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MH Exam 3 Study Guide
Mental Health (Galen College of Nursing)
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Mental Health Exam 3 Study Guide
Trauma/Stress/Dissociative Disorders
Trauma – subjective (Diathesis Stress Model) – war, interpersonal trauma,
witnessing something
Trauma-informed care- framework for tx (realize, recognize, respond, resist)
Post-Traumatic Stress Disorder:
Exposure to traumatic event (children may blame themselves)
Intrusion
o Flashbacks are dissociative (adults)
o Children may have reduced play, may act out trauma in play,
nightmares
Avoidance of stimuli associated with trauma
Negative change in cognition/mood – children have somatic symptoms
(GI upset, HA)
Change in arousal/activity – hypervigilant
Interventions:
o Psychoeducation – relaxation
o Pharm – antidepressants, antianxiety (clonidine given for
hyperarousal)
Goals:
o Manage anxiety, increase self-esteem, improve coping
Tx Effective if: Adults
o Recognize s/s r/t trauma
o Use new coping skills
o No flashbacks
o Adequate sleep with no nightmares
o Assume usual roles
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Tx Effective if: Kids
o Safety maintained
o Decreased anxiety
o Appropriate behavior
o Normal milestones
o Seek out help from adults
Acute Stress Disorder: Dx 3 days to 1 month after trauma, will improve or
progress to PTSD, tx - therapy
Reactive Attachment Disorder: No comfort from caregivers
Disinhibited Social Engagement Disorder: Will seek care from anyone
for comfort (no fear of strangers)
Adjustment Disorder: Precipitated by stressful event, s/s negatively impact
functioning, dx immediately or within 3 months of exposure
Dissociative Disorders:
Occurs after adverse event = severe interruption of consciousness
Is an UNCONSCIOUS defense mechanism
Can be protective for a child
Risk Factors: ACEs, traumatic events
Depersonalization: Focus on self, feels like observing own body
Derealization: Outside world-surroundings seem
unreal/distant/dream-like
Dissociative Fugue: Sudden, unexpected travel and inability to recall
one’s identity and information about past. May assume new identity.
After a few weeks/months, may remember former identity
Dissociative Identity Disorder
o 2 or more distinct personality traits
o Host often unaware of alters
o Switching during times of stress - may be dramatic or subtle
o Severe trauma in childhood
o Priority = SAFETY
Downloaded by madiba South Africa stuvia ()
MH Exam 3 Study Guide
Mental Health (Galen College of Nursing)
Scan to open on Studocu
Studocu is not sponsored or endorsed by any college or university
Downloaded by madiba South Africa stuvia ()
, lOMoARcPSD|44532475
Mental Health Exam 3 Study Guide
Trauma/Stress/Dissociative Disorders
Trauma – subjective (Diathesis Stress Model) – war, interpersonal trauma,
witnessing something
Trauma-informed care- framework for tx (realize, recognize, respond, resist)
Post-Traumatic Stress Disorder:
Exposure to traumatic event (children may blame themselves)
Intrusion
o Flashbacks are dissociative (adults)
o Children may have reduced play, may act out trauma in play,
nightmares
Avoidance of stimuli associated with trauma
Negative change in cognition/mood – children have somatic symptoms
(GI upset, HA)
Change in arousal/activity – hypervigilant
Interventions:
o Psychoeducation – relaxation
o Pharm – antidepressants, antianxiety (clonidine given for
hyperarousal)
Goals:
o Manage anxiety, increase self-esteem, improve coping
Tx Effective if: Adults
o Recognize s/s r/t trauma
o Use new coping skills
o No flashbacks
o Adequate sleep with no nightmares
o Assume usual roles
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, lOMoARcPSD|44532475
Tx Effective if: Kids
o Safety maintained
o Decreased anxiety
o Appropriate behavior
o Normal milestones
o Seek out help from adults
Acute Stress Disorder: Dx 3 days to 1 month after trauma, will improve or
progress to PTSD, tx - therapy
Reactive Attachment Disorder: No comfort from caregivers
Disinhibited Social Engagement Disorder: Will seek care from anyone
for comfort (no fear of strangers)
Adjustment Disorder: Precipitated by stressful event, s/s negatively impact
functioning, dx immediately or within 3 months of exposure
Dissociative Disorders:
Occurs after adverse event = severe interruption of consciousness
Is an UNCONSCIOUS defense mechanism
Can be protective for a child
Risk Factors: ACEs, traumatic events
Depersonalization: Focus on self, feels like observing own body
Derealization: Outside world-surroundings seem
unreal/distant/dream-like
Dissociative Fugue: Sudden, unexpected travel and inability to recall
one’s identity and information about past. May assume new identity.
After a few weeks/months, may remember former identity
Dissociative Identity Disorder
o 2 or more distinct personality traits
o Host often unaware of alters
o Switching during times of stress - may be dramatic or subtle
o Severe trauma in childhood
o Priority = SAFETY
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