Chapter 4 (Trauma Disorders)

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Questions and Answers

What type of behaviors indicate avoidance associated with PTSD?

Engaging in conversations about the traumatic event

Avoiding external reminders of distressing memories (correct)

Participating in activities that trigger strong emotions

Seeking out places that remind one of the trauma

Which of the following is NOT a symptom of negative alterations in cognitions and mood following a traumatic event?

Inability to remember an important aspect of the event

Excessive trust in others despite trauma (correct)

Persistent negative emotions such as fear or guilt

Diminished interest in significant activities

What age group does the PTSD: Preschool subtype specifically apply to?

Children aged 6 to 12 years

Children younger than 6 years old (correct)

Adolescents aged 13 to 17 years

Adults over 18 years old

Which cognitive change may occur due to PTSD after a traumatic event?

Blaming oneself or others for the trauma Signup and view all the answers

What characterizes PTSD with prominent dissociative symptoms?

Persistent experiences of depersonalisation or derealisation Signup and view all the answers

What is the defining period for PTSD with delayed expression?

Full criteria not met until 6 or more months after trauma Signup and view all the answers

What is one possible emotional state associated with PTSD?

Fear Signup and view all the answers

Which of the following best describes 'dissociative amnesia' in the context of PTSD?

Loss of memory for key aspects of the traumatic event Signup and view all the answers

Which of the following is NOT a criterion for Acute Stress Disorder (ASD)?

Presence of fewer than nine symptoms from five categories Signup and view all the answers

Which symptom category is NOT included in the diagnostic criteria for Acute Stress Disorder?

Cognitive symptoms Signup and view all the answers

What does a 'persistent inability to experience positive emotions' refer to in PTSD?

Inability to experience satisfaction or loving feelings Signup and view all the answers

What could be a common negative belief held by someone with PTSD?

The world is unsafe and can harm me Signup and view all the answers

What is the duration of symptoms necessary to diagnose Acute Stress Disorder?

3 days to 1 month Signup and view all the answers

Which statement best describes the nature of symptoms in Acute Stress Disorder compared to PTSD?

ASD symptoms tend to be short-term reactions following trauma Signup and view all the answers

Which of the following is an example of feelings of detachment or estrangement in PTSD?

Avoiding social situations entirely Signup and view all the answers

How many symptom categories are considered in diagnosing Acute Stress Disorder?

Five categories Signup and view all the answers

Which symptom is NOT associated with Acute Stress Disorder?

Compulsive behavior related to daily routines Signup and view all the answers

What is a characteristic of dissociative symptoms in Acute Stress Disorder?

Inability to remember an important aspect of the traumatic events Signup and view all the answers

Which symptom can manifest as flashbacks in individuals with Acute Stress Disorder?

Intense physiological reactions to distressing cues Signup and view all the answers

Which statement best describes an intrusion symptom of Acute Stress Disorder?

Recurrent, involuntary, and intrusive memories of the traumatic event Signup and view all the answers

What is the estimated percentage of men who have experienced at least one trauma in their lifetime?

60.7% Signup and view all the answers

What distinguishes an altered sense of reality in Acute Stress Disorder?

Seeing oneself from another's perspective Signup and view all the answers

Which of the following indicates a negative mood in someone with Acute Stress Disorder?

Inability to experience happiness Signup and view all the answers

Which trauma-related issue is women reported to experience more than men?

Rape Signup and view all the answers

What type of reactions might an individual experience in response to reminders of a traumatic event?

Intense or prolonged psychological distress Signup and view all the answers

What percentage of the population is estimated to experience a motor vehicle accident at least once in their lifetime?

23% Signup and view all the answers

What is the estimated incidence rate of PTSD from motor vehicle accidents?

12% Signup and view all the answers

What is a key aspect that distinguishes Acute Stress Disorder from other disorders?

Symptoms are not due to substance use Signup and view all the answers

Which of the following traumas are men more likely to report compared to women?

