Acute and Postraumatic Stress Disorders, Dissociative Disorders, and Somatoform Disorders - PowerPoint PPT Presentation

Loading...

PPT – Acute and Postraumatic Stress Disorders, Dissociative Disorders, and Somatoform Disorders PowerPoint presentation | free to download - id: 4f3549-YmZiN



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Acute and Postraumatic Stress Disorders, Dissociative Disorders, and Somatoform Disorders

Description:

chapter seven acute and postraumatic stress disorders, dissociative disorders, and somatoform disorders * * * * * * * * * * * * * * * * * * * * * * overview ... – PowerPoint PPT presentation

Number of Views:423
Avg rating:3.0/5.0
Slides: 33
Provided by: Stephani300
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Acute and Postraumatic Stress Disorders, Dissociative Disorders, and Somatoform Disorders


1
CHAPTER SEVEN
  • Acute and Postraumatic Stress Disorders,
    Dissociative Disorders, and Somatoform Disorders

2
OVERVIEW
  • Dissociation the disruption of the normally
    integrated mental processes involved in memory,
    consciousness, identity, or perception.

3
ACUTE AND POSTRAUMATIC STRESS DISORDERS
  • Traumatic stress
  • An event that involves actual or threatened death
    or serious injury to self or others and creates
    intense feelings of fear, helplessness, or
    horror.

4
ACUTE AND POSTRAUMATIC STRESS DISORDERS
  • Acute Stress Disorder (ASD)
  • Occurs within four weeks after exposure to a
    traumatic stress and characterized by
    dissociative symptoms as well as
  • Reexperiencing, avoidance of reminders, and
    marked anxiety or arousal.
  • Posttraumatic Stress Disorder (PTSD)
  • Defined by symptoms of reexperiencing, avoidance,
    and arousal, but PTSD is either longer lasting
    (30 days) or have a delayed onset.

5
ACUTE AND POSTRAUMATIC STRESS DISORDERS
  • The defining symptoms of both acute and
    posttraumatic stress disorder include
  • (1) reexperiencing
  • (2) avoidance
  • (3) persistent arousal or anxiety
  • Dissociative symptoms are common in the immediate
    aftermath of a trauma, but must be present for
    the diagnosis of ASD, but not PTSD.

6
ACUTE AND POSTRAUMATIC STRESS DISORDERS
  • Reexperiencing
  • Avoidance
  • Repeated, distressing images or thoughts
  • Intrusive flashbacks
  • Horrifying dreams
  • Attempts of avoid thoughts, feelings related to
    the event
  • Avoid people, places, or activities that remind
    them of the event
  • Numbing of responsiveness

7
ACUTE AND POSTRAUMATIC STRESS DISORDERS
  • Arousal or anxiety
  • Dissociative symptoms
  • Predicts a worse prognosis
  • Hypervigilance
  • Restlessness, agitation, and irritability
  • Exaggerated startle response
  • Dazed and act spaced out
  • Depersonalization
  • Derealization
  • Dissociative amnesia

8
ACUTE AND POSTRAUMATIC STRESS DISORDERS
  • Comorbidity
  • High for depression, other anxiety disorders, and
    substance abuse
  • Anger usually very prominent Risk for suicide
  • Frequency
  • Prevalence of PTSD 8 of people living in the
    United States (10 women, 5 of men)
  • Rape and assault pose especially high risk for
    PTSD.
  • Minorities are more likely experience PTSD.
  • See Figure 7-1

9
ACUTE AND POSTRAUMATIC STRESS DISORDERS
  • Biological Effects of Exposure to Trauma
  • People with PTSD show alterations in the
    functioning, and perhaps structure, or the
    amygdala and hippocampus.
  • The sympathetic nervous system is aroused and the
    fear response is sensitized in PTSD.
  • Does trauma change the brain? Differences between
    people with and without PTSD are correlations.

10
ACUTE AND POSTRAUMATIC STRESS DISORDERS
  • Psychological Factors in ASD and PTSD
  • Two-factor theory
  • Classical conditioning creates fear when the
    terror of trauma is paired with the cues
    associated with it.
  • Operant conditioning maintains avoidance by
    reducing fear (negative reinforcement).
    Avoidance prevents the extinction of anxiety
    through exposure.
  • The risk for PTSD depends on cognitive factors
    preparedness, purpose and blame.
  • Antidepressants such as SSRIs are helpful
  • Typical anxiety meds not effective

11
ACUTE AND POSTRAUMATIC STRESS DISORDERS
  • EMDR (Eye Movement Desensitization and
    Reprocessing)
  • CBT for PTSD
  • The most effective treatment for PTSD is
    reexposure to trauma.
  • Prolonged exposure
  • Imagery rehearsal therapy
  • Cognitive restructuring
  • Francine Sharpiro
  • Includes rapid back-and-forth eye movements
  • Prolonged exposure appears to be the active
    ingredient

12
DISSOCIATIVE DISORDERS
  • The symptoms of dissociative disorders are
    characterized by persistent, maladaptive
    disruption in the integration of memory,
    consciousness, or identity.
  • Controversial and disbelieved by many.

