NURS 663 MARYVILLE PSYCH EXAM #3
QUESTIONS AND ANSWERS
Pharmacologic agents for ptsd - answer-med tx is focused on diminishing intrusive
thoughts, hyperarousal, and avoidance, with some success and mixed results
Ptsd frequent comorbidity - answer-depressive disorder, anxiety disorders, and
behavioral problems associated with ______________
Sertraline and paroxetine - answer-that __________and ______________ are
approved by the food and drug administration (fda) in the treatment of ptsd in adults,
there is scant evidence to support its use for the core symptoms of ptsd in youth
Risperidone and aripiprazole - answer-fda approval for use in children and adolescents
with aggression, severe behavioral dyscontrol, and severe psychiatric disorders
Antiadrenergic agents - answer-treat dysregulation of the noradrenergic system in
adults and youth with ptsd
Clonidine and guanfacine - answer-alpha2-agonists examples
Alpha2 agonists - answer-decrease norepinephrine release, such as, are
Propranolol - answer-centrally acting β-antagonists example
Prazosin - answer-α-1-antagonists example
Propranolol use - answer-hypothesized to improve hyperarousal and intrusive thoughts
through attenuation of norepinephrine postsynaptically
Prazosin use - answer-nightmares associated with trauma
Modify ptsd sx - answer-off-label medications including antidepressants, atypical
antipsychotics, adrenergic modulators/sympatholytic, and anticonvulsants/mood
stabilizers
Clonidine and propranolol - answer-nightmares and exaggerated startle response: some
evidence in adults, but children case report only
Guanfacine and clonidine - answer-__________ may reduce nightmares in children with
ptsd and ____________may diminish symptoms of reenactment of traumatic events in
children
,Mood-stabilizing agents - answer-divalproex, carbamazepine, topiramate, and
gabapentin have been utilized for adults with ptsd with modest improvement; some
Clonidine with dosage ranges of 0.05 to 0.1 mg twice daily - answer-may provide some
relief for the symptoms of hyperarousal, impulsivity, and agitation in young children with
ptsd; in children some evidence
Benzodiazepines - answer-no controlled trials supporting use in children
Trauma-focused cbt - answer-10-16 treatment sessions, including 9 components
itemized in the acronym practice
Practice elements - answer-psychoeducation on typical reactions to ptsd.
Parenting skills- praise, time-out, reinforcement
Relaxation- muscle, breathing, cognitive tech
Affective expression and modulation- id feelings
Cognitive coping and processing cognitive triangle
Trauma narrative:developed over time by child,
In vivo exposure and mastery of trauma reminders- how to deal with reminders
Conjoint child-parent sessions- this component may involve several sessions in which
the child and parent share their understanding
Enhancing future safety-family changes
Emdr - answer-exposure and cognitive reprocessing interventions are paired with
directed eye movements, alternating tones or tapping
Cbits - answer-cognitive behavioral interventions for trauma in schools
Cbits description - answer-intervention that administers treatment in the school setting
for children who screen positive for ptsd and whose parents agree to treatment in
school.
Cbits elements - answer-consists of 10 weekly group sessions
1-3 individual imaginal exposure sessions
2-4 optional sessions with parents
1 parent education session.
Similar to trauma-focused cbt, incorporates psychoeducation, relaxation, training,
cognitive coping skills, gradual exposure to traumatic memories
Sparcs - answer-structured psychotherapy for adolescents responding to chronic stress
Sparcs description - answer--consists of a group intervention,
-16 sessions
-focus on the needs of adolescents (12-19 years old) chronic trauma and ptsd.
-utilizes cognitive behavioral techniques, and -incorporates many of the components of
tf-cbt
, -includes mindfulness techniques and relaxation.
Target - answer-trauma affect regulation:guide for education and therapy
Target description - answer--affect regulation therapy,
-combines cbt components, such as cognitive procession, with affect modulation.
