Trauma & Stress Disorders Overview
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Questions and Answers

What is the most effective treatment for PTSD?

  • Exposure-based treatment (correct)
  • Antidepressant drug therapy
  • Mindfulness-based techniques
  • Cognitive processing therapy

    • Which of the following is NOT a type of exposure therapy for PTSD?

  • In vivo exposure
  • Virtual reality exposure
  • Covert exposure
  • Couple or family therapy (correct)

    • What is a common term for group therapy for PTSD?

  • Rap groups (correct)
  • Small veterans outreach programs
  • Cognitive-behavioral therapy
  • Mindfulness-based techniques

    • Which of the following is NOT a general goal of treatment for acute and posttraumatic stress disorders?

    <p>Eliminate all anxiety symptoms (D)</p> Signup and view all the answers

    Which of the following is a type of community intervention for PTSD?

    <p>Psychological debriefing (D)</p> Signup and view all the answers

    Which of these is NOT a component of the stress response?

    <p>Stressful situation (B)</p> Signup and view all the answers

    Which neurotransmitter is associated with the fight-or-flight response?

    <p>Norepinephrine (B)</p> Signup and view all the answers

    What is the role of the adrenal cortex in the stress response?

    <p>Release of cortisol (A)</p> Signup and view all the answers

    Which of the following disasters has the highest recorded death toll?

    <p>Flood in the Huang River, China (1931) (B)</p> Signup and view all the answers

    According to the provided content, what percentage of torture victims are estimated to develop PTSD?

    <p>30-50% (A)</p> Signup and view all the answers

    Which of the following is NOT considered a traumatic event?

    <p>Failing a test (B)</p> Signup and view all the answers

    Which of these is NOT a contributing factor to the development of acute and posttraumatic stress disorder?

    <p>Gender identity (A)</p> Signup and view all the answers

    What is the main difference between acute stress disorder and posttraumatic stress disorder?

    <p>Posttraumatic stress disorder lasts for longer than 1 month (C)</p> Signup and view all the answers

    What percentage of individuals do not develop full-blown PTSD until 6 or more months after a traumatic event?

    <p>25% (A)</p> Signup and view all the answers

    What is the most common stress disorder that can develop from victimization?

    <p>Post Traumatic Stress Disorder (D)</p> Signup and view all the answers

    How can stress contribute to physical disorders?

    <p>All of the above (D)</p> Signup and view all the answers

    Which disaster caused the most deaths in Central America?

    <p>Hurricane Mitch (1998) (A)</p> Signup and view all the answers

    What percentage of US adults reported high terrorism fears years after the 9/11 attacks?

    <p>42% (A)</p> Signup and view all the answers

    What is the DSM-5-TR classification for acute stress disorder and posttraumatic stress disorder?

    <p>Trauma and Stressor-Related Disorders (B)</p> Signup and view all the answers

    Which of the following is NOT a type of torture mentioned in the provided text?

    <p>Emotional torture (A)</p> Signup and view all the answers

    Based on the provided content, which event is NOT categorized as a triggering event for acute and posttraumatic stress disorders?

    <p>Chronic illness (B)</p> Signup and view all the answers

    What type of therapy would be recommended for Victor's emotional distress associated with traumatic memories?

    <p>Eye Movement Desensitization and Reprocessing (A)</p> Signup and view all the answers

    Which of the following medications are commonly used to address anxiety and depression associated with PTSD?

    <p>SSRIs or SNRIs (C)</p> Signup and view all the answers

    What is a key aspect of the treatment plan that aims to help Victor cope with hypervigilance and irritability?

    <p>Mindfulness and relaxation techniques (A)</p> Signup and view all the answers

    Which of the following is NOT a recommended lifestyle or self-care strategy for Victor?

    <p>Moderate alcohol consumption (D)</p> Signup and view all the answers

    What type of therapy would likely be helpful for Victor to improve communication and strengthen his relationship with his fiancée?

