Transcript W_George___Post_Trau..._Stress_Disorder

Post-Traumatic Stress
Disorder
Wilma George
ECED 6952 Seminar in Crisis & Disaster
Counseling
Auburn University Of Montgomery
P. Hard
What is Post-Traumatic Stress Disorder
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A Type of anxiety disorder.
Occurs after one has seen or
experienced a traumatic event that
involved the thereat of injury or
death.
History
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Recognized as a formal diagnosis since
1980.
Had different names as early as the
American Civil War- Soldier’s Heart
World War I-Combat Fatigue
World War II-Gross Stress Reaction
Vietnam- Post Vietnam Syndrome
Battle Fatigue & Shell Shock
Complex Post-Traumatic Stress
Disorder (C-PTSD)
Causes
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Any trauma, defined as an event that is lifethreatening or that severely compromises the
emotional well being of an individual or causes
intense fear.
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Experiencing or witnessing a severe accident or
physical injury.
Receiving a life threatening medical diagnosis.
Victim of kidnapping or torture
Exposure to war combat or to a natural disaster.
Victim of rape
Mugged, robbed, or assaulted.
Enduring physical, sexual, or emotional abuse.
Devastating life events (divorce or u unemployment)
Risk Factors
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Increased duration of a traumatic event.
Higher number of traumatic events
endured.
Higher severity of trauma experienced.
Having an emotional condition prior to the
event.
Having little social support in the form of
family or friends.
Children, females and people w/ learning
disabilities/violence in the home.
Protective Factors
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Disaster-preparedness training
(police, firefighters, mental health
professionals, paramedics, and
other medical professionals).
Medications
Signs & Symptoms
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Symptoms of PTSD fall into three
main categories:
1.
Recurrence- Reliving the event,
which disturbs day to day activity.
a. Flashbacks episodes
b. Recurrent distressing memories
c. Repeated dreams
d. Physical reactions to situations
2.
Avoidance –Having a phobia, of
places, people, and experiences.
a.
b.
c.
d.
e.
f.
g.
Emotional “numbing,” or feeling as though
you don’t care about anything.
Feelings of detachment.
Inability to remember important aspects of
the trauma.
Lack of interest in normal activities.
Less expression of moods.
Staying away from places, people, or objects
that remind you of the event
Sense of having no future.
3.
Chronic Physical signs of Hyperarousal.
a. Difficulty concentrating.
b. Exaggerated responses to things
that startles the individual.
c. Excess awareness.
d. Irritability or outbursts of anger.
e. Sleeping difficulties.
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Guilt about the event which includes
symptoms such as:
Agitation, or excitability
 Dizziness
 Fainting
 Feeling your heart beat in your chest
 Fever
 Headaches
 Paleness
Which are typical of anxiety, stress, and tension.
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Assessing PTSD
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Self Test (The National Institute of
Mental Health)
Practitioners
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Difficult (somatization, depression, drug
addiction).
Often Co-occurs w/bipolar, eating disorders,
obsessive compulsive disorders, panic disorders,
social anxiety disorder, and generalized anxiety
disorder.
When examining children or teenagers interview
both child and parent, but separately.
Challenges During
Assessing/Diagnosis Children
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The feelings of the adolescent that the adult may
not be aware of.
They express their symptoms differently from
adults.
Go backward or regress in development.
Become accident-prone.
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Engage in risky behaviors.
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Become clingy.
Suffer from physical complaints.
Trouble sitting still, focusing or managing impulses
(mistaken for ADHD).
Tools Used to Diagnosis Children
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Rating Scale or structured psychiatric interviews in
its entirety or portions such as:
Rating Scales
 Diagnostic Interview for Children and AdolescentsRevised-(DICA-R).
 Diagnostic Interview Schedule for Children-Version IV
(DISC-IV).
 Schedule for Affective Disorders and Schizophrenia for
School Age Children (K-SADS).
Structured Interviews
 Clinician-Administered PTSD Scale-Child and
Adolescent Version.
 Child PTSD checklist.
 Child PTSD Symptom Scale.
Tools Used to Assess the Severity of
PTSD in Children.
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Child Post-traumatic Stress Reaction
Index.
Child and Adolescent Trauma Survey.
Trauma Symptom Checklist for Children.
Child Trauma Screening Questionnaire has been found by some
professionals to be useful in predicting which children who endure
a traumatic event will go on to develop PTSD.
Treatment
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Psychological/ Psychotherapy
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Helps the individual manage the trauma by talking
about it directly.
Exploration and modification of inaccurate ways of
thinking about the trauma.
Teaching the person ways to manage symptoms.
Individual and/or group cognitive behavioral
psychotherapy.
Eye movement desensitization and reprocessing
(cognitive therapy).
Family counseling, couples counseling, parenting
classes, and conflict-resolution education.
Addressing sleeping problems. (Rehearsing adaptive
ways to cope with nightmares (imagery rehearsal
therapy), Relaxation techniques, Positive self talk).
Treatment
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Educating/Providing Information
 Teaching Individuals about what PTSD is.
 How many others suffer from PTSD.
 Causes (by an extraordinary stress
rather than weakness).
 Treatment
 What to expect from treatment.
Treatment
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Medications
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Serotonergic antidepressants (SSRIs).
Prozac-Fluoxetine
2.
Zoloft-Sertraline
3.
Paxil-Paroxetine
Less likely to experience an relapse associated w/ PTSD
in the first year if antidepressant treatment is
continued.
First group of medications approved by the U.S. Food &
Drug Administration to treat PTSD.
Help to modify information that is taken in from the
environment, decrease anxiety, depression, and
panic.
Help reduce aggression, impulsivity, and suicidal
thoughts.
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Decreases the Physical Symptoms
Catapres-Clonidine
Tenex-Guanfacine
Propranolo
Mood Stabilizers
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Lamictal
Gabitril
Depakote
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Mood Stabilizers/ Antipsychotic
Risperdal
 Zyprexa
 Seroquel
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Antipsychotic medications most useful to treat
those who have PTSD and suffers w/agitation,
dissociation, paranoia, brief psychotic
reactions.
Non effective medications•
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Cymbalta
Wellbutrin
Effexor
Valium & Xanax (cause withdrawal
symptoms and risk of overdose).
References
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http://www.medicienet.com/script/main/a
rt.asp?articlekey=12578
http://www.ask.com/wiki/Posttraumatic_s
tress_disorder
http://www.nlm.nih.gov/medlineplus/prin
t/ency/article/000925.htm
American Psychiatric Association
(1994).Dignostic and statistical manual of
mental disorders: DSM-IV. Washington,
DC: American Psychiatric Association.
ISBN 0890420610.