-adolescents (13-19) exposed to maltreatment and/or chronic traumatic exposure to
such things as community violence or domestic violence.
-12 sessions, which focuses on past or current situations.
Target efficacy - answer---like sparcs treatment, gradual exposure may occur in the
context of recounting past trauma but is not a core component of treatment.
--reduces anxiety, depression, and ptsd
--promising treatment for girls with h/o delinquency, especially to reduce anger and to
enhance optimism and self efficacy.
Crisis intervention/psychological debriefing - answer-1. Several sessions immediately
after an exposure to a traumatic event; encouraged to describe the traumatic event in
the context of a supportive environment.
2. Psychoeducation is provided and guidance about the management of initial emotional
reactions may be provided.
3. No controlled studies have yet provided evidence that this intervention leads to a
more positive outcome
Ptsd criteria add'l info - answer-1. Over 6 years old
2. Sx over 1 month duration, or dx criteria may not have occurred until at least 6 months
after the trauma
3. Constricted emotions can show up suddenly after major life event, stressor, or
accumulated stressors that challenge defenses.
4. Can hide in somatic complaints or co-occur with depression, substance abuse,
anxiety or after head injury
Ptsd differential diagnosis: medical - answer-hyperthyroidism, caffeinism, migraine,
asthma, seizure disorder, and catecholamine or serotonin-secreting tumors. Some
prescription medications and even some otc medications may have similar effects, such
as antiasthmatics, sympathomimetics, steroids, ssris, and antipsychotics, diet pills,
antihistamines, and cold medicines
Ptsd differential diagnosis - answer-anxiety disorders, such as separation anxiety
disorder, obsessive-compulsive disorder (ocd) or social phobia, depressive disorders,
bereavement trauma, disruptive behavior d/o
Ptsd-associated psychosis - answer-does not respond well to neuroleptic (antipsychotic)
medication; may respond better to psychosocial interventions. The hallucinations and
delusions connect to the traumatic situation and perpetrators. Older kids show
symptoms like adults.
QUESTIONS AND ANSWERS
Pharmacologic agents for ptsd - answer-med tx is focused on diminishing intrusive
thoughts, hyperarousal, and avoidance, with some success and mixed results
Ptsd frequent comorbidity - answer-depressive disorder, anxiety disorders, and
behavioral problems associated with ______________
Sertraline and paroxetine - answer-that __________and ______________ are
approved by the food and drug administration (fda) in the treatment of ptsd in adults,
there is scant evidence to support its use for the core symptoms of ptsd in youth
Risperidone and aripiprazole - answer-fda approval for use in children and adolescents
with aggression, severe behavioral dyscontrol, and severe psychiatric disorders
Antiadrenergic agents - answer-treat dysregulation of the noradrenergic system in
adults and youth with ptsd
Clonidine and guanfacine - answer-alpha2-agonists examples
Alpha2 agonists - answer-decrease norepinephrine release, such as, are
Propranolol - answer-centrally acting β-antagonists example
Prazosin - answer-α-1-antagonists example
Propranolol use - answer-hypothesized to improve hyperarousal and intrusive thoughts
through attenuation of norepinephrine postsynaptically
Prazosin use - answer-nightmares associated with trauma
Modify ptsd sx - answer-off-label medications including antidepressants, atypical
antipsychotics, adrenergic modulators/sympatholytic, and anticonvulsants/mood
stabilizers
Clonidine and propranolol - answer-nightmares and exaggerated startle response: some
evidence in adults, but children case report only
Guanfacine and clonidine - answer-__________ may reduce nightmares in children with
ptsd and ____________may diminish symptoms of reenactment of traumatic events in
children
,Mood-stabilizing agents - answer-divalproex, carbamazepine, topiramate, and
gabapentin have been utilized for adults with ptsd with modest improvement; some
Clonidine with dosage ranges of 0.05 to 0.1 mg twice daily - answer-may provide some
relief for the symptoms of hyperarousal, impulsivity, and agitation in young children with
ptsd; in children some evidence
Benzodiazepines - answer-no controlled trials supporting use in children
Trauma-focused cbt - answer-10-16 treatment sessions, including 9 components
itemized in the acronym practice
Practice elements - answer-psychoeducation on typical reactions to ptsd.
