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Questions and Answers
A person is involved in a car accident and is diagnosed with PTSD three weeks later. Which DSM-5 criteria would not yet be met for a PTSD diagnosis?
A person is involved in a car accident and is diagnosed with PTSD three weeks later. Which DSM-5 criteria would not yet be met for a PTSD diagnosis?
- Having negative alterations in cognition and mood related to the accident.
- Exhibiting efforts to avoid thoughts or feelings associated with the accident.
- Experiencing recurrent, involuntary, distressing memories of the accident.
- Demonstrating symptoms from each of the four PTSD categories. (correct)
Which of the following best exemplifies the 'avoidance' symptom category in PTSD?
Which of the following best exemplifies the 'avoidance' symptom category in PTSD?
- Displaying hypervigilance and an exaggerated startle response to stimuli.
- Feeling detached from others and emotionally numb after a traumatic experience.. (correct)
- Having persistent negative beliefs about oneself and the world following a trauma.
- Experiencing flashbacks where the traumatic event feels like it is happening again.
Which of the following scenarios would be categorized as an 'intrusive symptom' of PTSD?
Which of the following scenarios would be categorized as an 'intrusive symptom' of PTSD?
- A victim of a robbery developing a belief that they are inherently unsafe and cannot trust anyone.
- A former soldier feeling detached and unable to connect with their family after returning from deployment.
- A survivor of a house fire experiencing vivid nightmares about being trapped in the burning building. (correct)
- A veteran consciously avoiding driving on highways after experiencing a roadside bomb explosion.
A person with PTSD reports a loss of interest in hobbies and difficulty experiencing joy, which category of symptoms does this fall under?
A person with PTSD reports a loss of interest in hobbies and difficulty experiencing joy, which category of symptoms does this fall under?
After experiencing a traumatic event, an individual begins to blame themselves for what happened, despite evidence to the contrary. Which PTSD symptom category does this behavior align with?
After experiencing a traumatic event, an individual begins to blame themselves for what happened, despite evidence to the contrary. Which PTSD symptom category does this behavior align with?
Which of the following is an example of a maladaptive response to a traumatic event, as it relates to stress-related disorders?
Which of the following is an example of a maladaptive response to a traumatic event, as it relates to stress-related disorders?
Why might a clinician assess for avoidance behaviors when evaluating a patient for potential PTSD?
Why might a clinician assess for avoidance behaviors when evaluating a patient for potential PTSD?
How do flashbacks differ from recurrent distressing memories in individuals with PTSD?
How do flashbacks differ from recurrent distressing memories in individuals with PTSD?
Which of the following is an example of a hyper-arousal symptom commonly observed in individuals with PTSD?
Which of the following is an example of a hyper-arousal symptom commonly observed in individuals with PTSD?
A patient with PTSD reports frequent nightmares. Which medication would be the MOST appropriate first-line treatment to address this specific symptom before considering other options?
A patient with PTSD reports frequent nightmares. Which medication would be the MOST appropriate first-line treatment to address this specific symptom before considering other options?
Which of the following pre-trauma factors could increase an individual's susceptibility to developing PTSD after experiencing a traumatic event?
Which of the following pre-trauma factors could increase an individual's susceptibility to developing PTSD after experiencing a traumatic event?
What is the primary mechanism of action by which Prazosin (Minipress) alleviates nightmares in individuals with PTSD?
What is the primary mechanism of action by which Prazosin (Minipress) alleviates nightmares in individuals with PTSD?
Which of the following factors occurring during a traumatic event would MOST likely contribute to the severity of subsequent PTSD?
Which of the following factors occurring during a traumatic event would MOST likely contribute to the severity of subsequent PTSD?
A patient with PTSD is experiencing significant agitation and anger outbursts. Which class of medication might be considered to manage these symptoms?
A patient with PTSD is experiencing significant agitation and anger outbursts. Which class of medication might be considered to manage these symptoms?
What is a potential risk factor for PTSD that falls under the category of 'Post-Trauma Factors'?
What is a potential risk factor for PTSD that falls under the category of 'Post-Trauma Factors'?
Why are benzodiazepines recommended for short-term use only in the treatment of panic attacks associated with PTSD?
Why are benzodiazepines recommended for short-term use only in the treatment of panic attacks associated with PTSD?
A patient with PTSD also has a history of hypertension. What consideration is MOST important when prescribing Prazosin (Minipress) for nightmares?
A patient with PTSD also has a history of hypertension. What consideration is MOST important when prescribing Prazosin (Minipress) for nightmares?
Which medication used to treat anxiety is most similar in its mechanism of action to minipress?
