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Questions and Answers
What symptom does the security guard experience that relates to his excessive concern for threats?
What symptom does the security guard experience that relates to his excessive concern for threats?
Which of the following best describes the type of stress that Doreen Welsh experienced during the incident?
Which of the following best describes the type of stress that Doreen Welsh experienced during the incident?
What behavior demonstrates the security guard's avoidance of reminders of his traumatic experiences?
What behavior demonstrates the security guard's avoidance of reminders of his traumatic experiences?
What immediate emotional reaction did Doreen Welsh report experiencing during the plane incident?
What immediate emotional reaction did Doreen Welsh report experiencing during the plane incident?
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How does the security guard's experience of being easily startled relate to his mental health condition?
How does the security guard's experience of being easily startled relate to his mental health condition?
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Which of the following ways can lead to the development of Acute and Post-Traumatic Stress Disorders?
Which of the following ways can lead to the development of Acute and Post-Traumatic Stress Disorders?
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Which scenario is NOT included as a means of exposure that could precipitate Acute and Post-Traumatic Stress Disorders?
Which scenario is NOT included as a means of exposure that could precipitate Acute and Post-Traumatic Stress Disorders?
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What type of trauma exposure primarily involves inappropriate sexual experiences without the need for violence or injury?
What type of trauma exposure primarily involves inappropriate sexual experiences without the need for violence or injury?
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For which of the following is emotional exposure to trauma considered sufficient for the development of trauma-related disorders?
For which of the following is emotional exposure to trauma considered sufficient for the development of trauma-related disorders?
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What type of exposure is considered extreme and repetitive, which can also contribute to stress disorders?
What type of exposure is considered extreme and repetitive, which can also contribute to stress disorders?
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Which of the following is NOT commonly associated with CPTSD?
Which of the following is NOT commonly associated with CPTSD?
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Which therapy method focuses primarily on extinguishing conditioned fear responses through visualization?
Which therapy method focuses primarily on extinguishing conditioned fear responses through visualization?
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What is a primary goal of cognitive-behavior therapy (CBT) in treating trauma?
What is a primary goal of cognitive-behavior therapy (CBT) in treating trauma?
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In the context of group management for acute stress, what is the purpose of the 'reaction phase'?
In the context of group management for acute stress, what is the purpose of the 'reaction phase'?
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Which of the following describes a controversial aspect of the CPTSD diagnosis?
Which of the following describes a controversial aspect of the CPTSD diagnosis?
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What is the primary educational focus during the teaching phase for victims of trauma?
What is the primary educational focus during the teaching phase for victims of trauma?
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What is one potential complication of using cannabinoids for anxiety in patients with PTSD?
What is one potential complication of using cannabinoids for anxiety in patients with PTSD?
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Which medication is indicated for managing anxiety spikes and flashbacks in individuals experiencing PTSD?
Which medication is indicated for managing anxiety spikes and flashbacks in individuals experiencing PTSD?
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Under what circumstance can mental health information typically be disclosed without patient consent?
Under what circumstance can mental health information typically be disclosed without patient consent?
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What is the potential drawback of using post-stressor memory-dulling treatments, such as propranolol?
What is the potential drawback of using post-stressor memory-dulling treatments, such as propranolol?
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Study Notes
Introduction to Psychopathology
- These lecture notes are copyrighted and for private student use only
- Reproduction in whole or in part without instructor permission is prohibited
- All course materials (lectures, discussions, handouts, examinations, and web materials) are protected by US federal copyright law and the California Civil Code
- Students are permitted to make notes solely for personal educational use
- Exceptions may be made for students with disabilities, but completing and selling study guides is forbidden
Traumatic and Stressor-Related Disorders
- Exposure to actual or threatened death, serious injury, or sexual violence (in children or inappropriate sexual experiences) may cause acute and post-traumatic stress disorders
- Exposure can occur directly experiencing the event, witnessing it others, learning it happened to a close friend or family member, or experiencing repeated or extreme exposure to the event's details
- The exposure must have been violent or accidental in situations where the event involved a close family member or close friend's death
- Exposure through electronic media, television, movies, or pictures is not included unless part of a job
Reactions to Extreme Trauma
- Intrusive recollections (daytime flashbacks, nightmares, illusions), acute distress
- Dissociative symptoms ("psychic numbing"): emotional detachment, being in a "daze," avoiding trauma-related activities, forgetting or fogginess about trauma, feeling that the current setting is dreamlike and not real, feeling detached from one's body
- Chronic hyperarousal: exaggerated startle, insomnia, hypervigilance, motor restlessness (agitation)
- Irritability, unprovoked angry outbursts, and aggressiveness
- Survival guilt / shame – belief that one doesn't deserve to live, have been marginalized. Reckless, impulsive behaviors
Major Trauma and Stressor-Related Disorders (DSM-5-TR)
- Acute stress disorder (ASD): disability lasting more than 2 days and less than 1 month
- Occurs in 20% of cases not involving interpersonal assault, and 20-50% of cases following interpersonal assault
- Extreme anxiety interfering with sleep, energy levels, concentration, and leading to general withdrawal, absenteeism, and diminished self-care
- Post-traumatic stress disorder (PTSD): disability lasting at least 1 month from a traumatic episode or series of episodes, prevalences depend both on trauma and pre-existing risk factors
- About 10% of people with PTSD show delayed expression (signs/symptoms becoming sufficient to be diagnosed months after the event)
- Complex PTSD (CPTSD): prolonged trauma (research diagnosis, not in DSM-5-TR)
Case Studies
- Offer examples of acute stress and post-traumatic stress disorders
Acute and Post-Traumatic Stress Disorders: Case Examples
- Examples of disorders from 9/11, the 2001 US Airways Flight 1549, etc.