Physical attack Signup and view all the answers

Which demographic is more likely to report experiencing trauma related to accidents?

Men Signup and view all the answers

Which is a primary focus examined in trauma- and stressor-related disorders?

Diagnostic criteria Signup and view all the answers

What causes are considered for trauma- and stressor-related disorders?

Traumatic experiences Signup and view all the answers

What is a psychological risk factor associated with PTSD?

Negative Beliefs Signup and view all the answers

Which of the following is a known biological factor linked to PTSD?

Disruption of verbal memory Signup and view all the answers

Which type of trauma increases the risk of developing PTSD?

All types of trauma Signup and view all the answers

What behavioral model is related to the understanding of PTSD?

Mowrer’s Two-factor model Signup and view all the answers

What impact does social support have on PTSD outcomes?

Negative support can hinder recovery Signup and view all the answers

Which factor does NOT contribute to the aetiology of PTSD?

Higher intelligence Signup and view all the answers

What is the association between traumatic events and PTSD severity?

More severe trauma increases PTSD risk Signup and view all the answers

Which of the following can predict a slower recovery from PTSD?

Anger Signup and view all the answers

What is a common avoidance symptom associated with Acute Stress Disorder?

Efforts to avoid distressing memories Signup and view all the answers

How long after an identifiable stressor do emotional or behavioral symptoms occur for Adjustment Disorders to be classified?

3 months Signup and view all the answers

Which of the following is NOT one of the possible specifications for Adjustment Disorders?

With psychotic features Signup and view all the answers

What duration cannot exceed for symptoms of Adjustment Disorders unless there is an enduring stressor?

6 months Signup and view all the answers

Which of the following is considered a symptom of arousal in Acute Stress Disorder?

Problems with concentration Signup and view all the answers

Which characteristic of Adjustment Disorders makes it probably the least stigmatized?

It is often self-limiting Signup and view all the answers

In Acute Stress Disorder, what is exaggerated startle response classified under?

Arousal symptoms Signup and view all the answers

Which of the following accurately describes the timeline for an Adjustment Disorder diagnosis?

Symptoms must start within 3 months of stressor Signup and view all the answers

Study Notes

Copyright Notice

This material has been reproduced and communicated by the University of South Australia.
It is subject to copyright under the Copyright Act 1968 (Act).
Further reproduction or communication is also subject to copyright protection.

Includes: Reactive Attachment Disorder, Disinhibited Social Engagement Disorder, Posttraumatic Stress Disorder, Acute Stress Disorder, Adjustment Disorders, Prolonged Grief Disorder, Other Specified Trauma- and Stressor-Related Disorder, Unspecified Trauma- and Stressor-Related Disorder

Diagnoses of Anxiety Disorders

DSM IV-TR anxiety disorders categorized in three chapters in the proposed DSM-5: anxiety disorders, obsessive-compulsive, and trauma- and stressor- related disorders.
Agoraphobia transitioned from a subtype of panic disorder to a separate diagnosis.

Reactive Attachment Disorder
Disinhibited Social Engagement Disorder
Posttraumatic Stress Disorder
Acute Stress Disorder
Adjustment Disorders
Prolonged Grief Disorder
Other Specified Trauma- and Stressor-Related Disorder
Unspecified Trauma- and Stressor-Related Disorder

Learning Objectives

Describe current diagnostic criteria for PTSD
Identify PTSD prevalence and course of posttraumatic stress responses
Compare models accounting for PTSD development
Understand components of effective PTSD treatments and current challenges

PTSD contrasts with other disorders, it's a disorder of non-recovery.
Strong emotions, reactions, thoughts and behaviors occur during and after the traumatic event.
Recovery stalls for PTSD, instead of escalating over time.

