Trauma Class 3 Effects Of Trauma Part 1 PDF

The Effects of Trauma Part 1 CLASS 3 Materials based on: Briere, J.N., & Scott, C. (2015)....

The Effects of Trauma Part 1 CLASS 3 Materials based on: Briere, J.N., & Scott, C. (2015). Principles of Trauma Therapy: A Guide to Symptoms, Evaluation, and Treatment. Sage Publications Inc. based on Briere & Scott, 2015  Objectives  Review trauma from last class using a brief case example  Be able to identify risk factors for adverse posttraumatic reactions including victim related factors and stressor related factors.  Discuss two of the major classes of posttraumatic responses, depression and anxiety.  Practice identifying risk factors and symptoms using a case example. based on Briere & Scott, 2015  Case Study (Part 1)  Josh is a 27-year-old male who recently moved back in with his parents after his fiancée was killed by a driver 3 months ago. His fiancée, a beautiful young woman he’d known for the past 4 years, was walking across a busy intersection to meet him for lunch one day. He still vividly remembers the horrific scene as the driver ran the red light, running over his fiancée right before his eyes. He raced to her side, embracing her crumpled, bloody body as she died in his arms in the middle of the crosswalk. No matter how hard he tries to forget, he frequently finds himself reliving the entire incident as if it was happening all over again. based o case study from nhttp://www.psyweb.com/Casestud  Case Study  Discussion questions: In small groups of 3 or 4 students, discuss the following questions:  Based on what you learned about the definition of trauma, did Josh experience a traumatic event? Explain your answer using the definition from last class.  Referring to the list of events discussed in last class, what type of event is this? Based on a case study from nhttp://www.psyweb.com/Casestud  Risk Factors for Traumatic Stress Responses  There are many different ways in which people respond to a traumatic event  Two people who are exposed to the same event may have very different reactions  Research has shown that only a minority of people exposed to a trauma will develop a post- traumatic stress disorder  The majority of people may have no symptoms or only few or transient symptoms based on Briere & Scott, 2015  Risk Factors for Traumatic Stress Responses  There are a number of factors that contribute to risk of having adverse or more severe traumatic stress responses  It is important to understand that the risk is relative: having one or more risk factors does not mean that the person will develop symptoms or a full-blown stress disorder.  But they may be more likely to develop them. based on Briere & Scott, 2015  Risk Factors for Traumatic Stress Responses: Victim Variables Victim variables are characteristics of the individual that existed before exposure to the trauma Some of those variables are reactions during the trauma We will review those first based on Briere & Scott, 2015  Risk Factors for Traumatic Stress Responses: Victim Variables  Female gender: Women are at greater risk  Age: Younger or older individuals are at greater risk than those in middle adulthood  Poverty and low socio-economic status Briere & Scott (2015, pp. 26-27) based on Briere & Scott, 2015  Risk Factors for Traumatic Stress Responses: Victim Variables  Previous or co-existing psychological problems  Less adaptive coping styles  Family dysfunction and/or family history of psychopathology Briere & Scott (2015, pp. 26-27) based on Briere & Scott, 2015  Risk Factors for Traumatic Stress Responses: Victim Variables  Previous history of trauma exposure  Dissociation at the time of the trauma  Greater distress at the time of the trauma or immediately after the trauma Briere & Scott (2015, pp. 26-27) based on Briere & Scott, 2015  Risk Factors for Traumatic Stress Responses: Stressor Variables Stressor variables are those characteristics of the traumatic event itself that may increase the likelihood of adverse posttraumatic outcomes Briere & Scott (2015, pp. 29-31) based on Briere & Scott, 2015  Risk Factors for Traumatic Stress Responses: Stressor Variables  Intentional acts of violence lead to greater risk than non-interpersonal events  Presence of life threat  Physical injury Briere & Scott (2015, pp. 29-31) based on Briere & Scott, 2015  Risk Factors for Traumatic Stress Responses: Stressor Variables  In war, the extent of combat exposure  Witnessing death  Loss of friend or loved one due to a trauma Briere & Scott (2015, pp. 29-31) based on Briere & Scott, 2015  Risk Factors for Traumatic Stress Responses: Stressor Variables  Unpredictability and uncontrollability of the event  Sexual victimization  Trauma of longer duration or greater frequency Briere & Scott (2015, pp. 29-31) based on Briere & Scott, 2015  Risk Factors for Traumatic Stress Responses: Stressor Variables  Child abuse and neglect: especially likely to be associated with severe and longlasting problems.  This may be due to several factors:  They occur at a vulnerable developmental time  The trauma is relational  Occur over a long time period  Include multiple instances of abuse  Childhood trauma is a risk factor for adulthood trauma Briere & Scott (2015, pp. 29-31) based on Briere & Scott, 2015  Risk Factors for Traumatic Stress Responses: Stressor Variables  Social support: a powerful predictor of trauma response.  