Common Precipitants of Trauma and Stressor-Related Disorders
- Sexual violence (attempted or completed rape, and sexual assault)
- Military combat
- Physical/emotional abuse (childhood sexual/physical abuse, domestic violence, and workplace abuse)
- Human calamities (deliberate: bombings, torture, death camps, terrorism, being a crime victim or hostage; accidental: motor vehicle accidents, plane crashes, gun accidents, workplace accidents, physical trauma, climatic calamities)
Risk Factors for Developing Trauma and Stressor-Related Disorders
- Severity and chronicity of trauma, subsequent adverse life events
- Family history of depression, anxiety, or PTSD
- Racial or ethnic minority status
- Poor coping habits (smoking, drinking, drug use)
- Intergenerational trauma
- Poor social support
Complex PTSD (CPTSD)
- A special case of PTSD due to repeated or continuous trauma
- Symptoms are extreme and longer-lasting, often stemming from childhood abuse or neglect, war zone existence, or a series of illnesses, medical procedures, or surgeries
Psychotherapy for PTSD
- 1st-line treatment is exposure therapy (visualization of trauma) combined with relaxation
- Cognitive-Behavioral Therapy (CBT) helps neutralize negative thoughts and develop new interpretations
- Eye Movement Desensitization and Reprocessing (EMDR) is a dubious neurological model aiming to reduce anxiety through bodily awareness
- Group therapy, stress management training, and reframing relationships with abusers are also beneficial
Group Management for Acute Stress: Critical Incident Stress Debriefing
- Structured debriefing process involving fact, reaction, symptom, teaching, and reentry phases
- Note: insufficient evidence of its effectiveness in reducing future issues
Medication Treatment of ASD and PTSD
- Symptomatic care: anxiolytics (for short-term anxiety management), antidepressants (chronic depression), antipsychotics (paranoia/dissociative behaviors), sleep medications, Cannabinoids
- Antihypertensive medications (e.g., prazosin) for anxiety spikes, flashbacks, and nightmares (potentially effective for those already hypertensive)
- Experimental medications (e.g., post-stressor propranolol) that block adrenaline and reduce memory consolidation, but insufficient clinical trails are available
- Psychedelics (e.g., MDMA, psilocybin, LSD, ketamine, DMT) are promising but require more study for effectiveness and safety
Mental Health Law and Regulations
- Confidentiality: patient consent is needed for release of mental health information, except in specific circumstances
- Duty to warn, child/elder/dependent adult abuse
- Involuntary commitment (5150, 5250 holds), Lanterman-Petris-Short Act
- Assisted Outpatient Treatment (AOT) (e.g., "Laura's Law")
- Temporary Gun Seizure (California Law AB 1014)
A Crisis of Placement
- High rates of people with mental illness being placed in jails.
- Often lack of necessary treatment.
Involuntary Long-Term Custodial Care("Conservatorship")
- Gravely disabled from mental disorder or chronic alcoholism may be placed in the hands of a conservator temporarily or long-term
- Conservators are responsible to the court for a comprehensive treatment plan and management of the patient
- Licensed conservators can help family members
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Description
This quiz focuses on traumatic and stressor-related disorders as part of the Introduction to Psychopathology course. It covers the definitions, symptoms, and implications of acute and post-traumatic stress disorders. Explore how exposure to trauma can impact mental health and learn about the various ways individuals can be affected.
