exam three--chapter 16

trauma
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Terms in this set (35)
trauma
a deeply distressing or disturbing experience, objectively including physical and psychological
neglect
the most common form of child abuse in the US
PTSD in preschool kids
reduction in play, repetitive play that mirror traumatic event, social withdrawal, negative emotions
negative emotions r/t PTSD in preschool kids
fear, guilt, anger, horror, sadness, shame or confusion & aggressive/self destructive behaviors
genetic factor for trauma related disorders in children
stress and environment, methylation
-children who have been abused have a higher risk of abusing others and developing dysfunctional patterns in close interpersonal relationships
-blame themselves, negative thoughts "I am a bad person"
methylation
-process by which methyl groups are added to the DNA molecule
-it can change the activity of a DNA segment without changing the sequence
-typically acts to repress gene transcription
-in turn prevents the brain from regulating its response to stress
psychological factors of trauma related disorders in kids
attachment theory: relationship between infant and caretaker

(MAJOR key to growth and development)
assessment for trauma related disorders in kids
collecting possible data from multiple settings, mental status, and therapeutic drawing/playing activities (via observations)
developmental assessment for trauma related disorders in kids
age, setting
implementation of 3 stages for trauma related disorders in kids
1- safe
2- trust
3- encouraging environment

reducing arousal, regulating emotion, developmental skills catch up
PTSD symptoms in adultsre-experiencing of trauma (flashback) persistant symptoms of increased arousal (hyper arousal)hyper arousalreduced pain tolerance, exaggeration of startle responses, insomnia, fatigue, and accentuation of personality traitsadjustment disorder in adultsWeakening cognitive, emotional, and behavioural symptoms that negatively impacts normal functioning milder less specific version of PTSD treated with antidepressantsepidemiology of trauma related disorders in adults55-90%lifetime prevalence of trauma related disorders in adults3.5%average age onset for trauma related disorders in adults23 years olddissociative disordersoccur after significant adverse experience/trauma unconscious defense mechanism protects individual against overwhelming anxiety through emotional separationneurobiological factor of dissociative disorderincreased activation in limbic system and hippocampus (traumatic memory is processed in limbic system and stored in hippocampus)types of dissociative disorders1- depersonalization/ derealization 2- dissociative amnesia 3-dissociative identity disorderdepersonalizationfocus on *SELF*, observe own body and mental process watching yourself as in the moviederealizationfocus on *OUTSIDE WORLD* one's surrounding is unreal or distantdissociative amnesiainability to recall important personal information any age group can experience this affects females more often *dissociative fugue*- sudden, unexpected travel away and inability to recall one's identitydissociative identity disorderpresence of two or more distinct personality states each alternate personality (alter) has own pattern of: perceiving, relating to and thinking about the self and environment primary personality- religious and moralistic alter personality- pleasure seeking and non conformingassessment for dissociative disordershistory- early trauma (physical or psychological) *suicide risk*interventions for dissociative disorderspsycho education- grounding techniques: teaching reality, bring awareness to noticing real things in the present examples: stomping feet, taking a shower, holding an ice cube, exercisingtrauma informed careunderstanding, recognizing, and responding to the effects of all types of trauma emphasizes physical, psychological, and emotional safety for consumers and providersfour elements of trauma informed approach1- *realizes* the widespread impact of trauma and understands potential paths for recovery 2- *recognizes* the S&S of trauma 3- *responds* by fully integrating knowledge about trauma into policies, procedures, and practices 4- seeks to actively resist *re-traumatization*6 key principles of a trauma informed approachsafety trustworthiness/transparency peer support collaboration and mutuality empowerment, voice and choice cultural, historical, and gender issuesreactive attachment disorderconsistent pattern of inhibited, emotionally withdraw behaviors child rarely directs attachment behaviors towards any adult caregivers and does not seek comfort from them caused by- lack of bonding by 8 months lack of bonding caused by: severe neglect, repeated changes of primary caregivers, care in an institutional settingreactive attachment disorder exists alongside with?depressive disorders social problems PTSD cognitive and language problemsdisinhibited social engagement disorder2 or more distinct personalities occur to an individual remarkably friendly and confident no normal fear of strangers, willing to go off with people who are unknown to them rarely check back with caregivers, unfazed by separation from them by attaching to everyone, they are really not attaching to anyonedisinhibited social engagement disorder exists alongside with?ADHD PTSD cognitive and language delaysneurobiological factors-dissociative disorderslimbic system- where traumatic memories are processed hippocampus- stores this informationnursing diagnosis for dissociative disordersdisturbed personal identity ineffective role performance anxiety self controladvanced practice interventions for dissociative disorderssomatic therapy- combines talk therapy with body centered interventions and movement pt. will describe current physical sensations goal- safely disarm the pathological defense mechanism and replace it with other resources