Trauma and Stressor-Related Disorders

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Questions and Answers

What type of risk factors for PTSD includes female gender and lower education?

Environmental risk factors

Pretraumatic risk factors (correct)

Posttraumatic risk factors

Peritraumatic risk factors

Which of the following is NOT a neurobiological resilience factor?

An amygdala that does not overreact

A sympathetic nervous system that responds robustly to stress

A dopamine-mediated reward system

Excessive physiological activation during trauma (correct)

How do individuals with cognitive flexibility typically respond to stressful situations?

They extract personal meaning from the situation. (correct)

They become more pessimistic about outcomes.

They experience greater fear responsiveness.

They avoid dealing with the stressor.

What is a psychosocial factor that can enhance resilience to stress?

High levels of social support Signup and view all the answers

Which genetic aspect is related to stress vulnerability in PTSD?

Polymorphisms affecting the HPA-axis regulation Signup and view all the answers

What characterizes individuals who effectively cope after experiencing trauma?

They maintain optimism and hope despite challenges. Signup and view all the answers

Which situation is likely to lead to worse outcomes in terms of PTSD risk?

Dysfunctional coping strategies like avoidance Signup and view all the answers

What does pronounced dissociation during a traumatic event typically indicate?

Increased vulnerability to PTSD Signup and view all the answers

What is the primary risk factor for reactive attachment disorder?

Serious social neglect Signup and view all the answers

Which behavioral characteristic is NOT typically associated with reactive attachment disorder?

Restricted interests Signup and view all the answers

Which of the following is a correct statement regarding PTSD according to the DSM-5?

PTSD is placed under Stress and Trauma-Related Disorders. Signup and view all the answers

What is the essential feature of posttraumatic stress disorder (PTSD)?

Development of characteristic symptoms following a traumatic event Signup and view all the answers

Which population is estimated to have a PTSD prevalence rate of 13% to 20%?

U.S. soldiers who served in Iraq and Afghanistan Signup and view all the answers

Which of the following conditions shows a history of significant social neglect?

Reactive attachment disorder Signup and view all the answers

Which type of behaviors are prominent in individuals with PTSD?

Fear-based reexperiencing, emotional, and behavioral symptoms Signup and view all the answers

Which of the following does NOT typically characterize autism spectrum disorder?

Profound reduction in positive affect Signup and view all the answers

What does the presence of intrusion symptoms in PTSD include?

Recurrent distressing dreams related to the traumatic event Signup and view all the answers

Which of the following best describes the genetic factors associated with PTSD?

Risk for PTSD is moderately heritable and involves multiple gene systems. Signup and view all the answers

Which criterion is NOT part of the diagnostic criteria for PTSD?

Demonstrating acute anxiety response to any stressor Signup and view all the answers

How long must symptoms persist to meet the duration criterion for PTSD?

More than 1 month Signup and view all the answers

Which of the following statements about gene expression and PTSD is true?

External stimuli can alter gene expression related to PTSD. Signup and view all the answers

Which of the following is considered a marked alteration in arousal associated with PTSD?

Increased reactivity to minor stressors Signup and view all the answers

What is one of the main criteria for diagnosing PTSD related to avoidance?

Efforts to avoid distressing thoughts or memories Signup and view all the answers

In the context of PTSD, which of the following is NOT considered part of Criterion A for diagnosis?

Experiencing unrelated daily stresses at work Signup and view all the answers

Which symptom is NOT a characteristic of negative alterations in cognitions and mood associated with PTSD?

Persistent sleep disturbances Signup and view all the answers

What is a marked alteration in arousal and reactivity associated with the traumatic event?

Sleep disturbances Signup and view all the answers

What aspect of PTSD does the term 'negative alterations in cognitions and mood' refer to?

Persistent negative thoughts about oneself or the world Signup and view all the answers

For a diagnosis of PTSD, how long must symptoms persist according to Criteria B, C, D, and E?

At least 1 month Signup and view all the answers

What differentiates PTSD from Acute Stress Disorder regarding symptom duration?

Symptoms last longer in PTSD Signup and view all the answers

Which of the following is a physiological reaction characteristic of PTSD?

Irritable behavior with little provocation Signup and view all the answers

What type of behavior is associated with heightened arousal in PTSD?

Self-destructive and reckless behavior Signup and view all the answers

What emotional state is recognized as part of the negative alterations in mood related to PTSD?

Persistent fear Signup and view all the answers

What is a common symptom of PTSD related to auditory experiences?

