Trauma and Stressor Related Disorders

ABNORMAL PSYCHOLOGY C-PSYM311A 1ST SEMESTER – FINALS -​ M6.1: TRAUMA AND STRESSOR RELATED DISORDERS i. 2.​ Social and emotional problems -​ The child shows at least two of these: OVERVIEW Trauma- and stressor-related disorders are mental health conditions that happen after a person is exposed to a very stressful or traumatic event. These events can involve danger, serious injury, abuse, neglect, loss, or major life changes. What makes these disorders different from others is that exposure to a traumatic or stressful event is required for diagnosis. ●​ ●​ ●​ ●​ ●​ ●​ ●​ ●​ Reactive Attachment Disorder (RAD) Disinhibited Social Engagement Disorder (DSED) Acute Stress Disorder (ASD) Posttraumatic Stress Disorder (PTSD) Adjustment Disorders Prolonged Grief Disorder ●​ ●​ REACTIVE ATTACHMENT DISORDER (RAD) a. DEFINITION Reactive Attachment Disorder is a childhood disorder that develops when a child does not receive proper emotional care early in life. This includes situations where caregivers fail to provide comfort, affection, protection, or emotional support. Because of this neglect, the child does not form a healthy emotional bond with caregivers. RAD is considered an internalizing disorder, meaning the child’s distress is directed inward. Children with RAD often appear withdrawn, sad, emotionally distant, and uninterested in forming close relationships. b. DIAGNOSTIC CRITERIA A child may be diagnosed with RAD if all of the following are present: 1.​ Emotionally withdrawn behavior PAGE 1 CREATED BY JEMS Emotional neglect (not being comforted or cared for) Frequent changes in caregivers (such as many foster placements) Being raised in institutions where close bonding is difficult 4.​ Cause-and-effect relationship -​ The child’s emotional and social problems began after the neglect. People with these disorders often have intense emotional reactions, problems with fear and anxiety, difficulty regulating emotions, and changes in behavior after stressful experiences. ii. Little emotional response to others Rarely shows happiness or positive emotions Sudden sadness, fear, or irritability that has no clear cause 3.​ History of severe neglect -​ The child has experienced: Examples of trauma- and stressor-related disorders include: ●​ ●​ The child rarely seeks comfort from caregivers when upset and does not respond much when caregivers try to comfort them. 5.​ -​ Not autism The symptoms are not better explained by autism spectrum disorder. 6.​ Age requirement -​ Symptoms appear before age 5, and the child must be at least 9 months old developmentally. RAD can be labeled persistent if it lasts more than 12 months, and severe if all symptoms are strong and frequent. c. KEY FEATURES OF (RAD) Children with RAD do not show normal attachment behaviors. Even though they are capable of forming relationships, they fail to do so because they lacked early opportunities. When distressed, they do not seek help or comfort and do not feel better when comfort is offered. They often show very little joy during interactions and have difficulty controlling their emotions. Sudden fear, sadness, or irritability may appear even in safe situations. Because attachment is underdeveloped, emotional regulation is weak. d. PREVALENCE ABNORMAL PSYCHOLOGY C-PSYM311A 1ST SEMESTER – FINALS ●​ RAD is rare. Even among severely neglected children, less than 10% develop RAD. It is most often seen in children who were raised in institutions or experienced extreme neglect before being placed in foster care. e. RAD usually begins in infancy or early childhood. Symptoms appear between 9 months and 5 years of age. If the child is placed in a stable and nurturing environment early, symptoms may improve. However, without improved caregiving, problems may continue for years. If RAD continues into adolescence, it may cause social difficulties, emotional problems, and trouble forming relationships. f. These behaviors are not due to impulsivity alone (like ADHD). The child must also have experienced severe neglect early in life and be developmentally at least 9 months old. c. DEVELOPMENT AND COURSE iii. DISINHIBITED SOCIAL ENGAGEMENT DISORDER (DSED) a. DEFINITION DSED is another disorder caused by early neglect, but it looks very different from RAD. Instead of being withdrawn, children with DSED are overly friendly and socially disinhibited. They approach strangers without fear and act in ways that are not appropriate for their age or culture. DSED is considered an externalizing disorder, meaning behaviors are directed outward. b. DIAGNOSTIC CRITERIA A child with DSED: ●​ Approaches strangers without hesitation ●​ Acts overly familiar with adults they do not know ●​ Does not check unfamiliar places PAGE 2 back CREATED BY JEMS with caregivers in DEVELOPMENT AND COURSE DSED often