Which medication used to treat anxiety is most similar in its mechanism of action to minipress?
Which dosage range presents a typical, effective amount of Prazosin for treating PTSD related symptoms?
Which dosage range presents a typical, effective amount of Prazosin for treating PTSD related symptoms?
Which of the following is NOT a common side effect from taking Minipress?
Which of the following is NOT a common side effect from taking Minipress?
A patient with what condition would require extra assessment of the benefits versus the risks before using minipress?
A patient with what condition would require extra assessment of the benefits versus the risks before using minipress?
What effect do alpha one adrenergic blockers have on blood vessels that helps to reduce blood pressure?
What effect do alpha one adrenergic blockers have on blood vessels that helps to reduce blood pressure?
What can maladaptive coping strategies lead to?
What can maladaptive coping strategies lead to?
A patient is experiencing nightmares and flashbacks following a traumatic event. According to the information, what is the primary goal of using prazosin in this scenario?
A patient is experiencing nightmares and flashbacks following a traumatic event. According to the information, what is the primary goal of using prazosin in this scenario?
Which of the following therapies involves guided eye movements to help process traumatic memories?
Which of the following therapies involves guided eye movements to help process traumatic memories?
A patient is diagnosed with Acute Stress Disorder after experiencing a traumatic event. According to DSM-5 criteria, within what timeframe do the symptoms need to occur?
A patient is diagnosed with Acute Stress Disorder after experiencing a traumatic event. According to DSM-5 criteria, within what timeframe do the symptoms need to occur?
A first responder is called to the scene of a school shooting. Following the event, short-term crisis intervention is implemented. What does this intervention typically involve?
A first responder is called to the scene of a school shooting. Following the event, short-term crisis intervention is implemented. What does this intervention typically involve?
What is the critical timeframe for diagnosing Adjustment Disorder, according to the information?
What is the critical timeframe for diagnosing Adjustment Disorder, according to the information?
A patient is experiencing depression, anxiety and insomnia following a recent job loss. The patient is diagnosed with adjustment disorder. Which of the following treatments would be most appropriate as a first-line intervention?
A patient is experiencing depression, anxiety and insomnia following a recent job loss. The patient is diagnosed with adjustment disorder. Which of the following treatments would be most appropriate as a first-line intervention?
A patient is diagnosed with dissociative amnesia. What is the primary characteristic of this condition?
A patient is diagnosed with dissociative amnesia. What is the primary characteristic of this condition?
Which factor is most commonly associated with the development of dissociative disorders?
Which factor is most commonly associated with the development of dissociative disorders?
A patient is experiencing emotional numbing and amnesia following a traumatic event. What is the most likely explanation for these symptoms?
A patient is experiencing emotional numbing and amnesia following a traumatic event. What is the most likely explanation for these symptoms?
A patient is diagnosed with Acute Stress Disorder but their symptoms persist beyond one month. According to the DSM-5, what is the most likely revised diagnosis?
A patient is diagnosed with Acute Stress Disorder but their symptoms persist beyond one month. According to the DSM-5, what is the most likely revised diagnosis?
A patient is diagnosed with Adjustment Disorder. What characteristics differentiate Adjustment Disorder from Post Traumatic Stress Disorder (PTSD)?
A patient is diagnosed with Adjustment Disorder. What characteristics differentiate Adjustment Disorder from Post Traumatic Stress Disorder (PTSD)?
Following a traumatic event, an individual exhibits increased irritability, hypervigilance, and difficulty sleeping. Which category of symptoms does this best describe?
Following a traumatic event, an individual exhibits increased irritability, hypervigilance, and difficulty sleeping. Which category of symptoms does this best describe?
A victim of a car accident cannot remember the moments immediately before or after the crash. Which of the following best describes this symptom?
A victim of a car accident cannot remember the moments immediately before or after the crash. Which of the following best describes this symptom?
Which statement accurately differentiates acute stress disorder(ASD) from PTSD based on diagnostic criteria?
Which statement accurately differentiates acute stress disorder(ASD) from PTSD based on diagnostic criteria?
Which of the following is a therapy that aims to reframe negative thoughts associated with trauma, grief, or guilt?
Which of the following is a therapy that aims to reframe negative thoughts associated with trauma, grief, or guilt?
A patient reports being found miles away from their home with no recollection of how they got there and appears confused about their identity. Which condition is MOST likely indicated by these symptoms?
A patient reports being found miles away from their home with no recollection of how they got there and appears confused about their identity. Which condition is MOST likely indicated by these symptoms?
A patient experiencing depersonalization is MOST likely to report which of the following sensations?