Hearing one’s thoughts spoken in different voices Signup and view all the answers

Which of the following is NOT a requirement for the diagnosis of PTSD?

Development of symptoms within 3 days Signup and view all the answers

Which disorder involves the response to a stressor that does not meet Criterion A for trauma?

Adjustment disorder Signup and view all the answers

What distinguishes acute stress disorder from PTSD regarding symptom duration?

Symptoms in acute stress disorder resolve within 1 month Signup and view all the answers

What emotional issue may be experienced in both PTSD and complex trauma situations?

Regulating emotions Signup and view all the answers

Which type of grief symptom may co-occur with PTSD after a close individual's violent death?

Prolonged grief disorder symptoms Signup and view all the answers

Which symptom is NOT characteristic of acute stress disorder?

Physical injury evidence Signup and view all the answers

Which statement about acute stress disorder is accurate?

It involves the same trauma types as PTSD Signup and view all the answers

What is a key symptom of prolonged grief disorder?

Emotional numbness Signup and view all the answers

Which cognitive pattern is commonly experienced by individuals with prolonged grief disorder?

Maladaptive cognitions about the self Signup and view all the answers

How does prolonged grief disorder differ from normal grief regarding its duration?

It lasts at least 12 months Signup and view all the answers

Which of the following emotional states is commonly associated with prolonged grief disorder?

Feeling that life is meaningless Signup and view all the answers

In the context of prolonged grief disorder, how do intrusive memories differ from those in PTSD?

They center on thoughts about many aspects of the relationship Signup and view all the answers

What is an essential factor that complicates the course of prolonged grief disorder?

Comorbid posttraumatic stress disorder Signup and view all the answers

Which symptom would suggest a diagnosis of prolonged grief disorder?

Marked sense of disbelief about the death Signup and view all the answers

What differentiates prolonged grief disorder from depressive disorders?

Focus on feelings of loss and separation from a loved one Signup and view all the answers

Study Notes

Trauma and stressor-related disorders have profound effects on memories, cognitions, emotions, and behaviors.
Exposure to a traumatic or stressful event is a diagnostic criterion for these disorders.
Some individuals exposed to trauma may exhibit anhedonic, dysphoric, externalizing (angry and aggressive), or dissociative symptoms, rather than anxiety or fear-based symptoms.

Reactive Attachment Disorder

Characterized by a pattern of markedly disturbed and developmentally inappropriate attachment behaviors.
Children rarely or minimally turn to attachment figures for comfort, support, protection, and nurturance.
A crucial feature is the absence or gross underdevelopment of attachment between the child and caregiving adults.
Limited opportunities during early development lead to a failure of these children to display behavioral manifestations of selective attachments and a lack of consistent effort to obtain comfort, support, nurturance, or protection from caregivers.
Children exhibit diminished or absent expression of positive emotions during routines.
Conditions of social neglect are commonly present from the first months of life in those diagnosed.
Clinical features appear between 9 months and 5 years old.
Serious social neglect is the sole known risk factor for this disorder, though most severely neglected children do not develop it.
Prognosis depends on the caregiving environment after neglect.

Differential Diagnosis of Reactive Attachment Disorder

Autism Spectrum Disorder: Aberrant social behaviors are present in both, but children with ASD rarely have a social neglect history. Restricted interests and repetitive behaviors are not features of RAD.
Intellectual Developmental Disorder: Children with IDD show social and emotional skills comparable to their cognitive abilities and don't show the profound reduction in positive affect and emotion regulation difficulties found in RAD.

Post-Traumatic Stress Disorder (PTSD)

No longer considered an anxiety disorder.
PTSD is now listed under the Stress and Trauma-Related Disorders category.
Prevalence varies depending on trauma type. Rape results in higher rates than automobile accidents in both men and women.
The prevalence among U.S. soldiers in Iraq and Afghanistan is estimated to be 13-20%.
Characteristic symptoms develop after exposure to one or more traumatic events.
Symptoms can include fear-based reexperiencing, emotional, behavioral symptoms, anhedonic or dysphoric mood states, and negative cognitions.
Additional symptoms can include arousal and reactive-externalizing behaviors or dissociative symptoms.

PTSD - Etiology

Fear conditioning/learning: Classical (Pavlovian) and operant conditioning play a role
Information processing: Individuals are more likely to appraise situations as threatening if they feel unable to meet demands.
Neurobiological systems: Genetic polymorphisms related to stress vulnerability, difficulty extinguishing fear-conditioned memories, and poor regulation of the HPA axis are involved.

