Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Trauma And Stressor- Related Disorder

1,114 views

Published on

Diagnostic Criteria:
 exposure to actual or threatened death, serious, or sexual violence in one( or more) of the following ways:
1) Directly experiencing the traumatic events.
2) Witnessing in person
3) Learning that the traumatic event occur to close family member or friend.
4) Experiencing repeated or extreme exposure to aversive details of the traumatic events.

Published in: Health & Medicine
  • Be the first to comment

Trauma And Stressor- Related Disorder

  1. 1. Trauma And Stressor- Related Disorder
  2. 2. Posttraumatic stress disorder Diagnostic Criteria:  exposure to actual or threatened death, serious, or sexual violence in one( or more) of the following ways: 1) Directly experiencing the traumatic events. 2) Witnessing in person 3) Learning that the traumatic event occur to close family member or friend. 4) Experiencing repeated or extreme exposure to aversive details of the traumatic events.  Presence of one or more of the following intrusion symptoms associated with the traumatic event: 1) Recurrent distressing memories of the traumatic event. 2) Recurrent distressing dreams related with traumatic events. 3) Flashbacks in which one feels or acts as if traumatic event is occurring. 4) Intense or prolong psychological distress at exposure to internal /external cues that reminds of traumatic event. 5) Marked physiological reactions to internal or external cues that resemble an aspect of the traumatic events.  Persistent avoidance of stimuli associate with traumatic events, as evidence by one or both of following: 1) Avoidance of distressing memories, thoughts or feelings associated with traumatic events.
  3. 3. 2) Avoidance of external reminders that arouse that distressing memories associated with traumatic events.  Negative alterations in cognitions and mood associated with the traumatic events, beginning or worsening after the traumatic events, as evidence by two or more of following: 1) Inability to remember important aspect of traumatic events due to dissociative amnesia and to not other factors such as head injury, alcohol, or drugs. 2) Persistent and exaggerated negative beliefs or expectations about oneself, others or world. 3) Persistent, distorted cognitions about the cause or consequences of the traumatic events that lead to blaming of oneself. 4) Persistent negative emotional state. 5) Markedly diminished interest in significant activities. 6) Feeling of detachment from others. 7) Persistent inability to experience positive emotions.  Marked alterations in arousal and reactivity associated with the traumatic events, beginning or worsening after the traumatic events occurred, as evidenced by two or more of following: 1) Irritable behavior and angry outbursts. 2) Reckless or self-destructive behavior 3) Hyper vigilance. 4) Exaggerated startle response. 5) Problems with concentrations. 6) Sleep disturbances.  Duration of disturbance is more than 1 month.
  4. 4.  Cause significant distress in social, occupational or other important areas of functioning.  It is not attributed to physiological effects of substance or other medical conditions. Prevalence: 3.5% in adult US populations. Risk and prognostic factors:  Temperamental: Childhood emotional problems and prior mental disorders.  Environmental: Low socioeconomic status, lower education, exposure to prior trauma, Childhood adversity, cultural characteristics, lower intelligence, minority racial/ethnic status, family psychiatric history.  Genetic / Physiological: Female gender, younger age at time of exposure. DDx: Adjustment disorders, other posttraumatic conditions, acute distress disorders, anxiety disorders, major depressive disorders, personality disorders, dissociative disorders, conversion disorders, psychotic disorders, traumatic brain injury. Acute Stress Disorder
  5. 5. Diagnostic Criteria:  exposure to actual or threatening death, serious injury, or sexual violation in one or more of following ways: a..1. Directly experiencing the traumatic events. a..2. Witnessing in person the traumatic event. a..3. Learning that event occur to other family member. a..4. Experiencing repeated or extreme exposure to aversive details of the traumatic events.  Presence of 9 or more of following symptoms from any five categories: a. intrusive symptoms: a.1. Recurrent distressing memories of traumatic event. a.2. Recurrent distressing dreams a.3. Dissociative reactions e.g, flash backs a.4. Intense or prolong psychological distress or marked physiological reaction to internal/external cues, b. negative mood: a..5. Persistent inability to experience positive emotions. c. dissociative symptoms: 6. An alter sense of reality. 7. Inability to remember important aspect of traumatic event.