A patient experiencing depersonalization is MOST likely to report which of the following sensations?
A therapist is working with a patient diagnosed with Dissociative Identity Disorder (DID). Which therapeutic goal is MOST appropriate for this patient?
A therapist is working with a patient diagnosed with Dissociative Identity Disorder (DID). Which therapeutic goal is MOST appropriate for this patient?
A patient reports significant gaps in their memory, with no recollection of several hours at a time. During these periods, witnesses describe the patient's behavior and mood as drastically different. Which condition is MOST consistent with these symptoms?
A patient reports significant gaps in their memory, with no recollection of several hours at a time. During these periods, witnesses describe the patient's behavior and mood as drastically different. Which condition is MOST consistent with these symptoms?
A patient who experienced a traumatic event is having difficulty recalling specific details of the event. They can remember some parts clearly, while others are completely forgotten. Which type of amnesia is the patient MOST likely experiencing?
A patient who experienced a traumatic event is having difficulty recalling specific details of the event. They can remember some parts clearly, while others are completely forgotten. Which type of amnesia is the patient MOST likely experiencing?
Which therapeutic approach is generally considered MOST appropriate for addressing both depersonalization and derealization?
Which therapeutic approach is generally considered MOST appropriate for addressing both depersonalization and derealization?
A patient reports feeling detached from their body, as if they are watching themselves from outside. However, they acknowledge that their surroundings are real. Which condition BEST describes the patient's experience?
A patient reports feeling detached from their body, as if they are watching themselves from outside. However, they acknowledge that their surroundings are real. Which condition BEST describes the patient's experience?
A patient suddenly travels to a different state and starts a new life under a new name, with no memory of their past. After several weeks, their memory returns, and they are distressed to find themselves in an unfamiliar place. Which condition is MOST likely?
A patient suddenly travels to a different state and starts a new life under a new name, with no memory of their past. After several weeks, their memory returns, and they are distressed to find themselves in an unfamiliar place. Which condition is MOST likely?
What is the primary difference between depersonalization and derealization?
What is the primary difference between depersonalization and derealization?
Which factor is MOST commonly associated with the development of Dissociative Identity Disorder (DID)?
Which factor is MOST commonly associated with the development of Dissociative Identity Disorder (DID)?
A patient with Dissociative Identity Disorder (DID) presents with multiple alters, each with distinct characteristics. Which of the following is a common manifestation of these alters?
A patient with Dissociative Identity Disorder (DID) presents with multiple alters, each with distinct characteristics. Which of the following is a common manifestation of these alters?
Which of the following statements is TRUE regarding the treatment of Dissociative Identity Disorder (DID)?
Which of the following statements is TRUE regarding the treatment of Dissociative Identity Disorder (DID)?
During a therapy session, a patient describes feeling like they are living in a movie, where everything around them seems unreal and dreamlike. They are MOST likely experiencing:
During a therapy session, a patient describes feeling like they are living in a movie, where everything around them seems unreal and dreamlike. They are MOST likely experiencing:
A first responder finds a survivor of a mass casualty event miles away from the site. The survivor is confused, disoriented, and unable to recall any details of the event or their personal information. What condition might this survivor be experiencing?
A first responder finds a survivor of a mass casualty event miles away from the site. The survivor is confused, disoriented, and unable to recall any details of the event or their personal information. What condition might this survivor be experiencing?
What is the intended outcome of therapy, like Cognitive Behavioral Therapy(CBT) or Dialectical Behavior Therapy (DBT), for a patient with Dissociative Identity Disorder (DID)?
What is the intended outcome of therapy, like Cognitive Behavioral Therapy(CBT) or Dialectical Behavior Therapy (DBT), for a patient with Dissociative Identity Disorder (DID)?
Flashcards
Trauma & Stress-Related Disorders
Trauma & Stress-Related Disorders
Mental health conditions triggered by traumatic or highly stressful life events (e.g., combat, assault, disasters).
PTSD (Post-Traumatic Stress Disorder)
PTSD (Post-Traumatic Stress Disorder)
A mental health condition where symptoms occur for at least one month after experiencing a traumatic event.
Intrusive Symptoms (PTSD)
Intrusive Symptoms (PTSD)
Recurrent, involuntary, and distressing memories of the trauma, including flashbacks and nightmares.
