Stress Disorders: Trauma Reactions

Stress Disorders: Reactions to Extreme Trauma

• Intrusive Recollections: Trauma victims experience intrusive memories, daytime flashbacks, nightmares, and illusions, possibly triggered by associated cues (e.g., loud noises).
• Dissociative Symptoms: "Psychic numbing," emotional detachment, and feelings of being "zoned out" are common. Avoidance behaviors, memory fog, time distortion, and derealization/depersonalization are also seen.
• Chronic Hyperarousal: Trauma-related symptoms include heightened startle responses, insomnia, hypervigilance, restlessness, irritability, anger outbursts and aggression, especially in males.
• Survival Guilt/Shame: Feelings of unworthiness, marginalization, and reckless/impulsive behaviors may stem from survival guilt/shame.
• Depersonalization: Feeling detached from one's own body, as if observing from outside.
• Derealization: Surroundings feel unreal, dreamlike, or distorted.

Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD): Basic Differences

• ASD: Short-term response (2 days to under 1 month) to trauma, often following accidents or interpersonal trauma (20-50% of cases).
• PTSD: Diagnosed when symptoms persist beyond a month.

Risk Factors for ASD and PTSD

• Severity, Duration, and Nature of Trauma: A more severe, prolonged, or disturbing trauma increases risk.
• Pre-existing Mental Health Conditions: Anxiety, depression, or family history of these conditions.
• Family History of PTSD: Familial predisposition for the condition.
• Minority Status: Increased vulnerability.
• Poor Coping Mechanisms: Ineffective strategies for managing stress.
• Lack of Social Support: Limited assistance network.

Treatment for ASD and PTSD

• Psychotherapy: Exposure therapy, Cognitive Behavioral Therapy (CBT) focus on desensitizing responses and reinterpreting trauma.
• Other Therapies: EMDR and polyvagal therapy are also used, but have less definitive evidence.
• Support: Stress management and group therapy can aid recovery.

Delayed Expression Syndrome

• Symptoms Insufficient: Initial symptoms are subtle or mild, and increase over time to meet diagnostic criteria for PTSD.
• Incubation of Stress: Symptoms may take time to express, often due to social or mental barriers preventing immediate expression.

Complex PTSD (CPTSD)

• Repeated Trauma: CPTSD is for repeated or continuous trauma over months or years.
• More Extreme Symptoms: Symptoms are often more severe and long-lasting than in "simple" PTSD.
• Types of Trauma: Common causes include neglect, abuse (emotional, physical, sexual), domestic violence, war zones, human trafficking, and repeated serious illnesses/medical procedures.
• Changes in Worldview: CPTSD can significantly impact views/beliefs regarding relationships, religion, philosophy, and basic trust.
• Preoccupation with Trauma: Individuals may have intense preoccupation with events and potential revenge fantasies against perpetrators.
• Controversial Diagnosis: CPTSD is sometimes debated; some argue it is severe PTSD.

Critical Incident Stress Debriefing (CISD)

• Process: Fact, Reaction, Symptom, Teaching, Re-entry phases.
• Limited Evidence: Limited evidence supports the reduction of PTSD following CISD debriefings.

First-Line Psychotherapy and Medication Treatments for PTSD

• Psychotherapy (First-Line): Exposure therapy, CBT (including "thought neutralizing"), aimed at extinguishing conditioned fear responses and re-interpreting events. EMDR, Polyvagal therapy can also help.
• Group Therapy and Stress Management: Important supporting components.
• Medication (Symptomatic Care): Anxiolytics, antidepressants, antipsychotics, sleep medications.
• Medication (Specialized): Prazosin (anti-hypertensive) to reduce anxiety spikes, flashbacks, nightmares.
• Experimental Medications: Propranolol (memory intensity reduction), psychedelics (MDMA, psilocybin, etc.), with promising but unproven results.
• Caution: Memory-dulling medications could potentially lead to impairment of emotional recovery,

This quiz explores the various reactions individuals experience in response to extreme trauma, including intrusive recollections, dissociative symptoms, and chronic hyperarousal. You will also learn about survival guilt, depersonalization, and derealization as responses to acute stress disorders. Test your understanding of these critical psychological concepts.