    <p>Couples Therapy (C)</p> Signup and view all the answers

    Why might Victor's symptoms interfere with his job performance?

    <p>He might be experiencing hypervigilance and difficulty concentrating due to PTSD. (B)</p> Signup and view all the answers

    What is the primary objective of trauma-focused cognitive behavioral therapy (TF-CBT) for Victor?

    <p>To help Victor develop coping mechanisms for dealing with his triggers. (A)</p> Signup and view all the answers

    What is the main reason why prolonged exposure therapy (PE) is recommended for Victor?

    <p>To reduce the intensity of flashbacks and intrusive memories. (C)</p> Signup and view all the answers

    Which of the following symptoms is NOT listed in the provided information about Victor's condition?

    <p>Social Anxiety (B)</p> Signup and view all the answers

    What question would be MOST helpful in understanding the impact of Victor's symptoms on his personal life?

    <p>How have these symptoms impacted your daily functioning and relationship with your fiancée? (C)</p> Signup and view all the answers

    Which of the following questions directly assesses Victor's potential for self-harm?

    <p>Have you ever experienced thoughts of harming yourself or others? (A)</p> Signup and view all the answers

    Based on the provided information, which of the following criteria for PTSD is NOT met in Victor's case?

    <p>Criterion D: Negative alterations in cognitions and mood (C)</p> Signup and view all the answers

    What coping strategy does Victor employ to deal with his symptoms?

    <p>Avoiding reminders of the trauma (A)</p> Signup and view all the answers

    Which of the following is NOT considered a potential trigger for Victor's PTSD symptoms based on the information provided?

    <p>The smell of coffee (B)</p> Signup and view all the answers

    Which of the following best describes the likely cause of Victor's PTSD?

    <p>Exposure to combat during his second tour in Iraq (B)</p> Signup and view all the answers

    Which of the following questions aims to assess Victor's support network?

    <p>Do you have a support network besides your fiancée? (C)</p> Signup and view all the answers

    Which of the following symptoms is NOT exhibited by Victor in the case study?

    <p>Experiencing flashbacks of traumatic events (C)</p> Signup and view all the answers

    What is a potential reason Victor avoids seeing his friends from the Reserve unit?

    <p>He is afraid of being reminded of his traumatic experiences. (D)</p> Signup and view all the answers

    Which of the following is a potential concern about using psychological debriefing for Victor?

    <p>It might not be effective in addressing his specific symptoms. (A)</p> Signup and view all the answers

    What is the most likely provisional diagnosis for Victor based on the information provided?

    <p>Post-Traumatic Stress Disorder (D)</p> Signup and view all the answers

    Which of the following treatments is most likely to be recommended for Victor's condition?

    <p>Cognitive Behavioral Therapy (CBT) (A)</p> Signup and view all the answers

    What is a key aspect of psychological first aid approach to helping victims of trauma?

    <p>Providing support and resources to help the victim cope with their immediate needs. (A)</p> Signup and view all the answers

    Which of the following best describes the primary difference between psychological debriefing and psychological first aid?

    <p>Psychological debriefing encourages extensive discussion of trauma, while psychological first aid is more supportive and does not push individuals to talk. (D)</p> Signup and view all the answers

    Why might Victor be hesitant to provide specific details about his traumatic experiences?

    <p>All of the above (D)</p> Signup and view all the answers

    Flashcards

    PTSD Treatment Goals

    End lingering stress reactions, gain perspective, and return to constructive living.

    Common PTSD Therapies

    Includes antidepressants, cognitive-behavioral therapy, and mindfulness.

    Virtual Reality Therapy

    Uses simulated environments for exposure therapy in PTSD treatment.

    Cognitive Processing Therapy

    Focuses on changing unhelpful thoughts about the trauma.

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    Group Therapy for Veterans

    Involves small group support for combat veterans' shared experiences.

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    Psychological debriefing

    Crisis intervention where trauma victims discuss feelings post-incident.

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    Effectiveness concerns

    Research questions the effectiveness of psychological debriefing.