Flashbacks
Flashbacks
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Avoidance Symptoms (PTSD)
Avoidance Symptoms (PTSD)
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Emotional Numbing
Emotional Numbing
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Negative Alterations in Cognition and Mood (PTSD)
Negative Alterations in Cognition and Mood (PTSD)
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Distorted Blame
Distorted Blame
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Mini Press
Mini Press
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Trauma-Focused CBT
Trauma-Focused CBT
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EMDR
EMDR
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Prolonged Exposure Therapy
Prolonged Exposure Therapy
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Acute Stress Disorder
Acute Stress Disorder
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Dissociative Symptoms
Dissociative Symptoms
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Hyperarousal
Hyperarousal
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Amnesia (Trauma-Related)
Amnesia (Trauma-Related)
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Crisis Interventions
Crisis Interventions
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Adjustment Disorder
Adjustment Disorder
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Stressors (Adjustment Disorder)
Stressors (Adjustment Disorder)
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Dissociative Disorders
Dissociative Disorders
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Dissociative Amnesia
Dissociative Amnesia
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SSRI (Adjustment disorder)
SSRI (Adjustment disorder)
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Feelings associated with Adjustment disorder
Feelings associated with Adjustment disorder
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PTSD: Hyper-Arousal Symptoms
PTSD: Hyper-Arousal Symptoms
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PTSD: Pre-Trauma Risk Factors
PTSD: Pre-Trauma Risk Factors
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PTSD: Peri-Trauma Factors
PTSD: Peri-Trauma Factors
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PTSD: Post-Trauma Factors
PTSD: Post-Trauma Factors
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PTSD: First-Line Medication
PTSD: First-Line Medication
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PTSD: Prazosin (Minipress)
PTSD: Prazosin (Minipress)
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PTSD: Agitation Treatment
PTSD: Agitation Treatment
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PTSD: Panic Attack Meds
PTSD: Panic Attack Meds
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Minipress: Mechanism of Action
Minipress: Mechanism of Action
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Minipress: PTSD Benefit
Minipress: PTSD Benefit
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Propranolol for Anxiety
Propranolol for Anxiety
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Minipress: Common Side Effects
Minipress: Common Side Effects
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Minipress: Uncommon Side Effects
Minipress: Uncommon Side Effects
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Minipress: Renal Caution
Minipress: Renal Caution
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Minipress: Hypertension Caution
Minipress: Hypertension Caution
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Localized Amnesia
Localized Amnesia
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Selective Amnesia
Selective Amnesia
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Generalized Amnesia
Generalized Amnesia
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Dissociative Fugue
Dissociative Fugue
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Trauma-Focused Therapy
Trauma-Focused Therapy
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Cognitive Techniques (for Memory)
Cognitive Techniques (for Memory)
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Dissociative Identity Disorder (DID)
Dissociative Identity Disorder (DID)
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Alters Characteristics in DID
Alters Characteristics in DID
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Depersonalization
Depersonalization
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Derealization
Derealization
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Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT)
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Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy (DBT)
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Grounding techniques
Grounding techniques
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Benzodiazepines for Anxiety
Benzodiazepines for Anxiety
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Study Notes
- Trauma and stress-related disorders are mental health conditions triggered by traumatic or highly stressful life events.
- Such events could include combat, sexual assault, accidents, natural disasters, terrorist attacks, or childhood abuse.
- Individuals may exhibit emotional and behavioral responses such as anxiety, fear, dissociation, avoidance, and hypervigilance.
Post-Traumatic Stress Disorder (PTSD)
- According to DSM-5, PTSD requires the exhibition of symptoms for longer than one month, across four categories
Intrusive symptoms
- Recurrent, involuntary, and distressing memories of the trauma
- Flashbacks, which are feelings as if the trauma is happening again
- Nightmares related to the trauma (flashbacks can occur during nightmares)
- Intense emotional and physical reactions to trauma reminders
Avoidance
- Efforts to avoid thoughts, memories, or conversations about the event
- Avoidance of places, people, or situations associated with the trauma
- Emotional numbing or detachment from others
Negative Alterations in Cognition and Mood
- Persistent negative beliefs about oneself, others, or the world
- Distorted blame of self and others for the trauma
- Inability to experience positive emotions
- Loss of interest in activities
Hyperarousal Symptoms
- Irritability or anger outbursts
- Hypervigilance (constantly on edge)
- Exaggerated startle response
- Difficulty concentrating
- Trouble sleeping
PTSD Risk Factors
- Pre-trauma factors: pre-existing mental health conditions (anxiety, depression), genetic predisposition, childhood adversity
- Peritraumatic factors: severity and duration of the trauma, type of trauma, and the person's thoughts during the event
- Post-trauma factors: lack of social support, repeated exposure to trauma reminders, and maladaptive coping strategies (e.g., drinking, drug use, avoidance)
PTSD Treatment and Medication Management:
- SSRIs (Zoloft, Paxil, Prozac, etc.) are first-line treatments.