13
(No Transcript)
14
Amnesia
  • Retrograde Amnesia
  • Anterograde Amnesia
  • Is the amnesia biologically-based or psychogenic?
  • Organic amnesia usually involves personal and
    general information also may involve anterograde
    amnesia.
  • Psychogenic amnesia usually involves only
    personal information also may involve retrograde
    amnesia.

15
Classifying Dissociative Disorders
16
Classifying Dissociative Disorders
17
Classifying Dissociative Disorders
  • Dissociative Fugue

18
Classifying Dissociative Disorders
  • Dissociative Identity Disorder
  • a.k.a. multiple personality disorder

19
Dissociative Identity Disorder
  • Host personality retains persons name and
    identity and functions in the outside world.
  • Persecutory personalities may be aggressive and
    hostile.
  • Protector personalities may try to protect the
    host personality
  • Lost time loss of memory for events during
    which another personality was present.

20
Why should you doubt claims that dissociative
identity disorder is common?
  • 1. Most cases diagnosed by a handful of ardent
    advocates.
  • 2. Frequency (DID in particular) increased
    rapidly after release of the very popular book
    and movie Sybil.
  • 3. The number of personalities claimed to exist
    has grown rapidly, from a handful to 100 or more.
  • 4. Rarely diagnosed outside of the USA and
    Canada (only one case of DID has been reported
    in Great Britain in the last 25 years.)

21
DISSOCIATIVE DISORDERS
  • Causes of Dissociative Disorders
  • Psychological Factors in Dissociative Disorders
  • Little controversy that dissociative amnesia and
    fugues can be precipitated by trauma.
  • Trauma is suspected in DID, but much of the
    data is retrospective.
  • The vast majority of trauma victims do not
    develop a dissociative disorder.

22
DISSOCIATIVE DISORDERS
  • Causes of Dissociative Disorders
  • Biological Factors
  • Little to no evidence of biological and genetic
    factors.
  • Social Factors
  • Iatrogenesis the manufacture of a disorder by
    its treatments.
  • cases were created by the expectations of
    therapists?

23
Psychodynamic Perspectives
  • Freuds model
  • Topographic model
  • conscious
  • preconscious
  • unconscious

24
(No Transcript)
25
SOMATOFORM DISORDERS
  • Symptoms of Somatoform Disorders
  • Complaints about physical symptoms in the absence
    of medical evidence.
  • The problem is very real in the mind, though not
    the body.
  • Usual numerous, constantly evolving complaints
    such as chronic pain, upset stomach, dizziness.
  • Worry about a deadly disease despite negative
    medical evidence.

26
SOMATOFORM DISORDERS
  • Diagnosis of Somatoform Disorders
  • Conversion Disorder
  • Symptoms mimic neurological disorders
  • Make no anatomic sense
  • Implies that psychological conflicts are being
    converted into physical symptoms
  • Somatization Disorder
  • History of multiple somatic complaints in the
    absence of organic impairments.
  • Eight symptoms, onset prior to age 30

27
SOMATOFORM DISORDERS
  • Diagnosis of Somatoform Disorders
  • Hypochondriasis
  • Fear or belief that one is suffering from a
    physical illness.
  • Much more serious than normal or fleeting worries
    and can lead to substantial impairment in life
    functioning.
  • Pain Disorder
  • Preoccupation with pain
  • At risk for developing dependence on pain
    medication

28
SOMATOFORM DISORDERS
  • Body dysmorphic disorder
  • Malingering and factitious disorder
  • Preoccupation with some imagined defect in
    appearance
  • Repeated visits to the plastic surgeon
  • Exceeds normal worry about imperfections
  • Pretending to have a physical illness in order to
    achieve some external gain ()
  • Factitious disorder is motivated by a desire to
    assume a sick role

29
SOMATOFORM DISORDERS
  • Frequency of Somatoform Disorders
  • Gender, SES and Culture
  • More common among women (10 times)
  • More common among lower SES
  • Four times more common among African Americans
    and higher in Puerto Rico and Latin America
  • Comorbidity
  • Depression, anxiety, and antisocial personality
    disorder

30
SOMATOFORM DISORDERS
  • Causes of Somatoform Disorders
  • Biological Factors
  • Diagnosis by exclusion
  • Perils of this approach cases where some
    medical etiology can emerged later
  • Psychological Factors
  • Primary and secondary gain
  • Cognitive tendencies amplification, alexithymia
    (inability to express emotions in words)

31
FIGURE 7-6
  • Psychological Factors in Somatoform Disorders

32
SOMATOFORM DISORDERS
  • Treatment of Somatoform Disorders
  • Operant approaches to chronic pain
  • Reward successful coping and adaptation
  • Cognitive behavioral therapy
  • Cognitive restructuring
  • Antidepressants
  • Patients are likely to refuse a referral to a
    mental
  • health professional.
About PowerShow.com