What is the impact of adjustment disorder on functioning?
It results in significant impairment in personal, family, social, educational, or occupational areas of functioning.
p.7
Disinhibited Social Engagement Disorder
What age must symptoms of disinhibited social engagement disorder be evident by?
Before the age of five years.
p.2
Gender and Vulnerability Factors in Stress Disorders
Which gender is more commonly diagnosed with PTSD?
Females are more commonly diagnosed with PTSD.
What symptoms characterize the reaction to a stressor in adjustment disorder?
Preoccupation with the stressor, excessive worry, and recurrent distressing thoughts about the stressor.
p.7
Disinhibited Social Engagement Disorder
What behavior is characteristic of a child with disinhibited social engagement disorder?
Overly familiar behavior with unfamiliar adults.
p.7
Disinhibited Social Engagement Disorder
What is a key feature of disinhibited social engagement disorder?
A history of grossly insufficient care of a child.
p.8
Disinhibited Social Engagement Disorder
What co-occurring disorders are children with disinhibited social engagement disorder at risk for?
Post-traumatic stress disorder or complex post-traumatic stress disorder.
p.7
Management and Treatment Approaches
What happens if appropriate caregiving is not provided to children with reactive attachment disorder?
The disorder can persist for several years.
p.2
Post-Traumatic Stress Disorder (PTSD)
What emotional experiences are common in individuals with PTSD?
Common emotional experiences include anger, shame, sadness, humiliation, and guilt, including survivor guilt.
p.2
Post-Traumatic Stress Disorder (PTSD)
How does PTSD risk vary by trauma type?
PTSD risk varies significantly, with the highest risk thought to occur after traumas involving interpersonal violence.
p.2
Gender and Vulnerability Factors in Stress Disorders
What are some pre-traumatic risk factors for developing PTSD?
Pre-traumatic risk factors include female gender, divorced or widowed status, lower socioeconomic status, and previous traumatic experiences.
p.1
Introduction to Stress-Related Disorders
What types of stressful events can lead to disorders in this grouping?
Normal life experiences (e.g., divorce, bereavement) and extremely threatening or horrific events.
p.1
Post-Traumatic Stress Disorder (PTSD)
What is one of the essential features of Post-Traumatic Stress Disorder (PTSD)?
Exposure to an event of an extremely threatening or horrific nature.
p.3
Complex Post-Traumatic Stress Disorder (C-PTSD)
What feelings might a person with C-PTSD experience about themselves?
Feelings of being diminished, defeated, or worthless, often accompanied by shame and guilt.
p.8
Management and Treatment Approaches
What does treatment for disinhibited social engagement disorder involve?
The entire family to strengthen the bond between the child and caregivers.
When does the onset of adjustment disorder usually occur?
Within a month after exposure to a stressful life event, but can occur later.
p.2
Post-Traumatic Stress Disorder (PTSD)
When can the onset of PTSD occur after a traumatic event?
Onset can occur at any time during the lifespan, typically within three months, but can be delayed for years.
p.2
Gender and Vulnerability Factors in Stress Disorders
What is a post-traumatic risk factor for developing PTSD?
Chronic adversity, ongoing stress, and poor psychosocial support are post-traumatic risk factors.
p.1
Introduction to Stress-Related Disorders
What distinguishes the disorders associated with stress?
The nature, pattern, and duration of symptoms, along with associated functional impairment.
What is a defining feature of adjustment disorder?
A maladaptive reaction to an identifiable psychosocial stressor that usually emerges within a month of the stressor.
p.7
Management and Treatment Approaches
What can lead to remission of symptoms in children with reactive attachment disorder?
Provision of adequate care.
p.3
Management and Treatment Approaches
What is cognitive behavioural therapy with graded exposure aimed at?
Assisting trauma survivors to re-experience distressing memories to reduce their response to trauma and promote emotional processing.
p.5
Prolonged Grief Disorder
What is a key characteristic of prolonged grief reaction?
A persistent and pervasive grief response characterized by longing for the deceased or persistent preoccupation with the deceased accompanied by intense emotional pain.
p.7
Reactive Attachment Disorder
What emotional symptoms may children with reactive attachment disorder exhibit during non-threatening interactions?
Episodes of unexplained irritability, sadness, or fearfulness.
p.7
Reactive Attachment Disorder
What are children with reactive attachment disorder at higher risk for during adolescence and adulthood?
Developing depressive disorders and other internalizing disorders.
p.2
Post-Traumatic Stress Disorder (PTSD)
What are common symptomatic presentations of PTSD?
Common symptoms include general dysphoria, dissociative symptoms, somatic complaints, suicidal ideation, social withdrawal, and excessive substance use.
p.8
Disinhibited Social Engagement Disorder
What is the stability of symptoms in disinhibited social engagement disorder?
Symptoms are moderately stable and may persist throughout childhood and adolescence.
How do acute stressful life events affect the onset of adjustment disorder symptoms?