The Diagnosis of Posttraumatic Stress Disorder (PTSD)

Exposure to a traumatic event
Re-experiencing symptoms (flashbacks)
Avoidance symptoms (avoiding reminders)
Negative changes in cognitions and mood (emotional numbing)
Marked alterations in arousal (hypervigilance)
DSM-5 Diagnostic Criteria: Exposure to actual or threatened death, serious injury or sexual violence. This includes: direct experience, witnessing, learning of experience, or repeated exposure to details (like first responders).

DSM-5 Diagnostic Criteria - PTSD (cont.)

Intrusion symptoms (involving memories, dreams, or dissociative reactions)
Avoidance symptoms (avoiding reminders)
Negative alterations in cognitions and mood (such as negative beliefs about oneself)
Marked alterations in arousal and reactivity (such as irritability, exaggerated startle response)
Duration of symptoms (more than one month)
Disturbance impairs social, occupational or other areas of functioning.
The disturbance is not directly attributable to the physiological effects of a substance or another medical condition.

DSM-5 PTSD Subtypes/Specifiers

Preschool subtype (children under 6)
Prominent dissociative symptoms
Delayed expression (full criteria not met until 6+ months)

Acute Stress Disorder (ASD)

Symptoms similar to PTSD but shorter duration
Symptoms occur between 3 days and 1 month after trauma
Diagnostic criteria less specific than for PTSD

Adjustment Disorders

Emotional or behavioral symptoms within 3 months of a stressor
Doesn't persist for more than six months after the stressor, unless the stressor is enduring.
Categorized by various symptom types (e.g. with depressed mood, with anxiety)
Can't involve the criteria for another disorder

Prolonged Grief Disorder

Death of a close person (at least 12 months prior)
Intense yearning, preoccupation with thoughts, avoidance, intense emotional pain
Disturbance impairing social functioning (e.g. reintegration difficulty)
Grief response exceeding social norms
Symptoms are not due to another disorder
Symptoms are not due to another medical or drug condition

Trauma and PTSD: Prevalence and Epidemiological Factors

Approximately 60.7% of men and 51.2% of women have experienced at least one trauma
Men reported physical attacks, threats, accidents or witnessing traumas more frequently than women.
Women reported rape, molestation, neglect or abuse.
Less than 7% of the population develop PTSD over their lives.
Individuals exposed to higher trauma rates are more likely to develop PTSD (e.g. war veterans).

Comorbidity and PTSD

High comorbidity with major depression, dysthymia, bipolar disorder, generalised anxiety, panic, social phobia and obsessive-compulsive disorders, alcohol and drug use disorders.

Aetiology of PTSD

Genetics, severity and type of trauma.
Neurobiological factors (e.g., smaller hippocampal volume, disrupted verbal vs. non verbal memory, effect of cortisol).
Behavioral factors (e.g. Mowrer's two-factor model)
Psychological factors (coping mechanisms, perception of control, avoidance, dissociation).

Risk factors for PTSD

Gender (women more affected)
Type of traumatic event (e.g., sexual assault, physical abuse)
Peritraumatic dissociation
Prior trauma (greater risk when experiencing multiple previous traumas).
Negative beliefs, cognitive avoidance
Lack of social support

Types of Traumatic Events and PTSD

Relationships as well as traumas from accidents, physical/sexual abuse or threats are factors.

The Treatment of PTSD

Medication (e.g., SSRIs)
Cognitive-Behavioral Therapy (CBT) – psychoeducation, anxiety management, cognitive restructuring, imaginal exposure, in vivo exposure, relapse prevention
Psychological Treatment of PTSD
Exposure therapy to memories; either in vivo (direct exposure) or imaginal exposure, more effective than meds or support therapy.
Eye-movement desensitization and reprocessing (EMDR).
Cognitive therapy (enhancing coping abilities).

Prevention of PTSD

Difficult to assess effectiveness of early interventions.
Early intervention may involve CBT approaches.

Current Challenges in Treatment

High rates of treatment drop-out
Helping patients tolerate distress from exposure therapy
Enhancing extinction learning.
Developing community-based treatments

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