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Trauma-Stressor Related Disorders - Coggle Diagram

- - - - Experience or witness a traumatic event that the individual perceives as horrible/uncontrollable, learning traumatic event
    - - Trauma
        
        Event
        
        Impact injury, events involving terror/horror
        
        Results
        
        Acute stress disorder, PTSD, Dissociative d/o, adjustment disorder
      - Fatigue
        
        Event
        
        Wear + Tear, Accumulation of stress over time, prolonged neglect/abuse
        
        Result
        
        Major depression, panic attacks, attachment disorder, borderline personality disorder
      - Grief
        
        Event
        
        Loss injury, loss of valued persons
        
        Results
        
        Major depression, complicated grief, persistent depressive, attachment
  - - - Re-experiencing
        
        Recurrent/intruive memories, nightmares, fashbacks, psychological distress, physiological reactions
      - Negative mood
      - Hyper-arousal
        
        Sleep disturbance, irritable behaviur, hypervigilance, concentration issues, exaggerate startle response
      - Avoidance
      - Dissociation
        
        Reduction in awarenss of surroundings
    - - 60-80% will develop PTSD without treatment
    - - Psychological First Aid
        
        Reassure, Rest, Replenish, Restore, Retain
      - Medications
        
        Propranol/Clonindie (No benzo)
      - Cognitive Behaviour Therapy
        
        Focus on destructive cognitions
  - - - Intrusive symptoms
      - Avoidance
      - Negative gcongition/Mood
      - Hyper-arousal
    - - The longer untreated, the worse the prognosis (increased comorbiditiy/psycho-social loss)
    - - Phase 1
        
        Stabilitization: Manage/reduce survival mode, medication for insomnia, anger/Depression, psychoeducation
        
        Phase 2
        
        Integration of Traumatic Memories: Process traumatic memories, indentify distorted thnking patterns, damaged core values
        
        Phase 3
        
        Re-integration/Maintenance for the goal of consolidation
      - Pharmacotherapy
        
        Core medications
        
        First Line
        
        SSRIs: Proxetine, sertraline, fluoxetine
        
        SNRIs- Venlafaxine
        
        Second line
        
        SNRIs: Duloxetine, Desvenlafaxine
        
        NASSA - Mirtazapine
        
        Augmenting Medications
        
        Insomnia
        
        Trazadone, Mirtazapine, Zopiclone, Seroquel
        
        Nightmares
        
        Prazosin, Nabilone
      - Psychotherapy
        
        Compoentsn
        
        Psychoeducations
        
        Common reactiosn to trauma/etiology of PTSD, emotions, psychological processes
        
        Exposure
        
        Cognitive restructuring
        
        Core Beliefs: Working on beliefs
        
        Skills Training (Relaxation, assertivenes, communication)
        
        Activation (social, recreational, work)
      - Lifestyle
        
        Lifestyle changes
        
        Substance use,e xercise, diet, recreation/socialization
        
        Psychoeducation for family
        
        Couples/Family intervnetion
        
        Support Groups
- - - - Shows re-experience symptoms by repetitive play/re-enactment
      - Flashbakcs carely seen
      - Nightmares content may not be related to traumatic event
    - - Increased frequency of negative emotion
      - Diminished interest in activities
      - Socially withdrawn behaviour
      - Persistent reduction in epxpression of positive emotions
    - - Reckless, or self-destructive behaviour criteria is removed for children
    - - Specifies relationships with parents, siblings, peers, caregivers, with school bheaviour
  - - - Preschool Age
        
        Withdrawal, Denial, Participation, Anxious attachment, regression to previous level, relatively brief grieving period
      - School Age
        
        Lowered intellectual functioning, obsessive talking about incident, isolation, constant anxiety, behavioural issues, problems relating to peers
      - Adolescents
        
        Premature closure of identity formation, acting-out behaviour, self-criticism, fear of repetition of event in future
  - - - Type of Trauma, risk facotrs, protective facotrs, gathering informations from adults, assess comorbidities
    - - Degree of exposure, previous illness/trauma, parents severe reaction, insecure or disorganized attachment
    - - Intelligence, affect regulation, social support, self-esteem, child's beleif that his situation is secure
    - - Gather information from adults
      - Assess co-morbidities
      - Assess parents mental state
      - Assess functional level
  - - - Safety/Stabilization: Safety in child's enviornment, psycho-education, stress management, affective expression, cognitive coping skills, meidcation for co-morbidities
      - Phase 2
        
        Target: Re-experiencing symptoms, trauma experience
        
        Phase 3
        
        Consolidation/Resilience: Integration into social network
    - - Should not be used unless to treat comorbidity
      - First Line
        
        SSRI: Sertraline, fluoxetine, proxetine
        
        SNRI: Venlafaxine
    - - Compoennts
        
        Parental Treatment, Relaxation, Affective expression, Cognitive coping, trauma narrative, In vivo desensitization, Conjoint child, Enhancing safety
    - - Lifestyle
        
        Diet, sleep hygiene, substance use, social activities
      - Social
        
        Psychoeducation, family therapy, school intervention, gorup therapy