PTSD - Risk Factors

Pretraumatic factors include female gender, Hispanic race, younger age, lower education, lower intelligence, negative emotionality, and past psychiatric history.
Peritraumatic factors include high traumatic exposure, pronounced dissociation, and excessive peritraumatic physiological activation.
Posttraumatic factors include dysfunctional coping strategies (avoidance), low social support, and subsequent exposure to additional stressors and traumatic events.

PTSD - Resilience

Not all individuals exposed to trauma develop PTSD.
Neurobiological resilience factors include a robust sympathetic nervous system that returns rapidly to baseline, ability to contain CRF, well-functioning dopamine-mediated reward system, appropriate amygdala functioning, and strong cortical executive and inhibitory capacity.
Psychosocial factors such as optimism, humor, social support, an active coping style, openness to change, and extroversion are also correlated with resilience.
Cognitive flexibility, or the ability to reframe problems and find meaning in stressful situations, is associated with a greater sense of self-efficacy and less perceived threat.

PTSD - Genetics

PTSD risk is moderately heritable.
Specific genes related to dopaminergic, serotonergic, noradrenergic, and HPA axis systems have been linked to PTSD.
Epigenetic research shows that external and internal stimuli (e.g., social support, fear, stress) can trigger biochemical reactions that impact gene expression ("turning genes on" or "off").

PTSD - Diagnostic Criteria

Criterion A: Exposure to actual or threatened death, serious injury, or sexual violence (can include direct experience; witnessing; learning about it related to a family member or close friend).
Criterion B: Presence of one or more intrusion symptoms (e.g., distressing memories, recurring dreams, flashbacks).
Criterion C: Persistent avoidance of stimuli associated with the traumatic event(s) (avoid distressing memories, thoughts, or feelings; avoid external reminders).
Criterion D: Negative alterations in cognitions and mood (e.g., inability to remember an aspect; persistent negative beliefs or expectations; blaming oneself or others).
Criterion E: Marked alterations in arousal and reactivity (e.g., irritability; reckless or self-destructive behavior; hypervigilance; exaggerated startle response; sleep disturbance).
Criterion F: Duration of disturbance (B, C, D, and E) is more than 1 month. This distinction is crucial, as it separates PTSD from acute stress disorder.

Acute Stress Disorder

Characterized by characteristic symptoms lasting from 3 to 1 month following traumatic events.
Intrusion, negative mood, dissociative, avoidance, and arousal symptoms can be present.
The full symptom picture must last for at least 3 days but no more than 1 month to be diagnosed as ASD.
If symptoms last longer than 1 month, the diagnosis changes to PTSD.

Adjustment Disorders

Disturbance begins within 3 months of a stressor onset.
Disturbance must resolve within 6 months of the stressor's termination or its consequences.
Subjective distress or impairment in functioning is present, often manifested as decreased work/school performance and social relationship difficulties.
Adjustment disorder can complicate other medical conditions.

Differential Diagnosis of Adjustment Disorders

Major Depressive Disorder: If an individual demonstrates symptoms indicative of major depression, an adjustment disorder diagnosis is not applied.
PTSD: In adjustment disorders, the stressor can be any severity, unlike PTSD, which requires specific severity thresholds of trauma;
Bereavement: Prolonged grief disorder may be considered in cases of severe and prolonged grief reactions that last more than 12 months.

Prolonged Grief Disorder

Maladaptive grief reaction diagnosed at least 12 months after the death of a close relationship.
Characterized by persistent grief, intense yearning or longing for the deceased, frequent crying, and preoccupation with thoughts or memories of the deceased.
Symptoms must be present for at least one month and at a clinically relevant level for the diagnosis (e.g., difficulty functioning).
Must be distinguished from normal grief reactions, which resolve within a shorter timeframe and don't typically impair functioning as much.

Differential Diagnosis for Prolonged Grief Disorder

Normal grief: Distinguishing factor is that prolonged grief involves significantly more intense, persistent reactions and impairment in functioning.
Depressive Disorders: Prolonged grief is focused on loss and separation from a loved one, not reflecting on generalized low mood associated with depressive disorders.
PTSD: Intrusions in PTSD are typically focused on the traumatic event, while in prolonged grief, the intrusive thoughts may revolve around the positive aspects of the relationship.

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Description

Explore the profound impact of trauma and stressor-related disorders on individuals' memories, emotions, and behaviors. This quiz delves into the symptoms, diagnostic criteria, and specifics of disorders such as Reactive Attachment Disorder. Test your understanding of how these conditions manifest and affect behavior.