Chapter 13:
Understanding Trauma and Stressor-Related Disorders
Differentiate between trauma-related disorders and the body’s response to
extreme stressors.
Trauma-related disorders develop when an individual experiences extreme __________
threatening
or __________ events, leading to significant psychological and physiological effects.
distressing
Not everyone exposed to trauma will develop a disorder, but for some, the body's
response to stress becomes dysregulated
__________, affecting emotional regulation, memory, and
behavior. Protective factors, such associal
__________
support andresilience
__________, can influence
whether a person develops PTSD.
! Clinical Example: A 32-year-old veteran has returned from deployment and
experiences recurrent nightmares, flashbacks, and hypervigilance. He avoids
crowded areas and has difficulty connecting with family members. His spouse reports
that he frequently wakes up in a sweat, disoriented and anxious. What disorder might
PTSD
this patient be experiencing? __________
" Socratic Question: "How might trauma affect two people differently, leading one to
differences incopingmechanisms genetic
develop PTSD while another does not?" __________
predisposition socialsupport past traumaexposure caninfluencePTSDdevelopment
,The Body’s Response to Trauma
Explain how the autonomic nervous system and the HPA axis contribute to
trauma responses.
When faced with trauma, the body activates thesympathetic
__________ nervous system,
fightor flight
triggering the -or- response. Chronic activation of this system can lead to dysregulation
hypothalamic.EE
of the --__________
na
(HPA) axis, which affects mood and emotional regulation,
increases __________ hormone levels, and disrupts normal stress responses.
cortisol
The __________ andhippocampus
__________ brain regions play key roles in processing fear and
amygdala
memory, contributing to PTSD symptoms.
! Clinical Example: A 25-year-old woman who survived a car accident two weeks
ago describes feeling jumpy, difficulty sleeping, and reliving the crash when
hearing loud noises. What physiological and psychological mechanisms are
likely contributing to her symptoms? __________
hyperarousaloftheautonomicnervous
system intrusive memoryprocessing in thehippocampus amygdala
" Socratic Question: "What are some long-term physical health effects of chronic
stress and trauma?" __________
HTN cardiovasculardisease
infffsuppression Glissues
Diagnostic Criteria for PTSD, Acute Stress Disorder, and Adjustment
Disorders
Compare the symptom duration and diagnostic criteria of PTSD, acute
stress disorder, and adjustment disorders.
•
1
PTSD symptoms persist beyond __________ month(s) and
include __________, avoidance, negative mood alterations, and
intrusions
hyperarousal.
• 3
Acute Stress Disorder has similar symptoms but lasts between __________
30
and __________ days.
, • nonthreatening
Adjustment Disorders occur in response to __________ life stressors, leading
to emotional and behavioral changes that do not meet the criteria for PTSD.
Unlike PTSD, adjustment disorders __________ require exposure to a life-
donot
threatening event.
! Clinical Example: A 40-year-old patient loses his job and reports anxiety,
irritability, and difficulty sleeping for the past two weeks. How would you
differentiate between PTSD and an adjustment disorder in this case?__________
stressor wasjobloss
ratherthanlifethreateningevent
" Socratic Question: "Why might an adjustment disorder be mistaken for
depression?" __________
Treatment and Nursing Interventions
Identify first-line treatments and nursing interventions for PTSD and related
disorders.
• First-line therapy for PTSD: __________
focused
trauma cognitivebehavioraltherapyCBT
• First-line medication class: __________ (Examples: __________ and
SSRI's sertraline
__________)
paroxetine
• Early interventions for Acute Stress Disorder:crisisintervention
__________ and __________
psychoeducation
• Adjustment Disorder treatments focus on:COPIGategi.es
__________, __________, and
therapy
__________
stressmanagement
• Nursing interventions should focus on: providing a __________ and
safe
__________ environment, encouragingrelaxation
__________ techniques, and
supportive
validating emotions while avoiding reinforcement of avoidance
__________ behaviors.
, ! Clinical Example: A patient with PTSD refuses to discuss their trauma and avoids
reminders of the event. What is an appropriate nursing intervention? __________
offering
groundingtechniques validatingemotionswhilenotforcingtraumadiscussion
" Socratic Question: "Why might avoidance behaviors initially reduce anxiety but later
contribute to worsening PTSD symptoms?" __________
Providing Education to Clients and Families
Describe how to educate families and caregivers about trauma-
related disorders.
Families often struggle to understand why their loved ones cannot "move on" from
trauma. Providing information on P
__________, __________,
MechanismsPTSDsymptoms and __________ helps
treatmentptions
create a more supportive environment and reduces __________.Family members
Stigma
should be encouraged to __________
listen rather than force conversations about
trauma and support engagement inhealthy
__________.
activities
! Clinical Example: A spouse states, "I don’t understand why they can’t just move
Traumachanges the waythebrainprocessesstress
on." How should the nurse respond? __________
Healingtakestime supportfromlovedonescanmakeffference
" Socratic Question: "How can family members support a loved one with PTSD
without reinforcing avoidance behaviors?" __________
byencouragingopencommunicationpromotehealthy
copingstrategiesavoidingpressuringthepersonto discusstrauma
Key Takeaways
•
1
PTSD symptoms last longer than __________ month(s), while acute stress
30
disorder resolves within __________ days.
• The sympathetic HPA axis play a role in trauma
__________ nervous system and __________
response.