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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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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Somatic Disorders
Somatic Symptoms Disorder
o Excessive focus on physical symptoms
o High function impairment
o Seeking help, but unable to make clear dx d/t no evidence
o May become frustrated
o Symptoms are INVOLUNTARY
Illness Anxiety Disorder
o Extreme worry/fear of illness
o Actual symptoms are mild/absent
o Obsessive thoughts can become intrusive
o Some seek care, some avoid
o Social media increases fear/anxiety
Conversion Disorder
o Neuro symptoms WITHOUT neuro diagnosis
o Stress leads to physical symptoms including: paralysis,
blindness, movement, gait, numbness, seizures
o La belle indifference – lack of emotional concern with symptoms
o Always rule out physical cause first
o Interventions:
Be empathetic
Encourage expression of feelings/emotions
Make connections between physical and emotional s/s
Teach effective coping skills
Downloaded by madiba South Africa stuvia ()
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
Downloaded by madiba South Africa stuvia ()
, 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
Downloaded by madiba South Africa stuvia ()
, lOMoARcPSD|44532475
Somatic Disorders
Somatic Symptoms Disorder
o Excessive focus on physical symptoms
o High function impairment
o Seeking help, but unable to make clear dx d/t no evidence
o May become frustrated
o Symptoms are INVOLUNTARY
Illness Anxiety Disorder
o Extreme worry/fear of illness
o Actual symptoms are mild/absent
o Obsessive thoughts can become intrusive
o Some seek care, some avoid
o Social media increases fear/anxiety
Conversion Disorder
o Neuro symptoms WITHOUT neuro diagnosis
o Stress leads to physical symptoms including: paralysis,
blindness, movement, gait, numbness, seizures
o La belle indifference – lack of emotional concern with symptoms
o Always rule out physical cause first
o Interventions:
Be empathetic
Encourage expression of feelings/emotions
Make connections between physical and emotional s/s
Teach effective coping skills
Downloaded by madiba South Africa stuvia ()