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    Psychological first aid

    Support method focusing on adaptive functioning, not forced talking.

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    Victor's symptoms

    Difficulty sleeping, irritability, nightmares, intrusive memories.

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    Irritability

    Uncontrollable anger or frustration often due to stress.

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    Intrusive memories

    Unwanted, distressing memories that repeatedly return.

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    Avoidance behavior

    Staying away from reminders of trauma to reduce anxiety.

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    Nightmares

    Distressing dreams that can disrupt sleep and mental health.

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    ACTH

    A hormone that stimulates the adrenal cortex to release corticosteroids like cortisol.

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    Corticosteroids

    Hormones released by the adrenal cortex during stress, such as cortisol.

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    Fight-or-flight response

    The body's physiological reaction to perceived threats, preparing to either confront or flee.

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    Trauma

    An event where a person faces actual or threatened death, serious injury, or sexual violation.

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    Acute Stress Disorder

    Diagnosed when symptoms occur within 4 weeks of trauma and last less than 1 month.

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    Posttraumatic Stress Disorder (PTSD)

    Diagnosed when acute stress symptoms last longer than 1 month post-trauma.

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    Stressor

    An event that creates demands on an individual, often viewed as threatening.

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    Extraordinary stress and trauma

    Can play a central role in the development of certain psychological disorders.

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    Huang River Flood

    A catastrophic flood in 1931 in China that killed 3.7 million people.

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    2004 South Asia Tsunami

    A devastating tsunami that struck South Asia in 2004, resulting in 280,000 deaths.

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    Tangshan Earthquake

    A massive earthquake in 1976 in Tangshan, China, which killed 255,000 people.

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    PTSD causes

    Factors leading to PTSD include biological factors, childhood experiences, and trauma severity.

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    Terrorism impact

    Experiencing or fearing terrorism can lead to posttraumatic stress symptoms in victims.

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    Childhood experiences

    Negative childhood factors like neglect and poverty increase PTSD risk later in life.

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    Torture effects

    Between 30-50% of torture victims develop PTSD due to their experiences.

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    Psychological Terrorism Fears

    42% of U.S. adults report high terrorism fears years after attacks; affects safety perceptions.

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    Sleep disturbances

    Difficulty falling asleep, staying asleep, and nightmares.

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    Hypervigilance

    Excessive alertness and easily startled by noise or motion.

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    Criterion D

    Negative alterations in cognition and mood, like social withdrawal and irritability.

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    Criterion E

    Marked alterations in arousal and reactivity, including hypervigilance and sleep disturbances.

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    Irritability and social withdrawal

    Avoiding social interactions to prevent snapping at others.

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    Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

    Therapy to process trauma and change harmful thought patterns.

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    Prolonged Exposure Therapy (PE)

    Gradual exposure to trauma-related memories to reduce avoidance.

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    Emotional numbness

    Reluctance to express emotions or engage with the past.

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    SSRIs and SNRIs

    Medications for anxiety and depression in PTSD, like sertraline and venlafaxine.

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    Sleep Hygiene Education

    Techniques to improve sleep patterns and quality.

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    PTSD Diagnosis

    Post-Traumatic Stress Disorder diagnosed from traumatic experiences.

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    Veterans Support Groups

    Groups for veterans to share experiences and receive support.

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    Impact on daily functioning

    How symptoms affect daily life, work, and relationships.

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    Coordination of Care

    Collaborating with healthcare providers to monitor and address needs.

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    Study Notes

    Disorders of Trauma & Stress

    • The presentation is about disorders of trauma and stress.
    • A graphic shows a person with sticky notes covering their face, suggesting overwhelming tasks and issues.
    • The document highlights symptoms of stress disorders and proposes a variety of possible treatments, some tailored to different types or degrees of stress.