They typically result in a rapid onset of symptoms with a shorter duration.
p.5
Prolonged Grief Disorder
What are the essential features of prolonged grief disorder according to ICD-11?
History of bereavement, persistent grief response, atypically long duration of grief, and significant impairment in functioning.
p.8
Disinhibited Social Engagement Disorder
What increases the risk of developing disinhibited social engagement disorder in children?
A history of grossly insufficient care, particularly before the age of two years.
p.3
Management and Treatment Approaches
What does Eye Movement Desensitization and Reprocessing (EMDR) involve?
Incorporating cognitive behavioural therapy elements with bilateral eye movements while discussing traumatic memories.
p.3
Management and Treatment Approaches
What is the effectiveness of psychological debriefing after trauma according to NICE guidelines?
There is no evidence for its usefulness in preventing or treating PTSD.
p.6
Reactive Attachment Disorder
What is presumed to be responsible for the inhibited, emotionally withdrawn behavior in Reactive Attachment Disorder?
Grossly insufficient care.
p.7
Disinhibited Social Engagement Disorder
What distinguishes disinhibited social engagement disorder from other mental disorders?
The disinhibited social engagement behavior is not better accounted for by another mental disorder.
p.2
Management and Treatment Approaches
What management options are recommended for adults with PTSD?
Consider venlafaxine or SSRIs like sertraline, and antipsychotics like risperidone in addition to psychological therapies for severe symptoms.
p.1
Introduction to Stress-Related Disorders
Do most people who experience stressors develop a disorder?
No, most people do not develop a disorder despite experiencing stressors.
When do symptoms of adjustment disorder typically abate?
When the stressor is removed, sufficient support is provided, or additional coping mechanisms are developed.
p.7
Reactive Attachment Disorder
What is the risk for children with a history of grossly insufficient care who form selective attachments?
They may be at risk of developing disinhibited social engagement disorder.
p.4
Complex Post-Traumatic Stress Disorder (C-PTSD)
What additional elements are associated with complex PTSD?
Affect dysregulation, negative self-concept, and interpersonal disturbances.
p.5
Prolonged Grief Disorder
What emotional states may be experienced in prolonged grief disorder?
Sadness, guilt, anger, denial, blame, emotional numbness, and difficulty in engaging with social activities.
p.5
Management and Treatment Approaches
What management approaches are recommended for prolonged grief disorder?
Antidepressants combined with CBT, complicated grief therapy (CGT), and exposure interventions.
p.8
Disinhibited Social Engagement Disorder
How do symptoms of disinhibited social engagement disorder compare to those of reactive attachment disorder?
Symptoms of disinhibited social engagement disorder tend to be more persistent even after appropriate care is provided.
p.4
Complex Post-Traumatic Stress Disorder (C-PTSD)
What is a significant characteristic of complex post-traumatic stress disorder (C-PTSD)?
It results in significant impairment in personal, family, social, educational, occupational, or other important areas of functioning.
p.4
Post-Traumatic Stress Disorder (PTSD)
What are the core elements of PTSD?
Re-experiencing the traumatic event, deliberate avoidance of reminders, and persistent perceptions of heightened current threat.
p.5
Prolonged Grief Disorder
How long must grief responses last to be considered prolonged grief disorder?
For an atypically long period, markedly exceeding expected social, cultural, or religious norms.
How long do symptoms of adjustment disorder typically last after the stressor ends?
Symptoms resolve within 6 months.
p.7
Disinhibited Social Engagement Disorder
What are some signs of persistent neglect in children that may lead to disinhibited social engagement disorder?
Persistent disregard for the child’s basic emotional and physical needs.
p.2
Post-Traumatic Stress Disorder (PTSD)
What percentage of individuals with PTSD may experience complete recovery within three months?
Nearly one half of individuals diagnosed with PTSD.
p.4
Complex Post-Traumatic Stress Disorder (C-PTSD)
What is the relationship between early trauma exposure and complex PTSD?
Exposure to repeated traumas, especially in early development, increases the risk of developing complex PTSD.
p.4
Complex Post-Traumatic Stress Disorder (C-PTSD)
How does the severity of symptoms in PTSD compare to complex PTSD?
PTSD symptoms are usually less severe and less persistent compared to complex PTSD symptoms.
p.1
Introduction to Stress-Related Disorders
What are disorders specifically associated with stress related to?
Exposure to a stressful or traumatic event, or a series of such events or adverse experiences.
p.1
Introduction to Stress-Related Disorders
Is an identifiable stressor necessary for all stress-related disorders?
Yes, it is a necessary, though not sufficient, causal factor.
p.8
Disinhibited Social Engagement Disorder
What is the impact of early removal from an adverse environment on disinhibited social engagement disorder?
It decreases the likelihood that indiscriminate social behaviors will persist.
p.1
Post-Traumatic Stress Disorder (PTSD)
What are the three core elements of the PTSD syndrome?
