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.