Psychology Chapter on Stress Disorders

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Questions and Answers

What is NOT considered a way to be exposed to traumatic events that can lead to stress disorders?

Learning about the event from the news (correct)

Experiencing repeated exposure to disturbing details

Witnessing the event in person

Directly experiencing the event

Which of the following is a criterion for experiencing Post-Traumatic Stress Disorder?

Direct exposure to a traumatic event (correct)

Witnessing serious injury or death of a stranger

Experiencing the trauma in a dream

Reading about an injury in a book

In cases where a family member experiences death, which of the following is specifically required for it to be considered traumatic?

The death must be violent or accidental (correct)

The death must be long-term and anticipated

The details of the death must be known to many

The family member must have been ill

Which type of exposure may contribute to developing acute stress disorder?

Experiencing repeated exposure to distressing details Signup and view all the answers

Which statement is FALSE regarding exposure to trauma?

Witnessing an event affects only the observer's emotions Signup and view all the answers

Which of the following is NOT a symptom associated with dissociative experiences in stress disorders?

Hypersensitivity to noise Signup and view all the answers

What are some of the symptoms exhibited by the 10-year-old girl after the earthquake?

Loss of speech output and hypervigilance Signup and view all the answers

Which of the following statements best describes Victor's behavior following his military service?

He isolates himself due to feelings of irritability. Signup and view all the answers

Which of the following statements regarding Post-traumatic stress disorder (PTSD) is accurate?

PTSD symptoms must persist for at least one month for diagnosis. Signup and view all the answers

What aspect of the girl’s pre-morbid temperament is indicated in the case study?

She was playful and studious. Signup and view all the answers

Survival guilt in trauma survivors is commonly characterized by:

A sense of shame and unworthiness related to surviving when others did not. Signup and view all the answers

Following the earthquake, how did the girl respond to earthquake-related cues?

With intense fear and distressing dreams. Signup and view all the answers

Delayed Expression in PTSD refers to:

Symptoms emerging after a delay following a traumatic event. Signup and view all the answers

What mental health condition is primarily indicated for the girl based on her symptoms?

Acute Stress Disorder Signup and view all the answers

What is the approximate lifetime prevalence of Post-Traumatic Stress Disorder (PTSD) in the general U.S. population?

7% Signup and view all the answers

Which group is likely to show a longer duration of PTSD symptoms?

Females Signup and view all the answers

What percentage of individuals with Acute Stress Disorder (ASD) go on to develop PTSD?

90% Signup and view all the answers

What is a common symptom exhibited by children experiencing PTSD?

Loss of language development Signup and view all the answers

Which demographic group faces the highest risk of sexual violence in the U.S.?

Non-college females aged 18-24 Signup and view all the answers

What is the percentage of combat veterans who develop PTSD?

18% Signup and view all the answers

Which factor is associated with a greater risk of developing PTSD according to observed studies?

Intergenerational trauma Signup and view all the answers

Which characteristic differentiates Complex PTSD (CPTSD) from simple PTSD?

Recurrent and continuous trauma Signup and view all the answers

What percentage of P.O.W.s typically experiences lifelong PTSD symptoms?

78% Signup and view all the answers

Which demographic factor is linked to a longer course of PTSD symptoms?

Racial or ethnic minority status Signup and view all the answers

Which factor contributes to the higher reported prevalence of PTSD in females compared to males?

Increased likelihood of experiencing interpersonal violence Signup and view all the answers

In what way do symptoms of PTSD differ between males and females?

Females often experience longer durations of PTSD than males Signup and view all the answers

What percentage of individuals suffering from Acute Stress Disorder (ASD) ultimately develop PTSD?

Close to 90% Signup and view all the answers

What is a common symptom displayed by children experiencing PTSD compared to adults?

Developmental regression Signup and view all the answers

Which of the following statements is true regarding the global prevalence of PTSD?

Prevalence rates vary by gender, with females at approximately 7% lifetime prevalence Signup and view all the answers

What is the primary therapeutic approach recommended as the first-line treatment for PTSD?

Exposure therapy Signup and view all the answers

Which of the following is a key characteristic distinguishing Complex PTSD (CPTSD) from traditional PTSD?