Re-experiencing the traumatic event, deliberate avoidance of reminders, and persistent perceptions of heightened current threat.
p.3
Post-Traumatic Stress Disorder (PTSD)
What is a common behavioral response to heightened threat in individuals with PTSD?
Hypervigilance and an enhanced startle reaction to stimuli.
p.4
Complex Post-Traumatic Stress Disorder (C-PTSD)
What distinguishes the cause of PTSD from complex PTSD?
PTSD usually results from a single incident trauma, while complex PTSD results from prolonged or repetitive traumatic events.
p.6
Management and Treatment Approaches
What is the main biological treatment for adjustment disorder?
SSRIs (Selective Serotonin Reuptake Inhibitors).
p.2
Gender and Vulnerability Factors in Stress Disorders
What is a peri-traumatic risk factor for PTSD?
Trauma severity and perceived life threat are peri-traumatic risk factors.
p.1
Post-Traumatic Stress Disorder (PTSD)
What is meant by deliberate avoidance in PTSD?
Avoiding thoughts, memories, or situations that remind the person of the traumatic event.
p.8
Management and Treatment Approaches
What types of therapies may be included in the treatment for disinhibited social engagement disorder?
Expressive therapies such as play therapy or art therapy.
p.6
Reactive Attachment Disorder
What are the essential features of Reactive Attachment Disorder?
A history of grossly insufficient care and markedly abnormal attachment behaviors towards adult caregivers.
p.6
Reactive Attachment Disorder
What type of maltreatment is associated with Reactive Attachment Disorder?
Persistent maltreatment rather than isolated incidents.
p.6
Reactive Attachment Disorder
What general emotional disturbances may children with Reactive Attachment Disorder exhibit?
A relative lack of social and emotional responsiveness to others and limited positive affect.
p.3
Complex Post-Traumatic Stress Disorder (C-PTSD)
What are the essential features of Complex Post-Traumatic Stress Disorder (C-PTSD)?
Exposure to prolonged or repetitive traumatic events, development of core PTSD elements, and severe affect regulation problems.
p.4
Complex Post-Traumatic Stress Disorder (C-PTSD)
When do symptoms of complex PTSD typically onset?
After exposure to chronic, repeated traumatic events and/or victimization over months or years.
p.4
Complex Post-Traumatic Stress Disorder (C-PTSD)
How do the symptoms of complex PTSD compare to those of PTSD?
Symptoms of complex PTSD are generally more severe and persistent than those of PTSD.
p.4
Complex Post-Traumatic Stress Disorder (C-PTSD)
What additional clinical features may be present in complex PTSD?
Suicidal ideation and behavior, substance abuse, depressive symptoms, psychotic symptoms, and somatic complaints.
p.8
Disinhibited Social Engagement Disorder
What type of relationships do adolescents with a history of disinhibited social engagement disorder typically demonstrate?
Superficial peer relationships and increased conflict with peers.
p.8
Management and Treatment Approaches
What is recommended for treating children and adolescents diagnosed with disinhibited social engagement disorder?
Evidence-based treatment for maltreated children and enhancing secure attachment.
p.4
Gender and Vulnerability Factors in Stress Disorders
Which gender is at greater risk for developing complex PTSD?
Females are at greater risk than males.
What may worsen symptoms of preoccupation in adjustment disorder?
Reminders of the stressor(s), leading to avoidance of associated stimuli, thoughts, feelings, or discussions.
p.6
Reactive Attachment Disorder
What developmental level must a child reach to form selective attachments?
Typically at least 9 months of developmental age or 1 year chronological age.
p.6
Reactive Attachment Disorder
What risks do children with Reactive Attachment Disorder face?
They are at risk for developing co-occurring PTSD or complex PTSD.
p.3
Post-Traumatic Stress Disorder (PTSD)
What are the core elements of PTSD that must develop after a traumatic event?
Re-experiencing the trauma, deliberate avoidance of reminders, and persistent perceptions of heightened threat.
p.3
Complex Post-Traumatic Stress Disorder (C-PTSD)
What emotional issues are associated with Complex PTSD?
Severe problems in affect regulation, persistent feelings of worthlessness, and difficulties in sustaining relationships.
p.3
Complex Post-Traumatic Stress Disorder (C-PTSD)
How might a person with C-PTSD react to reminders of their trauma?
They may actively avoid thoughts and situations that remind them of the trauma.
p.1
Post-Traumatic Stress Disorder (PTSD)
What does re-experiencing the traumatic event involve?
Experiencing the event as occurring again, often through vivid intrusive memories, flashbacks, or nightmares.
What additional psychological symptoms may accompany adjustment disorder?
Depressive or anxiety symptoms, as well as impulsive 'externalizing' symptoms like increased substance use.
p.6
Reactive Attachment Disorder
What behaviors characterize a child with Reactive Attachment Disorder?
Minimal seeking of comfort when distressed and rare or minimal response to comfort when offered.