Parenting skills- praise, time-out, reinforcement
Relaxation- muscle, breathing, cognitive tech
Affective expression and modulation- id feelings
Cognitive coping and processing cognitive triangle
Trauma narrative:developed over time by child,
In vivo exposure and mastery of trauma reminders- how to deal with reminders
Conjoint child-parent sessions- this component may involve several sessions in which
the child and parent share their understanding
Enhancing future safety-family changes
Emdr - answer-exposure and cognitive reprocessing interventions are paired with
directed eye movements, alternating tones or tapping
Cbits - answer-cognitive behavioral interventions for trauma in schools
Cbits description - answer-intervention that administers treatment in the school setting
for children who screen positive for ptsd and whose parents agree to treatment in
school.
Cbits elements - answer-consists of 10 weekly group sessions
1-3 individual imaginal exposure sessions
2-4 optional sessions with parents
1 parent education session.
Similar to trauma-focused cbt, incorporates psychoeducation, relaxation, training,
cognitive coping skills, gradual exposure to traumatic memories
Sparcs - answer-structured psychotherapy for adolescents responding to chronic stress
Sparcs description - answer--consists of a group intervention,
-16 sessions
-focus on the needs of adolescents (12-19 years old) chronic trauma and ptsd.
-utilizes cognitive behavioral techniques, and -incorporates many of the components of
tf-cbt
, -includes mindfulness techniques and relaxation.
Target - answer-trauma affect regulation:guide for education and therapy
Target description - answer--affect regulation therapy,
-combines cbt components, such as cognitive procession, with affect modulation.
-adolescents (13-19) exposed to maltreatment and/or chronic traumatic exposure to
such things as community violence or domestic violence.
-12 sessions, which focuses on past or current situations.
Target efficacy - answer---like sparcs treatment, gradual exposure may occur in the
context of recounting past trauma but is not a core component of treatment.
--reduces anxiety, depression, and ptsd
--promising treatment for girls with h/o delinquency, especially to reduce anger and to
enhance optimism and self efficacy.
Crisis intervention/psychological debriefing - answer-1. Several sessions immediately
after an exposure to a traumatic event; encouraged to describe the traumatic event in
the context of a supportive environment.
2. Psychoeducation is provided and guidance about the management of initial emotional
reactions may be provided.
3. No controlled studies have yet provided evidence that this intervention leads to a
more positive outcome
Ptsd criteria add'l info - answer-1. Over 6 years old
2. Sx over 1 month duration, or dx criteria may not have occurred until at least 6 months
after the trauma
3. Constricted emotions can show up suddenly after major life event, stressor, or
accumulated stressors that challenge defenses.
4. Can hide in somatic complaints or co-occur with depression, substance abuse,
anxiety or after head injury
Ptsd differential diagnosis: medical - answer-hyperthyroidism, caffeinism, migraine,
asthma, seizure disorder, and catecholamine or serotonin-secreting tumors. Some
prescription medications and even some otc medications may have similar effects, such
as antiasthmatics, sympathomimetics, steroids, ssris, and antipsychotics, diet pills,
antihistamines, and cold medicines
Ptsd differential diagnosis - answer-anxiety disorders, such as separation anxiety
disorder, obsessive-compulsive disorder (ocd) or social phobia, depressive disorders,
bereavement trauma, disruptive behavior d/o
Ptsd-associated psychosis - answer-does not respond well to neuroleptic (antipsychotic)
medication; may respond better to psychosocial interventions. The hallucinations and
delusions connect to the traumatic situation and perpetrators. Older kids show
symptoms like adults.