    Overview

    • Fear, anxiety, and stress are discussed in the context of the "fight or flight" response.
    • The difference between acute stress disorder and PTSD is mentioned.
    • Triggers for psychological stress disorders are also a topic of interest.
    • Factors that increase risk of developing stress disorders are summarized.
    • Treatments for acute stress disorder and PTSD are examined.
    • A paper on anxiety and phobias and a case study about Victor are mentioned.

    Anxiety & Phobias Paper | Character Abnormalities

    • Students need to locate a movie, TV show, or streaming series that features a character with anxiety, stress, or phobia.
    • The essay should connect the character's stress to their disorder.
    • Relevant attitudes, behaviors, and beliefs of the character need to be documented.
    • Possible diagnoses should be identified using current DSM and ICD codes.
    • A psychological model (biological or cognitive) needs to explain the symptoms and behaviors.
    • A treatment plan, based on the model, is required to modify stress and reduce anxiety.
    • Research from credible sources (library databases, textbooks, internet) must support claims (at least 2-4).

    What happens when we become stressed?

    • The experience of stress begins in the hypothalamus.

    Stress and Arousal

    • Two major systems are activated during stress: autonomic nervous system (ANS) and endocrine system.
    • The ANS is a network of nerve fibers linking the brain to body organs.
    • The endocrine system is a network of glands releasing hormones throughout the body.

    Stress and Arousal: The Fight-or-Flight Response (part 3)

    • The ANS and endocrine system work together to cause arousal and fear reactions.
    • The presentation notes the sympathetic nervous system pathway and the hypothalamic-pituitary-adrenal (HPA) axis pathway.

    When we face a dangerous situation

    • The hypothalamus activates the sympathetic nervous system.
    • The sympathetic nervous system stimulates key organs (directly or indirectly).
    • The adrenal glands release epinephrine and norepinephrine.
    • When danger passes, the parasympathetic nervous system returns the body to normal.

    Hypothalamic-Pituitary-Adrenal (HPA) axis

    • The hypothalamus signals the pituitary gland to release adrenocorticotropic hormone (ACTH).
    • ACTH signals the outer layer of the adrenal glands, called the adrenal cortex, to release corticosteroids (stress hormones like cortisol) into the bloodstream.

    The reactions on display in these two pathways are referred to as the fight-or-flight response.

    • Individual patterns in people's autonomic and endocrine functioning differ in experiencing arousal and fear.

    Fear is a "package" of responses

    • Stressors cause fear.
    • The stress response is a person's reaction to demands.
    • Extreme stress and trauma can play a major role in stress disorders.

    Trauma

    • Trauma is an event where people experience actual or threatened death, serious injury, or sexual violence.
    • Many people experience heightened arousal, anxiety, and depression immediately after trauma

    Disorders of Trauma and Stress

    • Stress and psychological disorders, including acute stress disorder and PTSD, are categorized as trauma and stressor-related disorders in DSM-5-TR.
    • Stress-related physical (psychophysiological) disorders are under a separate category in DSM-5-TR.

    Acute Stress Disorder

    • Acute stress disorder involves symptoms starting within 4 weeks of a traumatic event and lasting less than one month.
    • If symptoms persist beyond 4 weeks, it is diagnosed as PTSD.
    • Approximately 25% of individuals don't immediately show full symptoms of the syndrome but may experience them 6 or more months later.
    • At least 50 percent of acute stress disorder cases develop into PTSD.

    Almost Identical

    • Symptoms of acute stress and PTSD are largely identical, aside from duration differences.
    • Symptoms include increased arousal, re-experiencing the event (flashbacks, nightmares), and avoidance behavior as central features.

    PTSD with Dissociative Symptoms

    • This subtype of PTSD involves disconnect, feelings of detachment, and unreality.
    • Individuals with PTSD with dissociative symptoms experience psychological separation and depersonalization, or feelings of unreal experiences.
    • A significant portion of people who experience PTSD have these symptoms.
    • It's frequently seen in those with repeated childhood abuse.

    Acute Stress Disorder and PTSD

    • These conditions occur throughout life and affect various aspects of life.
    • Percentage and prevalence rates of these disorders in the population are noted.

