Trauma and Stress-Related Disorders

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Questions and Answers

What personal trait has been identified as a positive predictor of growth following traumatic experiences?

Agreeableness

Introversion

Openness to change (correct)

Neuroticism

Which of the following is associated with cognitive flexibility during stressful situations?

Decreased self-efficacy

Perfectionism

Avoidance behavior

Reappraisal of events (correct)

What criteria helps differentiate PTSD from acute stress disorder?

Duration of symptoms lasting over 1 month (correct)

Presence of auditory hallucinations

Exposure to a traumatic event

Presence of emotional dysregulation

Which of the following is NOT one of the diagnostic criteria for PTSD?

Chronic pain syndrome Signup and view all the answers

Which system has specific genes linked to PTSD?

HPA axis systems Signup and view all the answers

Auditory pseudo-hallucinations may be associated with which feature of PTSD?

Paranoid ideation Signup and view all the answers

What role do external and internal stimuli play in the context of epigenetics and PTSD?

They can alter gene expression. Signup and view all the answers

Emotional regulation difficulties can arise from prolonged exposure to what type of events?

Prolonged and severe traumatic events Signup and view all the answers

What is a primary characteristic of Reactive Attachment Disorder?

Markedly disturbed and developmentally inappropriate attachment behaviors Signup and view all the answers

Which factor is considered pre-traumatic risk for developing PTSD?

Negative emotionality Signup and view all the answers

Which description accurately reflects the essential feature of PTSD?

Characteristic symptoms following exposure to one or more traumatic events Signup and view all the answers

Which is a common misconception about children with Reactive Attachment Disorder?

They often show strong emotional connections with caregivers Signup and view all the answers

What is a key risk factor associated with the peri-traumatic stage of PTSD?

High degree of traumatic exposure Signup and view all the answers

Which of these factors is NOT considered a psychosocial resilience factor after trauma?

Excessive isolation from support systems Signup and view all the answers

What commonly defines the developmental timeframe for noticing signs of Reactive Attachment Disorder?

9 months to 5 years Signup and view all the answers

How do some individuals with PTSD primarily react to their trauma experience?

With predominantly dysphoric or anhedonic states Signup and view all the answers

What is a critical differential diagnosis consideration for children exhibiting atypical social behaviors?

Intellectual developmental disorder Signup and view all the answers

Which neurobiological factor enhances resilience in individuals exposed to trauma?

Dopamine-mediated reward systems Signup and view all the answers

What is the essential feature of Acute Stress Disorder (ASD)?

Symptoms lasting from 3 days to 1 month following exposure to a traumatic event Signup and view all the answers

How long must symptoms be present to diagnose Prolonged Grief Disorder?

At least 12 months after the death Signup and view all the answers

What differentiates Adjustment Disorders from PTSD?

AD has no requirement for exposure to traumatic events Signup and view all the answers

Which of the following statements is true regarding the diagnosis of Major Depressive Disorder (MDD)?

It can be present regardless of a traumatic event being reported. Signup and view all the answers

Which symptom is NOT associated with Acute Stress Disorder?

Intrusive memories about the deceased Signup and view all the answers

How is Prolonged Grief Disorder primarily distinguished from normal grief?

By the duration of symptoms lasting over 12 months Signup and view all the answers

Which of the following is a characteristic symptom of Prolonged Grief Disorder?

Intense loneliness and emotional numbness Signup and view all the answers

Which of the following disorders has the requirement of symptoms resolving within 6 months of a stressor?

Adjustment Disorders Signup and view all the answers

Which statement best captures the distinct aspect of Adjustment Disorders?

They can result in functional consequences at work or school. Signup and view all the answers

What can complicate the course of Prolonged Grief Disorder?

Post-Traumatic Stress Disorder (PTSD) Signup and view all the answers

Study Notes

Shared Feature: Exposure to traumatic or stressful events is a diagnostic criterion. Symptoms can include anhedonia, dysphoria, anger/aggression, dissociation, or anxiety.