Helpful social support is very important in the victim’s recovery whereas negative social responses can lead to greater risk for distress.  Social responses often depend on the nature of the trauma. Briere & Scott (2015, pp. 29-31) based on Briere & Scott, 2015  Risk Factors for Traumatic Stress Responses: Stressor Variables  Social support  Discussion Question:  What do you think are some helpful supportive responses after a trauma?  What are some unhelpful or negative social responses? Briere & Scott (2015, pp. 29-31) based on Briere & Scott, 2015  Risk Factors for Traumatic Stress Responses: Stressor Variables  Discussion question:  What types of trauma do you think would be more likely to elicit supportive responses?  Which types of trauma might elicit less support, negative reactions, or social rejection? Briere & Scott (2015, pp. 29-31) based on Briere & Scott, 2015  Types of Posttraumatic Responses  Posttraumatic responses vary widely  They can include  Depression  Anxiety  Stress disorders  Dissociation  Somatic symptoms  Psychosis  Substance use based on Briere & Scott, 2015  Types of Posttraumatic Responses  Posttraumatic responses vary widely  They can include  Depression  Anxiety  Stress disorders  Dissociation  Somatic symptoms  Psychosis  Substance use based on Briere & Scott, 2015  Types of Posttraumatic Responses Depression  Major depression is the most common trauma reaction in addition to PTSD (Briere & Scott, pp. 33-35) based on Briere & Scott, 2015  Types of Posttraumatic Responses Depression  Symptoms include  Sadness  Hopelessness  Feelings of worthlessness, guilt, or having deserved the trauma  Suicidality (Briere & Scott, pp. 33-35) based on Briere & Scott, 2015  Types of Posttraumatic Responses Depression  Symptoms (cont.)  Loss of interest in activities that used to be enjoyable  Decreased concentration  Weight loss  Fatigue, loss of energy  Sleep problems (Briere & Scott, pp. 33-35) based on Briere & Scott, 2015  Types of Posttraumatic Responses Anxiety  Generalized Anxiety:  Non-specific anxiety symptoms  The anxiety is not necessarily related to the traumatic event  People may be have increased anxiety about many everyday things (Briere & Scott, pp. 35-36) based on Briere & Scott, 2015  Types of Posttraumatic Responses Anxiety  Panic attacks  Acute symptoms that usually last 10 – 60 minutes  Heart palpitations  Shortness of breath  Sweating  Cold extremities  Feeling of impending doom After trauma, these panic attacks may occur in response to trauma related events or triggers (Briere & Scott, pp. 35-36) based on Briere & Scott, 2015  Types of Posttraumatic Responses Anxiety  Phobic Anxiety  Trauma related symptoms are often phobic in nature  Avoiding people, places, situations that remind of the trauma (Briere & Scott, pp. 35-36) based on Briere & Scott, 2015  Types of Posttraumatic Responses Assessing Depression and Anxiety:  There are many different ways of assessing symptoms of depression and anxiety.  One measure that has been translated into Kurdish is the Hopkins Symptom Checklist (HSCL)  Look over the questionnaire to get an overview of its items based on Briere & Scott, 2015  Case Study (Part 1)  Josh is a 27 year-old male who recently moved back in with his parents after his fiancée was killed by a driver 3 months ago. His fiancée, a beautiful young woman he’d known for the past 4 years, was walking across a busy intersection to meet him for lunch one day. He still vividly remembers the horrific scene as the driver ran the red light, running over his fiancée right before his eyes. He raced to her side, embracing her crumpled, bloody body as she died in his arms in the middle of the crosswalk. No matter how hard he tries to forget, he frequently finds himself reliving the entire incident as if it was happening all over again. Based on a case study from nhttp://www.psyweb.com/Casestud  Case Study  Discussion question: In small groups of 3 or 4 students, discuss the following:  Based on the earlier discussions, identify the risk factors may make Josh more likely to have posttraumatic psychological reactions.  Check-in with the class and report what you found Based on a case study from nhttp://www.psyweb.com/Casestud  Case Study (Part 2)  Since the accident, Josh has had nightmares about the accident almost every night. He had to quit his job because his office was located in the building right next to the little café where he was meeting his fiancée for lunch the day she died. The few times he attempted to return to work were unbearable for him. He has since avoided that entire area of town.  Normally an outgoing, fun-loving guy, Josh has become increasingly withdrawn, “jumpy”, and irritable since his fiancé’s death. He’s stopped working out, playing his guitar, or playing basketball with his friends – all activities he once really enjoyed. His parents worry about how detached and emotionally flat he’s become. He feels guilty and talks about how it was his fault that his fiancee died because he asked her to go to lunch that day. Often, when he sees a car, his heart starts racing, he has trouble breathing, and feels a sense of doom. based on a case study from nhttp://www.psyweb.com/Casestud  Case Study  Discussion question: In small groups, discuss the following:  Make a list of all the symptoms described in this case.  Identify those symptoms that are anxiety related and those that are depression related.  Check-in with the class and report what you found Based on a case study from nhttp://www.psyweb.com/Casestud