting bodily functions.
  • Autonomic Nervous System:
    • Parasympathetic: Resting state functions.
    • Sympathetic: Fight or flight response.

Autonomic Nervous System Functions

  • Sympathetic Nervous System Functions:
  • Dilates pupils, accelerates heartbeat, inhibits digestion.
  • Stimulates glucose release and secretion of epinephrine/norepinephrine.
  • Parasympathetic Nervous System Functions:
  • Constricts pupils, slows heartbeat, stimulates digestive activity.
  • Promotes relaxation and rest functions.

Factors Impacting Stress

  • Types of Stress:
  • Positive stress (eustress) vs Negative stress (distress).
  • Resilience: Ability to adapt to stress.
  • Nature of Stressor: Innate vs learned stress responses.
  • Perception of Stressor: Individual's appraisal of the stressor.
  • Life Changes: Overlapping multiple stressors can exacerbate stress.
  • Coping Strategies:
  • Cognitive and behavioral methods used to manage stress.
  • Primary appraisals: Assess the risk presented by stressor.
  • Secondary appraisals: Evaluate available resources for coping.
  • Tertiary appraisals: Periodic reevaluation of stress.

Coping with Stress

  • Problem-focused coping: Tackles the stressor head-on.
  • Emotion-focused coping: Regulates emotional responses towards stressor.

Impact of Severe Stress

  • Severe or prolonged stress can lead to significant health problems:
  • Weakens immune system; changes brain structure over time.
  • Contributes to cardiovascular diseases; encourages unhealthy behaviors.
  • Linked to decreased self-efficacy and increased mortality rates.

Trauma Definition

  • Trauma refers to experiencing or exposure to actual or threatened death, serious injury, or sexual violation.

Trauma-Related Disorders

  • Adjustment Disorder: Maladaptive response to a stressor occurring within 3 months, not lasting beyond 6 months after stressor removal.
  • Acute Stress Disorder: Symptoms emerge within 4 weeks of an event and last less than a month.
  • Post-Traumatic Stress Disorder (PTSD): Symptoms last longer than a month, can arise well after the event.

PTSD Symptoms

  • Exposure:
  • Involves direct or indirect experience of trauma.
  • Intrusive Symptoms: Recurrent memories, distressing dreams, flashbacks.
  • Avoidance: Efforts to avoid reminders of trauma.
  • Changes in Cognition & Mood: Negative thoughts and emotions related to the trauma.
  • Increased Arousal: Hyperreactivity, vigilance, sleep disturbances.

DSM-5 Criteria for PTSD

  • Criterion A: Direct exposure to trauma.
  • Criterion B: Persistent re-experiencing of the traumatic event.
  • Criterion C: Avoidance of stimuli associated with trauma.
  • Criterion D: Negative changes in cognition and mood.
  • Criterion E: Hyperarousal and reactivity changes.

Who Develops Trauma Disorders?

  • Individuals of lower income levels are more susceptible to stress disorders.
  • Women are diagnosed at higher rates than men (20% women, 8% men).
  • Racial disparities exist, with white Americans less likely to develop trauma disorders.

Biological Factors

  • Genetics play a significant role (30-73% genetic influence).
  • Overactive brain-body stress circuitry may predispose individuals to stress disorders.

Childhood Experiences

  • Adverse childhood experiences elevate the risk of developing trauma disorders.
  • Examples include impoverished conditions, parental divorce, or abuse at an early age.

Socio-Cultural Considerations

  • Cultural and belief systems influence the prevalence and coping mechanisms related to trauma.

Treatment for Trauma

  • Goals of Treatment:
  • Resolve lingering stress reactions and gain perspective on experiences.
  • Psychological Interventions:
  • Cognitive-Behavioral Therapies: CPT, mindfulness techniques, exposure therapy.
  • Antidepressants and adjunct therapies such as EMDR.

Dissociative Disorders Overview

  • Dissociation: A disconnect in thoughts, memories, and identity.

Types of Dissociative Disorders

  1. Dissociative Amnesia: Memory loss, often related to trauma, not caused by medical issues.
  2. Dissociative Fugue: Loss of personal identity, often adopting new identity.
  3. Depersonalization-Derealization Disorder: Persistent detachment from self or surroundings.

Treatment for Dissociative Identity Disorder (DID)

  • Therapy: Integrating identities through CBT, family systems therapy.
  • Medications: Mood regulators and antidepressants to manage symptoms.