starts in early childhood and may continue into adolescence or adulthood. Even when caregiving improves, symptoms may persist. The disorder is rare, even among children who experienced severe neglect. d.. RISK FACTORS Risk factors include: RISK AND PROGNOSIS Severe neglect is the only known risk factor. However, most neglected children do not develop RAD. Recovery largely depends on the quality of care the child receives later in life. Is willing to go with strangers ●​ Early neglect ●​ Multiple caregiver changes ●​ Poor-quality caregiving ●​ Low ability to control impulses ●​ Reduced sensitivity to rewards iv. ACUTE STRESS DISORDER (ASD) a. DEFINITION Acute Stress Disorder occurs shortly after exposure to a traumatic event, such as violence, assault, accidents, or disasters. Symptoms appear within 3 days and last up to 1 month. b. SYMPTOMS In ASD, at least 2 (two) symptoms must be present may include: ●​ Intrusive memories or flashbacks ●​ Avoidance of reminders ●​ Emotional numbness ●​ Anxiety and fear ●​ Dissociation ●​ Trouble sleeping ●​ Irritability or anger Some people appear emotionally detached, while others react with intense fear or anger. ABNORMAL PSYCHOLOGY C-PSYM311A c. 1ST SEMESTER – FINALS The reaction is out of proportion to the stressor and causes problems in daily life. DEVELOPMENT AND OUTCOME ASD may resolve on its own, or it may develop into PTSD if symptoms last longer than one month. About half of people who develop PTSD first experience ASD. v. POSTTRAUMATIC STRESS DISORDER (PTSD) a. DEFINITION a. DEVELOPMENT AND DURATION Symptoms begin within 3 months of the stressor and usually resolve within 6 months after the stressor ends. If the stress continues, symptoms may persist. b. PTSD occurs when trauma symptoms last longer than one month after a traumatic event. Symptoms can begin immediately or appear months or even years later. b. HOW IT DIFFERS TO (PTSD) The stressor does not have to involve death, violence, or serious injury. Adjustment disorder is diagnosed when PTSD or ASD criteria are not fully met. vii. PROLONGED GRIEF DISORDER a. DEFINITION MAJOR SYMPTOM CLUSTER PTSD symptoms fall into four main categories: 1. Intrusion Flashbacks, memories. nightmares, and distressing 2. Avoidance Avoiding reminders, places, or thoughts related to the trauma. This disorder occurs when intense grief continues for more than 12 months (6 months for children and adolescents) after the death of a loved one. The person experiences constant yearning, sadness, and difficulty moving forward. b. SYMPTOMS 3. Negative changes in mood and thinking Feelings of guilt, numbness, hopelessness, and detachment. 4. Arousal and reactivity c. Symptoms include: Being easily startled, hypervigilant, irritable, aggressive, or having sleep problems. ●​ Intense longing for the deceased ●​ Preoccupation with memories of the person PREVALENCE AND COURSE ●​ Difficulty accepting the loss ●​ Emotional numbness or distress ●​ Impaired daily functioning PTSD affects people of all ages. About half of adults recover within three months, while others experience symptoms for years. Symptoms may return during stressful times. vi. At least 3 symptoms must be present to be diagnosed with PGD. ADJUSTMENT DISORDERS Adjustment disorder occurs when a person has an unusually strong emotional or behavioral reaction to a stressful life event, such as divorce, academic failure, bullying, job loss, or illness. PAGE 3 CREATED BY JEMS c. CHILDREN AND ADOLESCENTS Children may express grief through behavior, play, physical symptoms, or fears about safety. Adolescents may report emotional numbness. viii. CAUSES OF TRAUMA-RELATED DISORDERS a. BIOLOGICAL FACTORS ABNORMAL PSYCHOLOGY C-PSYM311A 1ST SEMESTER – FINALS Trauma affects brain areas involved in fear and stress, such as the amygdala and hippocampus. Stress hormones like cortisol may remain elevated, causing ongoing fear responses. Genetics also play a role, especially variations related to serotonin regulation. b. PSYCHOLOGICAL FACTORS People with anxiety, depression, negative thinking patterns, or avoidant coping styles are more vulnerable. Catastrophic thinking and constant rumination increase risk. c. SOCIOCULTURAL FACTORS Lack of social support increases risk. Childhood trauma, family conflict, discrimination, and cultural stressors also contribute. ix. TREATMENT a. MEDICATION Antidepressants may help reduce symptoms but do not work for everyone. Other medications may help with nightmares or anxiety. b. PSYCHOTHERAPY The most effective therapies include: ●​ Prolonged Exposure Therapy ●​ Cognitive Behavioral Therapy (CBT) ●​ Trauma-Focused CBT ●​ EMDR (Eye Movement Desensitization and Reprocessing) ●​ Mindfulness-based approaches These therapies help people process trauma, reduce fear, and develop healthier coping strategies. PAGE 4 CREATED BY JEMS