* Reactions to extreme trauma:
* Intrusive recollections and acute distress upon cues that suggest the trauma * Dissociative symptoms (psychic numbing) – STRONGEST SYMPTOM FOR PTSD * Emotional detachment, being in a daze, dropping out of activities, avoidance of trauma related topics, forgetting key aspect of trauma, derealization(external world is fake) and depersonalization. * Depersonalization disorder: one feels constantly that their body is unreal or foreign. * Chronic hyperarousal: insomnia, hypervigilance, motor restlessness * Aggressiveness and survival guilt
* Acute Stress Disorder and PTSD
* Risk Factors: experience a traumatic event-earthquake, rape, crash.. * Symptoms begins within four weeks and last for less than one month-ASD * If symptoms last longer than one month, then it is classified as PTSD * Can occur at any age, 2:1,
* Lead to depression, substance abuse or other anxiety disorders. * Particular triggers: combat, disasters, abuse, victimization * Abnormal activity of hormone cortisol and norepinephrine. Damage in hippocampus (memories) and amygdala (emotional response). * Predisposition and inheritance.
* Personality- more negative=more likely, childhood experiences- anxious and catastrophes at an early age, weak social support, multicultural factors Hispanics are more likely, and severity of trauma. * Treatment:
* Drug therapy, behavioral exposure techniques-flooding and relaxation training, insight therapy, family therapy, and group therapy. * Eye movement desensitization and reprocessing
* Move eyes in saccadic movements from side to side while flooding their minds with images of the objects they try to avoid. * Antianxiety drugs to ease tension and antidepressants to reduce occurrence of nightmares * Critical Incident Stress Debriefing: Basic Steps
* Crisis intervention that has victims of trauma talk about feelings and reactions within days on traumatic incident. * Disaster response team was created to mobilize psychologist to talk to victims of recent trauma. * Some believe the debriefing encourage people to dwell on traumatic event or suggest problems.
* Nature of Dissociation, typical manifestations of dissociation * Repression, escape behavior
* Possible relationship of anxiety to dissociative disorders * Normal->anxiety->dissociation(can be normal; daydreaming, spacing out) * Anxiety is so intense that they go past panic attacks and just dissociate * Experiences of depersonalization and derealization
* Feeling weird in their own bodies
* Dissociated Amnesia
* Inability to recall important personal information, exceeding normal forgetfulness * Brief episodes may be due to drug or medication side-effects * True amnesia, non-acknowledgement or selective memory * Associated with PTSD
* Confined to period of time after stressful event, only retrograde, restricted to personal episodes * Failures in memory encoding or retrieval
* Treatment involves anxiolytic medications and supportive psychotherapy (sometimes sedative-hypnotic meds) * May be localized( forgetting happened during a limited amount of time) , selective (remember specific events during the amnesic period) , generalized ( can’t remember what happened during the event or things that occurred earlier in his life) or continuous (forget new and ongoing experiences and what happened before and after the tragedy) * Dissociated Fugue
* Suddenly found yourself in a place you don’t remember how you got there. * Confusion of identity or adoption of new identity
* Retroactively diagnosed
* Occurs after personal trauma, episodes can last from...