Trauma and Stressor-Related Disorders: PTSD and Acute Stress Disorder, Summaries of Psychology

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Trauma- and Stressor-Related Disorders

Both posttraumatic stress disorder (PTSD) and acutestress disorder are marked by increased stress andanxiety following exposure to atraumatic or stressful event.

Although PTSD can appear at any age, it is mostprevalent in young adults, because they tend to bemore exposed to precipitatingsituations. Children can also have the disorder. Men and women di

ffer in the types of traumas to whic

they areexposed. Historically, men’s trauma was usuallycombat experience, and women’s trauma was mostcommonly assault or rape

The disorder is most likely to occur in those who are singldivorced, widowed, socially withdrawn, or of lowsocioeconomic level, but anyone can be efected, no one iimmune. The most important risk factors, however, for this disordeare the severity, duration, and proximity of a person’sexposure to the actual trauma. A familial pattern seems to exist for this disorder, and

firs

degree biological relatives of persons with a history ofdepression have an increased risk for developing PTSDfollowing a traumatic event.

Cognitive-Behavioral Factors The cognitive model of PTSD posits that afectedpersons cannot process or rationalize the trauma thatprecipitated the disorder. Theycontinue to experience the stress and attempt to avoexperiencing it by avoidance techniques. Consistentwith their partial ability to cope cognitively with theevent, persons experience alternating periods ofacknowledging and blocking the event.

Cognitive-Behavioral Factors Second, through instrumental learning, the conditionedstimuli elicit the fear response independent of the originaunconditioned stimulus,and persons develop a pattern of avoiding both theconditioned stimulus and the unconditioned stimulus. Sompersons also receivesecondary gains from the external world, commonlymonetary compensation, increased attention or sympathyand the satisfaction ofdependency needs. These gains reinforce the disorder anits persistence.

Table 11.1-4DSM-5 D

iagnost

ic Cr

iteria for Acute Stress D

isorde

A. Exposure to actual or threatened death, serious injury, or sexual violation in one (omore) of the following ways: Directly experiencing the traumatic event(s). Witnessingperson, the events(s) as it occurred to others.^ Learning that the traumatic events(s) occurred to a close family member or close frieNote: In cases of actual or threatened by death of a family member or friend, theevents(s) must have been violent or accidental.^ Experiencing repeated or extreme exposure to aversive details of the traumatic even(e.g., first responders collecting human remains; police officers repeatedly exposed todetails of child abuse).^ Note: This does not apply to exposure through electronic media, television, movies,pictures unless this exposure is work related. Read more:http://traumadissociation.com/acutestressdisorder

Dissociative Symptoms An altered sense of the reality of one's surroundings or onese(e.g., seeing oneself from another's perspective, being in a daze, time slowing.) Inabito remember an important aspect of the traumatic events(s) (typically due to dissociaamnesia and not to other factors such as head injury, alcohol, or drugs).^ Avoidance symptoms Efforts to avoid distressing memories, thoughts, or feelings abor closely associated with the traumatic event(s). Efforts to avoid external reminders (people, places, conversations, activities, objects,situations) that arouse distressing memories, thoughts, or feelings about or closelyassociated with the traumatic event(s). Read more:http://traumadissociation.com/acutestressdisorder

Arousal symptoms Sleep disturbance (e.g., difficulty falling or staying asleep, restlesssleep) Irritable behavior and angry outbursts (with little or no provocation) typicallyexpressed as verbal or physical aggression toward people or objects. Hypervigilance Problems with concentration Exaggerated startle response Read morhttp://traumadissociation.com/acutestressdisorder

Torture The intentional physical and psychological torture of onehuman by another can have emotionally damaging e

ffect

comparable to, andpossibly worse than, those seen with combat and othertypes of trauma. As de

fined by the United Nations, torture

is any deliberate in

fliction

of severe mental pain or su

fferring, usually through cruel,

inhuman, or degrading treatment or punishment. Thisbroad de

finition includes various forms of interpersonal violence, from chronicdomestic abuse to broad-scale genocide.

B Presence of one (or more) of the following intrusion symptoms associated with the traumaticevent(s), beginning after the traumatic event(s) occurred:1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).

Note:^ In

children older than 6 years, repetitive play may occur in which themes or aspects of the traumaticevent(s) are expressed.2. Recurrent distressing dreams in which the content and/or affect of the dream are related to thetraumatic event(s).

Note:^ In children, there may be frightening dreams without recognizable cont

3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumaticevent(s) were recurring. (Such reactions may occur on a continuum, with the most extremeexpression being a complete loss of awareness of present surroundings.)

Note:^ In children, traum

specific reenactment may occur in play.4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolizeresemble an aspect of the traumatic event(s).5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect othe traumatic event(s).

C Persistent avoidance of stimuli associated with the traumatic event(s), beginning after thetraumatic event(s) occurred, as evidenced by one or both of the following:1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closelyassociated with the traumatic event(s).2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objesituations) that arouse distressing memories, thoughts, or feelings about or closely associated withtraumatic event(s).