Changes in worldview and basic trust Signup and view all the answers

What is the main focus of Cognitive Processing Therapy (CPT) for trauma victims?

Neutralization of distressing thoughts Signup and view all the answers

Which of the following best describes the aim of 'sublimation' in the context of trauma recovery?

Turning trauma into social advocacy Signup and view all the answers

What is a commonly debated aspect regarding the diagnosis of CPTSD?

Its classification as a distinct disorder separate from PTSD Signup and view all the answers

What is a significant limitation of post-stressor treatments like propranolol in managing PTSD symptoms?

They may dull memory consolidation after traumatic events. Signup and view all the answers

Which medication is primarily indicated for managing anxiety spikes and nightmares associated with PTSD?

Prazosin (Minipress) Signup and view all the answers

Under what circumstance can mental health information be disclosed without patient consent?

When there is a serious threat of physical violence. Signup and view all the answers

Which class of medications is typically used to address chronic depression and irritability in PTSD patients?

Antidepressants (SSRIs) Signup and view all the answers

What is a potential outcome of using cannabinoids in the treatment of anxiety in PTSD patients?

It may exacerbate PTSD signs and symptoms. Signup and view all the answers

Study Notes

Introduction to Psychopathology

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Events that precipitate acute and post-traumatic stress disorders include: actual or threatened death, serious injury, or sexual violence (in children, inappropriate sexual experiences even without violence or injury), experienced directly, witnessed, learned about, or experiencing repeated or extreme exposure to aversive details. Exposure through electronic media, television, movies, or pictures does not qualify unless work-related.

Reactions to Extreme Trauma

Intrusive recollections (daytime flashbacks, nightmares, illusions) cause acute distress when triggered.
Dissociative symptoms ("psychic numbing") include emotional detachment, being in a daze, dropping out of usual activities, avoidance of trauma-related topics, forgetting key aspects, time distortion, feeling detached from one's body, and feeling like the current setting is dreamlike.
Chronic hyperarousal includes exaggerated startle, insomnia, hypervigilance, and motor restlessness (agitation).
Irritability, unprovoked angry outbursts, and aggressiveness are common reactions.
Survival guilt/shame, reckless, and impulsive behaviors may be related to events.

Acute stress disorder: Disability >2 days and <1 month. Occurs in 20% of cases not involving interpersonal assault (e.g., accidents) and 20-50% of cases following interpersonal assault. Symptoms include intense anxiety interfering with sleep, energy levels, concentration, and general withdrawal.
Post-traumatic stress disorder (PTSD): Disability ≥1 month from a traumatic episode or series of episodes. Prevalence depends on both the trauma and pre-existing risk factors. Complex PTSD (CPTSD) arises from prolonged trauma (research diagnosis, not in DSM-5-TR). -About 10% of people with PTSD show Delayed Expression, when signs are insufficient in the acute phase for diagnosis but increase over time

Case Studies

Examples of case studies regarding acute stress disorder and post-traumatic stress disorder are provided. Details of these cases are included.

Acute and Post-Traumatic Stress Disorders (Examples)

US Airways Flight 1549 (2009): Water landing, nearly impossible according to aviation experts, elicited significant stress in crew and passengers.

9/11/2001

Major event that caused significant stress disorders in people witnessing the event.

Post-Traumatic Stress Disorder (Prevalence)

Prevalence of PTSD: 2-3% in general US population, ~7% lifetime prevalence, and ~4% worldwide.
Factors affecting prevalence: gender (~2:1 F:M), age (adolescents 5-8%), interpersonal violence, and PTSD following acute stress disorder
Symptom patterns differentiating males and females. Females more likely to experience numbing and anxious avoidance, and suffer from PTSD longer than men. Males are likelier to show irritability and alcohol abuse. Children experiencing PTSD may demonstrate developmental regression.