- Prazosin (Minipress) can be used for nightmares or flashbacks.
- Mood stabilizers or atypical antipsychotics may be used for agitation (Risperdal, Seroquel, Depakote).
- Benzodiazepines can be used short-term for panic attacks.
Prazosin (Minipress)
- It's a blood pressure medication (alpha-1 adrenergic blocker).
- Off-label use for PTSD-related nightmares.
- It can help with sleep and stopping nightmares.
- The mechanism of action is the blockade of alpha-1 receptors, leading to the relaxation of blood vessels and reduced blood pressure.
- It can reduce the body's hyperarousal response to adrenaline.
- For social/performance anxiety, propranolol can be used; however, minipress works better for PTSD.
- Propranolol lowers hyperarousal symptoms of anxiety (heart pounding, etc.).
- Minipress dosage typically starts at 0.5mg and can be titrated up to 1-15mg (usual dose 3-5mg).
Minipress Side Effects
- Dizziness
- Drowsiness
- Orthostatic hypotension
- Nausea and vomiting
- Headache
- Uncommon side effects include blurred vision, urinary incontinence, and impotence -- discontinue use if these occur.
- Use with caution in patients with renal impairment or those on other antihypertensive medications
- The main goal is to improve the quality of life for individuals experiencing nightmares/flashbacks.
- It may not be a long-term medication.
Psychotherapy for PTSD
- Trauma-focused Cognitive Behavioral Therapy (CBT) helps reframe negative thoughts.
- Eye Movement Desensitization and Reprocessing (EMDR) uses guided eye movements to process traumatic memories.
- Prolonged Exposure Therapy reduces negative thoughts and avoidance behaviors (be cautious of retraumatization).
Acute Stress Disorder
- Similar to PTSD, but occurs within three days to one month after the trauma.
- If symptoms persist past one month, it may develop into PTSD.
Common Symptoms of Acute Stress Disorder
- Dissociative symptoms (feeling detached from reality)
- Intrusive thoughts, flashbacks, nightmares
- Avoidance of trauma-related stimuli
- Hyperarousal (irritability, being on edge)
- Emotional numbing or amnesia
Treatment for Acute Stress Disorder Includes
- Short-term crisis interventions
- Trauma-focused CBT
- SSRIs or short-term benzodiazepines
Adjustment Disorder
- A maladaptive emotional or behavioral response to a stressful life event within three months.
- Stressors may include divorce, job loss, chronic illness, or financial problems.
- No requirement for a life-threatening event.
Symptoms of Adjustment Disorder
- Depression
- Anxiety
- Anger
- Conduct problems in children
- Trouble sleeping
- Withdrawal from social interactions
- Increased worrying or feelings of hopelessness
- Impaired daily function
Treatment for Adjustment Disorder
- CBT
- Supportive therapy and counseling
- Possibly short-term use of antidepressants or anti-anxiety medications
Dissociative Disorders
- Involve disruptions in memory, identity, emotion, perception of reality, and behavior.
- Are commonly linked to severe childhood trauma and abuse.
Dissociative Amnesia
- Inability to recall important personal information, usually following a trauma.
- Localized Amnesia: Cannot recall events during a specific time period.
- Selective Amnesia: Partial memory loss.
- Generalized Amnesia: Complete memory loss (uncommon).
- Dissociative Fugue: Sudden travel or wandering away from home with identity confusion.
- Treatment includes trauma-focused therapy and cognitive techniques to improve memory recall.
Dissociative Identity Disorder
- Presence of two or more distinct personality states or alters.
- Each identity has different memories, behaviors, and speech patterns.
- Often related to severe, repeated childhood abuse.
Symptoms of Dissociative Identity Disorder Include
- Memory or time loss
- Rapid changes in mood, behavior, or identity
- Increase in self-injurious behaviors or suicidal tendencies
Treatment for Dissociative Identity Disorder
- Long-term psychotherapy
- Aims to integrate all identities into one.
- CBT and DBT may be used.
- Hypnotherapy may be used in some cases.
Depersonalization vs. Derealization
- Depersonalization: Feeling detached from oneself (out-of-body experience).
- Derealization: Feeling that the surroundings are unreal.
- Treatments include CBT and grounding techniques.
- Medication management includes SSRIs or short-term benzodiazepines for anxiety or panic attacks.
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Description
Trauma and stress-related disorders arise after exposure to traumatic events like combat or abuse. PTSD, as defined by DSM-5, involves intrusive symptoms, avoidance, negative alterations in cognition and mood, and marked alterations in arousal and reactivity. Symptoms must persist for more than one month.