PSYCHIA LONG QUIZ REVIEWER

TRAUMA & CRISIS

TRAUMA
- define as the delayed or protracted response to stress (WHO).
- 3 months or more after the trauma

POST TRAUMATIC STRESS DISORDER (PTSD)

- is a disturbing pattern of behavior demonstrated by someone who has experienced, witnessed,
or been confronted with a traumatic event such as a natural disaster, combat, or an assault.

4 Subcategories of Symptoms in PTSD

1. Reexperiencing the trauma through flashbacks, dreams, or recurrent and intrusive thoughts
2. Avoidance
3. Negative cognition or thoughts
4. Being on guard or hyperarousal

ETIOLOGY
Cause: Trigger:
- experiencing physical injury - natural disaster
- loss of loved ones in the event - lack of social support
- abuse, including childhood or domestic abuse - peri-trauma dissociation
- war and conflict - previous psychiatric history
- torture

RELATED DISORDERS
Adjustment Disorder
- A reaction to a stressful event that causes problems for the individual.
- Symptoms develop within a month, lasting no more than 6 months.
- Outpatient counseling or therapy is the most common and successful treatment.

Acute Stress Disorder

- Occurs after a traumatic event and is characterized by reexperiencing, avoidance, and
hyperarousal that occur from 3 days to 4 weeks following a trauma.
- Cognitive-behavioral therapy (CBT) involving exposure and anxiety management can help
prevent the progression to PTSD.

Reactive Attachment Disorder

- A condition where a child does not form healthy emotional bonds with their caretakers
(parental figures), often because of emotional neglect or abuse at an early age. Children with
RAD have trouble managing their emotions.

Disinhibited Social Engagement Disorder

- An attachment disorder in which a child displays indiscriminate friendliness—a lack of
appropriate social boundaries—with strangers.
TREATMENT
Counseling or Therapy
- Counseling or therapy, individually or in groups, for people with acute stress disorder may
prevent progression to PTSD.

Exposure Therapy
- Exposure therapy is a treatment approach designed to combat the avoidance behavior that
occurs with PTSD, help the client face troubling thoughts and feelings, and regain a measure of
control over his or her thoughts and feelings. The client confronts the feared emotions,
situations, and thoughts associated with the trauma rather than attempting to avoid them.
Example: returning to the place where one was assaulted or may use imagined confrontation.

Adaptive Disclosure
- Adaptive specialized is disclosure CBT approach developed by the military to offer an intense,
specific, short-term therapy for active-duty military personnel with PTSD.

Cognitive Processing Therapy

- Cognitive processing therapy. The therapy course involves structured sessions that focus on
examining beliefs that are erroneous or interfere with daily life, such as guilt and self-blame.

MEDICATIONS
- Selective Serotonin Reuptake Inhibitor (SSRI)
- Serotonin
- Norepinephrine reuptake inhibitor antidepressants
- Second- generation antipsychotic (such as risperidone)

NURSING DIAGNOSIS
- Impaired Coping
- Disturbed Sleep Pattern
- Social Isolation
- Impaired Social Interaction
- Risk for Self-Harm or Suicidal Ideation
- Impaired Concentration
CRISIS
- a turning point in individual’s life that produces an overwhelming emotional response.
- Normal duration to handle crisis is 4-6 weeks.

3 Resolutions:
- The person either returns to his or her pre-crisis level of functioning. (positive)
- The person begins to function at a higher level. (positive)
- The person’s functioning stabilizes at a level lower than pre crisis functioning. (negative)

ETIOLOGY
- a result of dysfunctional coping

STAGES OF CRISIS
1. STAGE I: Normal Stress and Anxiety
- The person is exposed to stressor, experiences anxiety, and tries to cope in customary
manner.

2. STAGE II: Rising Anxiety Level

- Anxiety increases when customary coping skills are ineffective.

3. STAGE III: Severe Level of Stress and Anxiety

- The person makes all possible efforts to deal with the stressor, including attempts at new
methods of coping

4. STAGE IV: Crisis

- When coping attempts fail, the person experiences disequilibrium and significant distress.

THREE (3) CATEGORIES OF CRISIS

1. Maturational Crisis
- Developmental crisis
- Predictable events in the normal course of life
- Leaving home for the first time, getting married, having a baby, and beginning a career

2. Situational Crisis
- Unanticipated or sudden events that threatens the individual’s integrity
- Death of a loved one, loss of job, and physical or emotional illness in the individual or family
member.

3. Adventitious Crisis
- Social Crisis
- Natural disaster: floods, earthquakes, or hurricanes; war; terrorist attack; riots; and violent
crimes: rape or murder

THREE FACTORS THAT INFLUENCE WHETHER AN INDIVIDUAL EXPERIENCE CRISIS

(AGUILERA, 1998)
1. The individual perception of the event
-Assisting the person to view the event or issue from a different perspective make it an
opportunity for growth or change rather than a threat.

2. The availability of emotional support

- Assisting the person in using existing support, can decrease the feelings of being alone or
overwhelmed.

3.The availability of coping mechanism

- Assisting the person in learning new methods of coping will help resolve the current crisis and
give him or her a new coping skill.