trauma & stressor related disorders

• Trauma and stressor related disorders include disorders in which exposure to a traumatic or stressful event is listed explicitly as a diagnostic criterion.
• Reactive attachment disorder of infancy or early childhood is characterized by a pattern of markedly disturbed and developmentally inappropriate attachment behaviors, in which a child rarely or minimally turns preferentially to an attachment figure for comfort, support, protection, and nurturance.
• The essential feature of reactive attachment disorder is absent or grossly underdeveloped attachment between the child and putative caregiving adults.
• When distressed, children with reactive attachment disorder show no consistent effort to obtain comfort, support, nurturance, or protection from caregivers.
• The child with reactive attachment disorder has a developmental age of at least 9 months.
• The prevalence of reactive attachment disorder is unknown, but the disorder is seen relatively rarely in clinical settings.
• SSRI medicine, or selective serotonin reuptake inhibitors, are a type of antidepressant medicine that can help you feel less sad and worried.
• SSRIs include fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).
• There are different types of counseling for PTSD.
• Eye Movement Desensitization and Reprocessing (EMDR) involves focusing on distractions like hand movements and sounds while talking about the traumatic event.
• Exposure therapy involves talking about the traumatic event over and over, in a safe place, until there is less fear.
• Several types of therapy have been shown to be effective in treating PTSD, including Cognitive therapy, Exposure therapy, and Eye Movement Desensitization and Reprocessing (EMDR).
• Cognitive therapy involves changing thoughts about the trauma that are not true or that cause stress.
• Reactive attachment disorder has been found in young children exposed to severe neglect before being placed in foster care or raised in institutions.
• Even in populations of severely neglected children, the disorder is uncommon, occurring in less than 10% of such children.
• Environmental factors contributing to the development of reactive attachment disorder include serious social neglect.
• Prognosis for reactive attachment disorder appears to depend on the quality of the caregiving environment following serious neglect.
• Reactive attachment disorder significantly impairs young children's abilities to relate interpersonally to adults or peers and is associated with functional impairment across many domains of early childhood.
• Disinhibited social engagement disorder is characterized by a pattern of behavior that involves culturally inappropriate, overly familiar behavior with relative strangers, violating the social boundaries of the culture.
• These episodes, often referred to as "flashbacks,” are typically brief but can be associated with prolonged distress and heightened arousal.
• A common reexperiencing symptom is distressing dreams that replay the event itself or that are representative or thematically related to the major threats involved in the traumatic event.
• Commonly, the individual has recurrent, involuntary, and intrusive recollections of the event.
• The emphasis is on recurrent memories of the event that usually include sensory, emotional, or physiological behavioral components.
• For young children, reenactment of events related to trauma may appear in play or in dissociative states.
• Intense psychological distress or physiological reactivity often occurs when the individual is exposed to triggering events that resemble or symbolize an aspect of the traumatic event.
• The triggering cue could be a physical sensation, particularly for individuals with highly somatic presentations.
• Witnessed events include observing threatened or serious injury, unnatural death, physical or sexual abuse of another person due to violent assault, domestic violence, accident, war or disaster, or a medical catastrophe in one's child.
• A life-threatening illness or debilitating medical condition is not necessarily considered a traumatic event.
• The individual may experience dissociative states that last from a few seconds to several hours or even days, during which components of the event are relived and the individual behaves as if the event were occurring at that moment.
• Negative alterations in cognitions or mood associated with the event begin or worsen after exposure to the event.
• Stimuli associated with the trauma are persistently avoided.
• Medical incidents that qualify as traumatic events involve sudden, catastrophic events such as waking during surgery, anaphylactic shock.
• Indirect exposure through learning about an event is limited to experiences affecting close relatives or friends and experiences that are violent or accidental.
• For children, sexually violent events may include developmentally inappropriate sexual experiences without physical violence or injury.
• The individual commonly makes deliberate efforts to avoid thoughts, memories, feelings, or talking about the traumatic event and to avoid activities, objects, situations, or people who arouse recollections of it.
• Posttraumatic Stress Disorder includes exposure to war as a combatant or civilian, threatened or actual physical assault, sexual violence, being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war, natural or human-made disasters, and severe motor vehicle accidents.
• The essential feature of disinhibited social engagement disorder is a pattern of behavior that involves culturally inappropriate, overly familiar behavior with relative strangers, violating the social boundaries of the culture.
• The child with disinhibited social engagement disorder has a developmental age of at least 9 months.
• The prevalence of disinhibited social attachment disorder is unknown.
• Disinhibited social engagement disorder appears to be rare, occurring in a minority of children, even those who have been severely neglected and subsequently placed in foster care or raised in institutions.