Trauma and Stressor Related Dx Flashcards

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1

Trauma and Stressor Related Dx- list

  1. Reactive attachment dx
  2. disinhibited social engagement disorder
  3. post traumatic stress dx
  4. acute stress dx
  5. adjustment dx
  6. prolonged grief dx
  7. other specified trauma and stressor related dx
  8. unspecified trauma and stressor related dx

2

Reactive attachment dx

  • consistent pattern of inhibited, emotionally withdrawn bx toward adult caregivers, manifested by both of the following:
    • child rarely/minimally seeks comfort when distressed
    • child rarely/minimally responds to comfort when distressed
  • persistent social and emotional disturbance characterized by at least 2 of the following:
    • minimal social and emotional responsiveness to others
    • limited positive affect
    • episodes of unexplained irritability, sadness, or fearfulness that are evidenced even during nonthreatening interactions with adult caregivers
  • child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following
    • social neglect or deprivation due to persistent lack of basic needs met (emotional, stimulation, affection) by caregiver
    • repeated changes of primary caregivers that limit opportunities to form stable attachments
    • rearing in usual settings that severely limit opportunities to form selective attachments
  • criteria for ASD not met
  • disturbance evidence before age 5 yrs
  • child has developmental age of at least 9 months

3

RAD - specifiers

  • specify if: persistent (present for more than 12 months)
  • specify current severity: specified as severe when a child exhibits all symptoms of the disorder, with each symptom manifesting at relatively high levels

4

disinhibited social engagement disorder

  • a pattern of behavior in which a child actively approaches and interacts with unfamiliar adults and exhibits at least 2 of the following:
    • reduced or absent reticence in approaching and interacting with unfamiliar adults
    • overly familiar verbal or physical behavior
    • diminished or absent checking back with adult caregiver after venturing away, even in unfamiliar settings
    • willingness to go off with an unfamiliar adult with minimal or no hesitation
  • behaviors in A are not limited to impulsivity but include socially disinhibited bx
  • child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following:
    • social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults
    • repeated changes of primary caregivers that limit opportunities to form stable attachments
    • rearing in unusual settings that severely limit opportunities to form selective attachments
  • the child has a developmental age of at least 9 months

5

disinhibited social engagement disorder-specifiers

  • specify if persistent: disorder present for 12 months or more
  • considered severe when the child exhibits all symptoms of the disorder with each symptom manifesting at relatively high levels

6

persistent avoidance of stimuli

  • refers to PTSD in children younger than 6
    1. avoidance of or efforts to avoid activities, places, or physical reminders that arouse recollections of the trauma event
    2. avoidance of or efforts to avoid people, conversations, or interpersonal situations that arouse recollections of the trauma event

7

PTSD specifiers

  • same specifiers for over and under 6 presentations
  • specify if with dissociative symptoms
    • depersonalization
    • derealization
  • specify if with delayed expression = full diagnostic criteria aren't met until at least 6 months after the event

8

negative alterations in cognitions

  • refers to PTSD in children younger than 6
    1. substantially increased frequency of negative emotional states
    2. markedly diminished interest or participation in significant activities, including constriction of play
    3. socially withdrawn bx
    4. persistent reduction in expression of positive emotions

9

post traumatic stress dx-- in individuals older than 6 years

  • applies to adults, adolescents, and children's older than 6 years
  • exposure to actual or threatened death, serious injury, or sexual violence's in 1 or more:
    • directly experiencing trauma event
    • witnessing in person the event as it happened to others
    • learning the trauma event occurred to a close fam member or close friend.
    • experiencing repeated or extreme exposure to aversive details of the trauma events
  • presence of one or more of the following intrusion symptoms associated with the traumatic events, beginning after the trauma event occurred:
    • recurrent, involuntary, and intrusive distressing memories of the event
    • recurrent distressing dreams relating to or about the event
    • dissociative reactions
    • intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the trauma event
    • marked physiological reactions to the internal or external cues that symbolize or resemble an aspect of the trauma event
  • persistent avoidance of stimuli associated with trauma event, beginning after event occurred and evidenced by 1 or both of following:
    • avoidance or efforts to avoid distressing memories, thoughts, feelings
    • avoidance of or efforts to avoid external reminders that arouse distressing memories, thoughts, etc
  • negative alterations in cognitions and mood associated with the traumatic events, beginning or worsening after the traumatic event occurred, evidenced by 2+ symptoms
  • marked alterations in arousal and reactivity associated with the traumatic events, beginning or worsening after the trauma event occurred, evidenced by 1+ symptoms.
  • duration of the disturbance is more than 1 month
  • causes distress
  • not due to effects of a substance

10

post traumatic stress dx-- individuals younger than 6

  • exposure to actual or threatened death, serious injury, or sexual violence in one or more of the following way:
    • directly experiencing
    • witnessing in person the events as it occurred to others, especially primary caregivers
    • learning that the traumatic event occurred to a parent/ caregiver
  • presence of one or more intrusion symptoms
    • recurrent,, involuntary, distressing memories
    • recurrent distressing dreams
    • dissociative reactions as if the trauma is current
    • intense psychological distress at exposure
    • mark psychological reactions to reminders
  • one or more symptoms representing either persistent avoidance of stimuli associated with the trauma event or negative alterations in cognitions and mood
  • alterations in arousal and reactivity associated with the traumatic event, beginning or worsening after the trauma event, evidenced by 2 or more symptoms
  • duration of disturbance lasting 1 month or more
  • causes distress
  • not due to effects of a substance

11

acute stress dx

  • exposure to actual or threatened death, serious injury, or sexual violence in one or more ways (direct, witness, learning of, reputed extreme exposure)
  • presence of 9 or more symptoms in any of the following 5 categories of symptoms:
    1. intrusion symptoms
    2. negative mood
    3. dissociative symptoms
    4. avoidance symptoms
    5. arousal symptoms
  • duration is 3 days- 1 month after trauma exposure
  • causes distress
  • not due to a substance

12

adjustment dx

  • development of emotional or behavioral symptoms in repose to an identifiable stressor occurring within 3 months of the stressor onset
  • symptoms or behaviors care clinically significant, evidenced by 1 or both:
    • marked distress that is out of proportion to the severity or intensity of the stressor
    • significant impairment areas of functioning
  • stress related disturbance does not meet criteria for another mental disorder and not merely the exacerbation of a preexisting mental disorder
  • symptoms do not represent normal bereavement are not better explained by prolonged grief dx
  • one the stressor or its consequences have terminated, symptoms do not persists for more than an additional 6 months

13

adjustment disorder specifiers

  • specify if:
    • with depressed mood
    • with anxiety
    • with mixed anxiety and depressed mood
    • with disturbance of conduct
    • with mixed disturbance of emotions and conduct
    • unspecified
  • specify if:
    • acute
    • persistent (symptoms lasting more than 6 months, usually because of a chronic stressor)

14

prolonged grief dx

  • the death, at least 12 months ago, of a person who was close to the bereaved individual (for children and adolescents, at least 6 months ago)
  • since the death, the development of a persistent grief response characterized at least one of these symptoms, present for at least 1 month:
    • intense yearning/longing for the deceased
    • preoccupation with thoughts/ memories of the deceased
  • since the death, at least 3 symptoms present most days to a significant degree (present for at least 1 month)
    • identity disruption
    • disbelief about death
    • avoidance of reminders that person is dead
    • intense emotional pain
    • difficulty reintegrating into activitiers or relationships
    • emotional numbness
    • feeling life is meaningless
    • intense loneliness
  • causes distress
  • duration and severity clearly exceed expected social, cultural, religious norms
  • not better explained by another mental condition