Sexual violence: >300,000 attempted or completed rapes annually in the US (~10:1 F:M).
Military combat: PTSD develops in 18% of combat veterans and 70% of POWs, lasting 1-2 years, but in 30% and 78% of veterans lifetime.
Physical/emotional abuse (childhood sexual/physical abuse, domestic violence, workplace abuse): Crucial
Human calamities (e.g., deliberate acts, accidents, physical trauma, climatic calamities): including bombings, torture, death camps, terrorism, being a crime victim or hostage, motor vehicle accidents, plane crashes, gun accidents, workplace accidents, surgery, disease, disfigurement, head trauma, floods, tsunamis, tornados, hurricanes, earthquakes, and fires.

Severity and chronicity of trauma, and subsequent adverse life events.
Family history of depression or anxiety disorders, family history of PTSD.
Racial or ethnic minority status, poor coping habits (smoking, drinking), intergenerational trauma (“Don't trust others, don't trust the world”).
Poor social support in specific groups like combat veterans, rape and assault victims.

Complex PTSD (CPTSD)

-Special case of PTSD reserved for repeated or continuous trauma over months or years.

Symptoms can be more extreme and longer-lasting.
Common kinds of CPTSD trauma: neglect or emotional, physical and/or sexual abuse; growing up in a family with domestic abuse; being a POW or living in a war zone; being a victim of human trafficking, having a series of illnesses, medical procedures, or surgeries.
Associated with changes in worldview, religion, philosophy, basic trust, and views of relationships;preoccupation with traumatic history, and revenge fantasies.
Controversy over the diagnosis; debate centers around whether it is simply severe PTSD ("Research diagnosis not in DSM-5-TR")

Psychotherapy for PTSD

First-line treatment: exposure therapy combined with relaxation.
Cognitive-Behavioral Therapy (CBT) focuses on neutralizing thoughts and finding new ways of interpreting trauma.
Eye Movement Desensitization and Reprocessing (EMDR), Polyvagal therapy, group therapy, and stress management training are other approaches.
- Finding meaning in tragedy ("sublimation").

Group Management for Acute Stress: Critical Incident Stress Debriefing

Fact, reaction, symptom, teaching, and re-entry phases are involved in this group management process.

Medication Treatment of ASD and PTSD

Symptomatic care includes anxiolytics, antidepressants, psychoactive drugs, and sleep medications. Experimental treatments, including psychedelic administration and post-stressor propanolol, are being explored.

Mental Health Law and Regulations (California)

California Mental Health laws are described in a publication (2019) from the California Hospital Association (www.calhospital.org > Publications > Manuals).
Confidentiality guidelines are crucial for patient protection. Mental health information cannot be released without patient consent, except in specific circumstances such as duty to warn/protect. -Involuntary commitment procedures (i.e., "5150" or "5250 holds")

Involuntary Commitment

Involuntary commitment and hospitalization are covered in the Lanterman–Petris–Short (LPS) Act (1967). This is preferred only if needed in certain cases, such as the patient posing an imminent danger, or if chronic alcoholism.
Types of involuntary commitment procedures.

Crisis of Placement

People in a mental health crisis are more likely to encounter the police rather than receive medical assistance.
Individuals in crisis often spend time in jails, but this does not necessarily resolve the crisis.
Increased risk of violence and further mental health deterioration may occur in these situations.

Assisted Outpatient Treatment (AOT)

Allows court-ordered outpatient treatment for people with mental disorders (with controversial civil rights implications).
Acts as a bridge for crisis patients before discharge from inpatient facilities.
AOT assignments last 180 days and are renewable. Evidence shows AOT reduces arrests, incarcerations, and hospitalizations.

Mental Health Law Touches UCSB

Reporting of Elliot Rodger's crimes and his planned 2014 rampage. A detailed report by the Sheriff's office details a planned event.

CA Law AB 1014 - Temporary Gun Seizure

Authorities a to court issue gun-violence restraining orders if the law enforcement officer asserts and a judge finds reasonable grounds to believe that the person, by owning or having a firearm, is causing injury to themselves or others.
Restraining orders are issued without prior notice.
A 21-day hearing occurs on the issuance of the order.

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Description

Test your knowledge on stress disorders in this quiz focusing on Post-Traumatic Stress Disorder (PTSD) and acute stress disorder. Questions include criteria for diagnosis, symptoms, and types of trauma exposure. Gain insights into how traumatic events can affect individuals, particularly children and military personnel.