    Acute and Posttraumatic Stress Disorders

    • Hispanic, African American, and American Indian populations are more prone to stress disorders.
    • Studies associate such differences to financial constraints or sociocultural bias.

    Any event can trigger a stress disorder. However...

    • Some events, like combat, disasters, victimization, and torture are more likely to cause stress disorders.

    What triggers acute and posttraumatic stress disorders?

    • War-related combat trauma, like shell shock, is a trigger.
    • Disasters and accidents, including natural disasters or traffic incidents, can trigger acute and post-traumatic stress disorders.
    • Individual-focused incidents, like assault or sexual violence, are relevant factors.

    Acute and Posttraumatic Stress Disorders

    • Combat and stress disorders, known as shell shock or combat fatigue, can follow combat experiences.
    • Post-Vietnam War, a high percentage of combat veterans experienced post-traumatic stress disorders.

    Acute and Posttraumatic Stress Disorders

    • Disasters and accidents like earthquakes, floods, tornadoes, fires, airplane crashes, and major car accidents can trigger acute and post-traumatic stress disorders.
    • Civilian traumas are a key trigger of such stress disorders 10 times more common than combat.

    Triggering Events

    • Extensive data is provided on various types of disasters around the globe including dates and locations.
    • Details about number of casualties from past disasters are presented.

    Victimization and stress disorders:

    • People who have been abused or victimized often experience lingering stress symptoms.
    • Research shows more than one-third of victims of physical or sexual assault develop PTSD.

    What triggers acute and posttraumatic stress disorders?

    • Terrorism, including the 9/11 attacks and mass shootings.
    • Torture, classified as physical, psychological, and sexual torture, as well as torture through deprivation.

    Terrorism and torture:

    • The experience of terrorism triggers posttraumatic stress symptoms in a significant portion of the affected population.
    • A considerable proportion of New Yorkers and Americans report increased concerns and reduced feeling of security post-terrorism events.
    • 30 to 50 percent of torture victims develop PTSD, a severe form.

    Why do people develop acute and posttraumatic stress disorder?

    • Biological and cognitive factors.
    • Childhood events like neglect or abuse.
    • Social support systems, and the severity of traumas are also important factors.

    Biological Factors

    • Brain-body stress routes and inherited predispositions.
    • Childhood experiences with neglect, abuse, poverty, or conflicts can increase PTSD risk.

    Biological Factors

    • Abnormal neurotransmitter and hormone activity (especially norepinephrine and cortisol) contribute to PTSD.
    • The brain's stress circuit (amygdala, prefrontal cortex, and other areas) are implicated in PTSD.
    • These stress-related brain structures may change structure or activity levels as a result of acute stress or trauma.

    Biological Factors

    • Once a stress disorder sets in, further biochemical arousal and damage can take place (particularly within the hippocampus and amygdala).
    • A biological/genetic predisposition can play a critical role in stress reactions.

    Childhood Experiences

    • Researchers have found that certain childhood experiences correlate with an increase risk of stress disorders.
    • These factors include impoverished childhoods, family experience with psychological disorders, emotional trauma, or physical abuse, or the early impact of experiences like catastrophe or traumatic events.
    • Being younger than 10 during parental separation or divorce appears as a relevant childhood factor.

    Cognitive Factors and Coping Styles

    • Cognitive factors, like unhelpful thought patterns or memory impairments, and inflexible coping styles, are shown to correlate with increased risk of stress disorders.
    • Inflexible coping styles lead to heightened risk of PTSD.
    • People with negative worldviews and limited social support systems may experience added vulnerabilities.
    • Resilience and hardiness, or positive attitudes, can be protective.

    The Severity and Nature of the Trauma

    • More severe trauma or greater exposure increases thelikelihood of developing a stress disorder.
    • Intentionally inflicted trauma, mutilation, severe physical injury, or sexual assault often leads to these stress disorders.