Reactive Attachment Disorder (RAD)

Essential Feature: Absent or grossly underdeveloped attachment between the child and caregivers.
Diagnostic Criteria: Limited early opportunities for attachment lead to a lack of comfort-seeking & nurturance-seeking behavior. Children show diminished or absent positive emotions during caregiver interactions.
Development: Manifests between 9 months and 5 years, often due to social neglect from infancy.
Risk Factors: Severe social neglect, but not all severely neglected children develop RAD. Prognosis depends on post-neglect caregiving.
Differential Diagnosis: Distinguish from autism (similar social behaviors, but no neglect history) or intellectual developmental disorder (social/emotional skills match cognitive abilities).

Post-Traumatic Stress Disorder (PTSD)

Classification: No longer an anxiety disorder, now categorized under Stress and Trauma-Related Disorders.
Rates: Vary based on trauma type (e.g., rape higher than car accidents). About 13-20% in US soldiers.
Essential Feature: Characteristic symptoms developing after exposure to trauma. Symptoms may be fear-based, anhedonic/dysphoric, arousal/reactive, or dissociative (or a combination).
Etiology: Fear conditioning, information processing, and neurobiological factors.
Risk Factors:
Pre-traumatic: Female gender, Hispanic race, younger age, lower education, lower intelligence, negative emotionality, prior family/personal psych history.
Peri-traumatic: High trauma exposure, dissociation, physiological activation.
Post-traumatic: Dysfunctional coping (avoidance), low social support, subsequent stressors.
Resilience: Not everyone exposed to trauma develops PTSD. Factors conducive to recovery.
Neurobiological: Robust stress response with rapid return to baseline; containing CRF, optimistic dopamine reward system, non-overreactive amygdala, strong cortical executive function.
Psychosocial: Optimism, humor, social support, active coping, openness, extraversion.
Cognitive: Reframing problems and finding meaning in stressful situations, leading to threat reduction and self-efficacy.
Genetics: Moderately heritable, associated with dopaminergic, serotonergic, noradrenergic, and HPA axis systems.
Epigenetics: External and internal stimuli (social support, fear, stress) can affect gene expression (turning genes on/off).
Diagnostic Criteria:
Exposure to trauma.
Intrusion symptoms.
Avoidance of trauma-related stimuli.
Negative alterations in mood/cognitions.
Marked alterations in arousal/reactivity.
Duration over 1 month.
Clinically significant distress/impairment.
Not due to substance use or medical condition
Associated Features: Pseudo-hallucinations, paranoid ideation, poor emotion regulation/interpersonal relationships, and/or dissociative symptoms (especially in prolonged trauma). Grief can involve combined PGD and PTSD (violent death).
Differential Diagnosis:
Adjustment Disorders (less severe, non-violent trauma.)
Acute Stress Disorder (symptoms last <1 month).
Major Depressive Disorder (distress may or may not be preceded by a traumatic event).

Acute Stress Disorder (ASD)

Essential Feature: Similar to PTSD, symptoms last 3 days to 1 month post-trauma.
Differential Diagnosis: Adjustment Disorder and PTSD (distinguish by symptom duration).

Adjustment Disorders

Essential Feature: Emotional/behavioral symptoms within 3 months of a stressor , resolving within 6 months of stressor's end.
Stressor: Single or multiple, recurring or continuous.
Consequences: Decreased performance, social relationship changes, co-morbidity in medical conditions.
Differential Diagnosis: MDD (if stressors trigger sx), PTSD, Bereavement (distress disproportionate/impaired by grief).

Prolonged Grief Disorder (PGD)

Essential Feature: Maladaptive grief reaction 12+ months post-death of a significant other.
Symptoms: Intense yearning, sorrow, preoccupation, avoidance of reminders, emotional numbness, difficulty reintegrating.
Characteristics: Disbelief, guilt, diminished expectations.
Comorbidity: PTSD (common after violent death).
Differential Diagnosis: Normal grief (severe sx persist for 12+ months), Depressive disorders (loss-focused distress), PTSD (intrusive memory is related to specific traumatic event in PGD while in PTSD is related to the trauma).

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Description

This quiz explores Trauma and Stress-Related Disorders, focusing on Reactive Attachment Disorder (RAD). It emphasizes diagnostic criteria, developmental factors, and the significant impact of early attachment experiences. Test your knowledge on how these disorders manifest and their risk factors.