  6. 6. d. avoidance symptoms 8. Effort to avoid distressing memories. 9. Efforts to avoid external reminders of traumatic event. e. arousal symptoms 10. Sleep disturbances 11. Irritable behaviors 12. Hypervigilence. 13. Problems with concentration. 14. Exaggerated startle response.  Duration of disturbance is 3 days to 1 month after trauma exposure.  Clinical significant distress in social, occupational and other important areas of functioning.  It is not attributed to physiological effects of a substance or other medical condition. Associated features: a..6. feeling excess guilty a..7. Flashback memories of trauma. a..8. panic attacks a..9. Chaotic or impulsive behavior. Prevalence: Less than 20% after trauma
  7. 7. Risk and Prognostic Factors:  Temperamental: prior mental disorders, neuroticism,etc  Envirmental: exposure to trauma  Genetic and Physiological: females DDx: Adjustment disorders, panic disorders, dissociative disorders, PTSD, OCD, psychotic disorders, traumatic brain injury. Adjustment disorder Diagnostic criteria Emotional or behavioral response to an identifiable stressor(s) occurring within 3 month of onsent of the stressor(s) Marked distress that is out of proportion to the severity or intensity of the stressor Significant impairment in social, occupational, or other important areas of functions Stress-related disturbance does not meet the criteria for another mental disorder Symptoms do not represent normal bereavement Once the stressor or its consequence have terminated, the symptoms do not persist for more than an additional 6 months
  8. 8. Prevalence Outpatient 5- 20% In hospital psychiatric consultation, most common diagnosis, reaching 50% Risk factors and prognostic features  Environmental a..1. Disadvantaged life circumstances experience high rates of stressors Associated features The stressor may be a single event or multiple stressors Stressors may be recurrent or continuous Stressors can affect a single individual, the entire family, or large group/community Some stressors may accompany a specific developmental event May be diagnosed after the death of a loved one DDx MDD,PTSD ,Personality disorders ,Normative stress reaction, Psychological factors affecting other medical conditions
  9. 9. Reactive attachment disorder Diagnostic criteria  Emotionally drawn behavior towards adult caregivers; manifested by both of the following: a..1. Child minimally seeks comfort when distressed a..2. Child minimally responds to comfort when distressed Social and emotional disturbance characterized by at least two of the following: a..1. Minimal social/ emotional responsiveness to others a..2. Limited positive affect a..3. Episodes if unexplained irritability, sadness, or fearfulness Experienced a pattern of extremes of insufficient care The criteria are not met for autism spectrum disorder Evident before age 5 years Child has development age of 9 months Prevalence Rare Found in children exposed to severe neglect before being placed in foster care Occurs in less than 10% of children exposed to severe neglect
  10. 10. Risk factors and prognostic factors Environmental- being exposed to extreme cases of neglect; however the majority of children that experience such neglect do not develop this disorder Prognosis depends on the quality of care giving following serious neglect Associated features Developmental delays a..1. Delay in cognition and language Malnutrition or other signs of poor care DDx Autism spectrum disorder ,Intellectual disability ,Depressive disorders Disinhibited social engagement disorder Diagnostic criteria Pattern of behavior in which a child actively approaches and interacts with unfamiliar adults Behaviors are not limited to impulsivity The child had experience a pattern of extremes of insufficient care
  11. 11. The child has a developmental age of 9 months Prevalence Rarely seen in the clinical setting High risk populations, occurs in only 20% of children Risk and prognostic factors Environmental Course modifiers- signs of this disorder may persist after placement in normative care giving Associated Features Developmental delays (Cognitive and language delays ) Malnutrition or other signs of poor care DDx Attention deficit/ hyperactive disorder

×