    The Severity and Nature of the Trauma (Part 2)

    • Experiencing repeated or multiple traumas can predispose people towards more severe forms of PTSD, known as complex PTSD.

    The Developmental Psychopathology Perspective

    • Stress disorders develop from a complex interplay of biological, psychological, and environmental factors.

    Developmental Psychopathology

    • Biological predisposition for overactive stress pathways may be inherited or developed from early childhood experiences.
    • This explains vulnerability to stress disorders when exposed to trauma.

    Developmental Psychopathology

    • A childhood filled with protective factors can reduce the risk of stress disorders.
    • Stress and trauma can sensitize brain circuits, leading to a heightened likelihood of a stress disorder if trauma is experienced later on.
    • Even without predisposition, trauma severity can be a strong risk factor.

    Goals for acute and posttraumatic stress disorders

    • A sizable proportion of PTSD cases show improvement within 12 months.
    • The rest of the cases with the disorder may endure for years.
    • Treatment procedures vary, based on the type of trauma faced.
    • Common goals include ending lingering stress responses, understanding painful experiences, and returning to fulfilling lives.

    How do clinicians treat acute and posttraumatic stress disorders?

    • Antidepressants, cognitive-behavioral therapy, exposure therapy, eye movement desensitization and reprocessing (EMDR), and group or couple therapy are potential treatment pathways.
    • Small veterans' programs, community outreach, debriefing, and psychological first aid can be vital components.

    MindTech: Virtual Reality Therapy: Better Than the Real Thing?

    • Virtual reality exposure therapy is effective in treating PTSD by providing immersive, controlled exposure.

    How do clinicians treat acute snd posttraumatic stress disorder?

    • Couples or family therapy, including support for spouses and children.
    • Group therapy (often referred to as "rap groups" in earlier models).
    • Individual counseling.
    • Combinations of these options can also be incorporated into treatments.

    How do clinicians treat acute and posttraumatic stress disorders?

    • Psychological debriefing (critical incident stress debriefing) is a targeted intervention in which victims are assisted in talking about their trauma.
    • However, research has questioned long-term effectiveness.
    • An alternative approach, is psychological first aid, which focuses on adaptive functioning and does not necessitate extensive or explicit discussion of trauma.

    Case Study | Victor

    • The case study details a veteran and discusses his exhibiting issues like sleep disturbances, emotional numbness, hypervigilance, avoidance, and intrusive memories.
    • Multiple questions are posed to further understand and treat the case further.
    • Victor's case shows a common problem in veterans.

    What symptoms is Victor exhibiting?

    • Victor exhibits sleep disturbance, hypervigilance, irritability, intrusive memories, avoidance behaviors, diminished interest, and emotional numbness.

    What additional questions would you like to ask Victor?

    • Questions about the duration, impact on relationships and daily life, coping strategies, triggers, recent emotional state, substance use, and whether he's sought or benefited from therapy before or not would help in understanding and treating his situation.

    What is your provisional diagnosis for Victor?

    • Victor's symptoms align with Post-Traumatic Stress Disorder (PTSD) based on criterion A-E.
    • The experience of trauma in combat is a key factor in diagnosis.

    Based on your diagnosis, what kind of treatment plan would you recommend for Victor?

    • A range of treatment approaches such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), prolonged Exposure therapy (PE), eye movement desensitization and reprocessing (EMDR), and couples therapy are proposed.
    • Victor needs support, including pharmacological interventions (SSRIs or SNRIs), lifestyle techniques (sleep hygiene, mindfulness, and physical activity), and peer support (veterans' groups).

    Questions, Comments, What's Next?

    • The presentation mentions upcoming classes on dissociative disorders, a case study due date, and a paper due date.

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    Related Documents

    Disorders of Trauma & Stress (1) PDF

    Description

    This quiz covers the key concepts related to trauma and stress disorders, including symptoms, triggers, and treatments for conditions like acute stress disorder and PTSD. It also explores the fight or flight response and the impact of anxiety and phobias on individuals. Engage with case studies and media examples to enhance your understanding.

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